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研究生:胡靜文
研究生(外文):Hu, Ching-Wen
論文名稱:血液透析老人患者生命意義、自我照顧、社會支持、復原力與生活品質之相關:過渡理論觀點
論文名稱(外文):The Relationship among Meaning of Life, Self-care, Social Support, Resilience and Quality of Life of Elderly Patients with Hemodialysis:Transition Theory Perspective
指導教授:于潄于潄引用關係
指導教授(外文):Yu, Shu
口試委員:林惠如劉介宇陳俞琪林柏松
口試委員(外文):Lin, Hung-RuLiu, Chieh-YuChen, Yu-ChiLim, Paik-Seong
口試日期:2021-12-21
學位類別:博士
校院名稱:國立陽明交通大學
系所名稱:護理學系
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2021
畢業學年度:110
語文別:中文
論文頁數:155
中文關鍵詞:過渡理論血液透析老人患者生命意義社會支持復原力生活品質調節中介模型
外文關鍵詞:transition theoryelderly with hemodialysismeaning of lifesocial supportresiliencequality of lifemoderation mediated model
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背景:隨著人口老化及醫療科技的進步,高齡透析人口持續快速攀升,臺灣末期腎臟病發生率與盛行率均高居世界第一,血液透析老人患者的生活品質亟需被重視。
目的:本研究以過渡理論的觀點,探討血液透析老人患者之生命意義、自我照顧、社會支持、復原力與生活品質之相關因素。
研究方法:本研究採橫斷式、描述相關性研究設計,以立意取樣於中部某區域教學醫院血液透析治療中心患者為研究對象,共收集有效問卷共198份。問卷內容包括血液透析老人患者生命意義量表、自我照顧行為量表、社會支持量表、復原力量表及臺灣版世界衛生組織生活品質量表等五部分,以SPSS 20.0套裝軟體進行分析。
結果:血液透析老人患者之生命意義為中等程度、自我照顧為中下程度、社會支持為中上程度、復原力為中上程度與生活品質為中等程度。初期組血液透析老人患者的復原力顯著低於長期組、生活品質之社會範疇也顯著低於長期組。研究對象基本屬性之年齡、教育程度、接受透析時間、有無慢性病、血色素值、白蛋白值與生活品質呈顯著相關。生命意義、自我照顧、社會支持、復原力與生活品質呈顯著正相關。血液透析老人患者生活品質預測因子有生命意義、社會支持、症狀困擾數目及復原力,共可解釋54.6% 的總變異量,其中生命意義對血液透析老人的生活品質單獨解釋變異量達39.1%。社會支持對血液透析老人患者生活品質具有中介效果。
結論/實務應用:血液透析老人患者生命意義、自我照顧、社會支持、復原力與生活品質有相關,其中生活品質之社會範疇分數最低,生命意義是生活品質最重要的預測因子,社會支持對血液透析老人患者生活品質具有中介效果。建議需增加社會支持網絡及人際互動,肯定老人患者存在的價值以提升生命意義,激發或培養其復原力,另外多聆聽老人患者的想法、鼓勵說出心中想法,增進其自尊及自信,引領血液透析老人患者因應過渡疾病治療的歷程,提升整體生活品質。
Background:The aging of population and the advancement of medical technology, the elderly dialysis population continues to rise rapidly. The incidence and prevalence of end-stage renal disease in Taiwan rank among the highest in the world. The quality of life of elderly undergoing regular hemodialysis deserves close attention.
Purpose:Based on the transition theory perspective, this study was to explore the relationships among the meaning of life, self-care, social support, resilience and quality of life in elderly undergoing regular hemodialysis.
Methods:A cross-sectional descriptive correlation study design, with intentionally sampling patients in the hemodialysis treatment center of a regional teaching hospital in the central part of the study. A total of 198 valid questionnaires were collected. The 5 structured questionnaires used to collect data included: Meaning of Life Scale for elderly on hemodialysis, Self-care Behavior Scale, Social Support Scale, Chinese version of the Resilience Scale and the World Health Organization Quality of Life Taiwan Version. Date was analyzed using SPSS 20.0 software.
