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研究生:葉建周
研究生(外文):YEH, JIANG-CHOU
論文名稱:運動、營養衛教及智慧型裝置 對血液透析病人自我健康管理之成效
論文名稱(外文):The Effects of Exercise, Nutrition Education and Intelligent Devices on the Self-Management of Hemodialysis Patients
指導教授:鄭博文鄭博文引用關係
指導教授(外文):CHENG, BOR-WEN
口試委員:林昭維童超塵呂學毅趙正敏
口試委員(外文):LIN, JOU-WEITONG,CHAO-CHENLU, HSUEH-YIZHAO,ZHENG-MIN
口試日期:2020-04-15
學位類別:博士
校院名稱:國立雲林科技大學
系所名稱:工業工程與管理系
學門:工程學門
學類:工業工程學類
論文種類:學術論文
論文出版年:2020
畢業學年度:108
語文別:中文
論文頁數:162
中文關鍵詞:血液透析病人運動飲食衛教穿戴式手環雲端管理平台
外文關鍵詞:hemodialysis patientsexercisediet health educationwearable wristbandcloud management platform
相關次數:
  • 被引用被引用:0
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目錄
摘要i
ABSTRACTii
誌謝iii
目錄vi
表目錄xii
圖目錄xiv
第一章 緒論1
1.1研究背景1
1.2研究動機3
1.2.1智慧型穿戴式裝置的普及3
1.2.2運動保健觀念的提高5
1.2.3雲端管理平台的便利性6
1.2.4飲食衛教知識的提升7
1.3研究目的8
1.4研究流程10
1.5名詞解釋11
第二章 文獻探討12
2.1慢性腎臟病(Chronic Kidney Disease, CKD)12
2.1.1慢性腎臟病定義12
2.2慢性腎臟危險因子14
2.2.1高血壓14
2.2.2高血糖15
2.2.3高血脂16
2.2.4小結16
2.3血液透析(Hemodialysis)17
2.3.1血液透析定義17
2.4合併症(又稱共病)19
2.5血液透析病人身體功能20
2.5.1身體功能定義與評估方式20
2.5.2透析間期體重增加(Interdialytic weight gain,IDWG)21
2.5.3影響慢性病病人身體功能相關因素21
2.5.4生活品質定義與評估22
2.6血液透析病人與營養之關係23
2.6.1血液透析飲食介紹23
2.6.2熱量25
2.7營養評估工具25
2.7.1主觀性整體評估26
2.8營養衛教26
2.9穿戴式裝置、雲端管理平台相關探討27
2.9.1穿戴式裝置27
2.9.2雲端管理平台29
第三章 研究方法30
3.1研究架購30
3.2研究假設31
3.3研究設計31
3.4研究對象32
3.5研究資料收集32
3.6研究及量測工具34
3.6.1個人屬性基本資料表34
3.6.2體能活動適應能力問卷(Physical Activity Readiness Questionnaire,PAR-Q) 34
3.6.3坐到站秒數(STS-10)35
3.6.4坐到站次數(STS-60)35
3.6.5六分鐘步行測試(Six Minute Walk Test, 6MWT)36
3.6.6透析間期體重增加(Interdialytic weight gain, IDWG)38
3.6.7血液透析病人生活品質量表(KDQOL-36TM)38
3.6.8主觀整體營養評估量表(Subjective Global Assessment,SGA)39
3.6.9腎臟病飲食衛教內容39
3.6.10電子式握力計(Electronic Hand Dynamometer)40
3.6.11營養衛教問卷41
3.6.11.1營養師衛教專業41
3.6.11.2衛教成效 41
3.6.11.3病人認知信任感42
3.6.11.4病人自覺責任感42
3.7預試問卷分析42
3.7.1問卷專家效度名單42
3.7.2預試問卷43
3.7.3預試問卷項目分析43
3.7.4「營養師衛教專業」預試問卷構面分析45
3.7.5「衛教成效」預試問卷構面分析46
3.7.8「病人認知信任感」預試問卷構面分析47
3.7.9「病人自覺責任感」預試問卷構面分析48
3.8高○科技藍芽智慧手環49
3.9高○科技健康管理平台50
3.10資料分析方法55
3.10.1描述性統計55
3.10.2獨立樣本t檢定55
3.10.3成對樣本t檢定55
3.10.4單因子變異數分析(One Way ANOVA)55
3.10.5皮爾森積差相關分析(Pearson Correlation)56
3.10.6質性訪談(Qualitative interview)56
3.11IRB倫理議題56
第四章 結果57
4.1研究對象描述性統計57
4.2獨立樣本t檢定 59
4.2.1「性別」對「營養師專業衛教影響飲食習慣成效」之影響60
4.2.2「每週有無運動習慣」對「營養師專業衛教影響飲食習慣成效」之影響61
4.2.3「近六個月有無接受營養師衛教」對「營養師專業衛教影響飲食習慣成效」之影響 62
4.3單因子變異數分析63
4.3.1「年齡」對「營養師專業衛教影響飲食習慣成效」之影響63
4.3.2「教育程度」對「營養師專業衛教影響飲食習慣成效」之影響 64
4.3.3「職業類別」對「營養師專業衛教影響飲食習慣成效」之影響 65
4.3.4「婚姻狀況」對「營養師專業衛教影響飲食習慣成效」之影響 66
4.3.5「每月薪資」對「營養師專業衛教影響飲食習慣成效」之影響 67
4.3.6「透析治療年資」對「營養師專業衛教影響飲食習慣成效」之影響68
4.3.7「每次運動時間」對「營養師專業衛教影響飲食習慣成效」之影響69
4.4成對樣本t檢定 70
4.4.1受測者生理狀況之自我體能分析70
4.4.2受測者心理狀況之生活品質分析75
4.4.3受測者血液生化指數分析79
4.4.4受測者透析間期體重增加(IDWG)分析82
4.4.5受測者主觀整體營養評估量表(SGA)分析82
4.5皮爾森相關係數分析85
4.5.1受測者運動步數與自我體能之關聯性85
4.5.2受測者運動步數與生活品質量表之關聯性86
4.5.3受測者運動步數與血液生化指數之關聯性86
4.5.4受測者運動步數與透析間期體重增加(IDWG)之關聯性88
4.5.5受測者運動步數與主觀整體營養評估量表(SGA)之關聯性88
4.6深度訪談89
4.6.1資料整理89
4.6.2訪談總結95
第五章 討論96
5.1研究假設驗證96
5.2運動結合藍芽智慧手環、我顧健康APP、健康管理平台之績效評估98
5.3飲食結合營養師衛教、我顧健康APP、健康管理平台之績效評估100
5.4受測者主觀經驗探討101
5.5其他研究之比較與分析102
第六章 結論104
6.1研究結論104
6.2研究建議105
6.3研究限制107
參考文獻 108
附錄120
附錄一、「臺大醫學院附設醫院IRB201812145RINA-核准公文」120
附錄二、「臺大醫學院附設醫院IRB201812145RINA-變更核准公文」124
附錄三、「臺大醫學院附設醫院臨床試驗/研究許可書」126
附錄四、「臺大醫學院附設醫院臨床試驗/研究受試者說明暨同意書」128
附錄五、「主觀性整體評估SGA (Subjective Global Assessment)」137
附錄六、「營養師專業衛教影響飲食習慣成效分析-預試問卷」138
附錄七、「營養師專業衛教影響飲食習慣成效分析-正式問卷」142


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