Results:The meaning of life of elderly with hemodialysis is medium, self-care is medium to low, social support is medium to high, resilience is medium to high, and quality of life is medium. The resilience of the hemodialysis elderly patients in the initial group was significantly lower than that in the long-term group, and the social domain of quality of life was also significantly lower than that in the long-term group. The age, education level, time of receiving dialysis, chronic disease, hemoglobin value and albumin value of the research subjects were significantly correlated with the quality of life. Life meaning, self-care, social support, and resilience were significantly and positively correlated with quality of life. The predictors of the quality of life of the elderly patients on hemodialysis included the meaning of life, social support, the number of symptoms and resilience, which could explain 54.6% of the total variance, of which the meaning of life alone explained 39.1% of the variance in the quality of life of the elderly on hemodialysis. Social support has a mediating effect on the quality of life of elderly patients with hemodialysis.
Conclusions / Implications for Practice: The meaning of life, self-care, social support and resilience of the elderly patients on hemodialysis are related to the quality of life. The social domain score of the quality of life is the lowest, and the meaning of life is the most important predictor of the quality of life. The social support has a mediating effect on the quality of life of elderly patients with hemodialysis. It is recommended to increase the social support network and interpersonal interaction, affirm the value of the elderly to enhance the meaning of life, stimulate or cultivate their resilience, and listen to the thoughts of the elderly, encourage their thoughts, enhance their self-esteem and self-confidence, and leading them to adjusting and transition the course of disease treatment, and improve elderly with hemodialysis overall quality of life.
誌謝
中文摘要……………………………………………………………………………….. ⅰ
英文摘要……………………………………………………………………………….. ⅱ
目錄…………………………………………………………………………………….. iv
圖目錄………………………………………………………………………………….. ⅵ
表目錄………………………………………………………………………………….. ⅶ

第一章、緒論………………………………………………………………………….. 1
第一節、研究背景、重要性與動機…………………………………………….. 1
第二節、研究目的……………………………………………………………….. 7
第二章、文獻探討…………………………………………………………………….. 8
第一節、血液透析老人患者過渡期間之生活品質………..…………………… 8
第二節、血液透析老人患者過渡期間生活品質之過渡影響因素…………….. 19
第三節、血液透析老人患者過渡期間復原力調節效果……………………….. 54
第三章、研究方法…………………………………………………………………….. 56
第一節、研究設計……………………………………………………………….. 56
第二節、名詞界定……………………………………………………………….. 58
第三節、研究對象與場所……………………………………………………….. 61
第四節、研究工具……………………………………………………………….. 62
第五節、資料分析及處理……………………………………………………….. 66
第六節、研究倫理考量………………………………………………………….. 68
第四章、研究結果…………………………………………………………………….. 69
第一節、血液透析老人患者基本屬性、生命意義、自我照顧、社會支持、復
原力與生活品質之現況……………………………………………….. 69
第二節、血液透析老年患者基本屬性在生命意義、自我照顧、社會支持、復
原力與生活品質的差異……………………………………………….. 84
第三節、血液透析老人患者基本屬性之年齡、接受透析時間、最近檢驗報告
血色素值、白蛋白值與生命意義、自我照顧、社會支持、復原力與
生活品質之相關性…………………………………………………….. 88
第四節、血液透析老人患者其生活品質之預測分……………………………94
第五節、社會支持、復原力對血液透析老人患者生活品質之中介效果、調節
效果……………………………………………………………………… 98
第六節、不同期間之血液透析老人患者生命意義、自我照顧、社會支持、復
原力與生活品質過渡期間的差異…………………………………….. 107
第五章、討論………………………………………………………………………….. 110
第一節、血液透析老人患者生命意義、自我照顧、社會支持、復原力現況.. 110
第二節、血液透析老年患者基本屬性與生活品質的差異及影響因子………116
第三節、不同期間之血液透析老人患者復原力與生活品質的差異………….119
第六章、結論與建議………………………………………………………………….. 120
第一節、研究主要成果………………………………………………………….. 120
第二節、研究貢獻……………………………………………………………….. 122
第三節、研究建議……………………………………………………………….. 124
第四節、研究限制……………………………………………………………….. 126
參考文獻……………………………………………………………………………….. 127
中文文獻………………………………………………………………………….. 127
英文文獻………………………………………………………………………….. 134
附錄問卷……………………………………………………………………………….. 142
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