1.7)血清白蛋白濃度為3.90±0.52 gm/dl(建議標準:>4.0 gm/dl);血比容積為30.82±4.70%(建議標準:33~36%);正常化蛋白質代謝率為1.03±0.23 gm(建議標準:>0.9 gm)。透析院所、性別、年齡、宗教信仰、個人收入、家庭收入、合併罹患其他慢性疾病及自我照顧自我效能,為可能影響腹膜透析病患治療成效之相關因素。 相關因素之確認,可協助健康政策擬定者制定合適的相關政策、協助臨床照護者發展有效之健康促進介入措施。為促進病患之治療成效,可使用以下之策略;例如:落實透析病患相關之社會福利措施、提供透析專業人員訓練及繼續教育、定期舉辦個人/團體護理指導、建立腎友支持性團體及提供腹膜透析病患之持續訓練等。' /> 腹膜透析病患治療成效之相關因素探討 = Factors Related to Treatment Outcome in Peritoneal Dialysis Patients|Airiti Library 華藝線上圖書館
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  • 學位論文

腹膜透析病患治療成效之相關因素探討

Factors Related to Treatment Outcome in Peritoneal Dialysis Patients

指導教授 : 廖媛美

摘要


本研究為橫斷式之描述性、相關性研究,旨在瞭解腹膜透析病患之自我照顧自我效能、自我照顧行為及治療成效,探討個人基本資料、疾病特性、自我照顧自我效能及自我照顧行為與治療成效之關係,並探討影響治療成效之的相關因素。研究對象為來自臺北地區兩所醫學中心及兩所區域教學醫院之200位腹膜透析病患,研究者採用自擬式結構性問題、「CAPD自我效力量表」、「CAPD自我照顧量表」、「臺灣簡明版世界衛生組織生活品質問卷」及病患之病歷完成資料收集,以描述性統計、皮爾森積差相關值檢定(Pearson's correlation)、單因子變異數分析(one way ANOVA)、獨立t檢定(t-test)、強迫進入變數法迴歸分析(enter multiple regression)及邏輯斯迴歸分析(Logistic regression)進行資料處理與統計分析。 研究結果顯示:本研究腹膜透析病患之自我照顧自我效能量表得分平均值為208.75±28.09分(range = 0~250),自我照顧行為量表得分平均值為219.13±30.07分(range = 0~250)。自我照顧自我效能各因素之得分,以處理異常狀況之得分最高,調整生活型態之得分最低。自我照顧行為各因素得分以護理導管及導管出口處之得分最高,調整生活型態之得分最低。腹膜透析病患生活品質之總分平均得分為91.88±14.81分(range = 28~140),量表中環境功能層面之得分最高,心理層面之得分最低。本研究大部分腹膜透析病患達到美國腎臟醫學會建議之標準的治療成效指標:每週尿素氮(BUN)清除率Kt/V平均值為2.08±0.47(建議標準:>1.7)血清白蛋白濃度為3.90±0.52 gm/dl(建議標準:>4.0 gm/dl);血比容積為30.82±4.70%(建議標準:33~36%);正常化蛋白質代謝率為1.03±0.23 gm(建議標準:>0.9 gm)。透析院所、性別、年齡、宗教信仰、個人收入、家庭收入、合併罹患其他慢性疾病及自我照顧自我效能,為可能影響腹膜透析病患治療成效之相關因素。 相關因素之確認,可協助健康政策擬定者制定合適的相關政策、協助臨床照護者發展有效之健康促進介入措施。為促進病患之治療成效,可使用以下之策略;例如:落實透析病患相關之社會福利措施、提供透析專業人員訓練及繼續教育、定期舉辦個人/團體護理指導、建立腎友支持性團體及提供腹膜透析病患之持續訓練等。

並列摘要


This study was a cross-sectional, descriptive, correlational study. Research aims were: (a) to understand peritoneal dialysis patients’ self-care efficacy, self-care behavior, and treatment outcomes, and (b) to examine the relationships between patients’ treatment outcomes and individual characteristics, disease-related characteristics, self-care efficacy, and self-care behavior, and (c) to explore possible factors related to patients’ treatment outcomes. The 200 subjects of this study were recruited from the peritoneal dialysis centers at two medical centers and two regional hospitals in Taipei. Self-developed questions, CAPD self- efficacy scale, CAPD self-care scale, the Taiwanese world organization quality of life-BREF, and patients’ medical records were used to collect the related information. Data analyses were completed by descriptive statistics, Pearson’s correlation, one way ANOVA, independence t test, enter multiple regression and Logistic regression. Study results showed the mean scores of the peritoneal dialysis patients’ self-care efficacy and self-care behavior were 208.75±28.09 (range = 0~250) and 219.13±30.07 (range = 0~250), respectively. The result of CAPD self- efficacy factors, the highest score was found at the managing abnormal conditions factor, and the lowest score was found at the adjusting life style. The result of CAPD self- behavior factors, the highest score was found at the caring for the catheter exit site factor, and the lowest score was found at the adjusting life style. The mean score of peritoneal dialysis patients’ quality of life was 91.88±14.81 (range = 28~140). With the highest score was found at the environment domain, and the lowest score was found at the psychological domain. The majority treatment outcomes were within the standard levels recommended by the National Kidney Foundation: Kt/V 2.08±0.47 (recommendation: >1.7), serum albumin 3.90±0.52 gm/dl (recommendation: > 4.0gm/dl), hematocrit 30.82±4.70% (recommendation: 33-36%), and nPNA 1.03±0.23 gm (recommendation: > 0.9gm). Study results also showed peritoneal dialysis patients’ treatment outcomes were associated with dialysis institution, gender, age, religion, personal income, family income, co morbidities and self-care efficacy. Confirming the possible factors related to peritoneal dialysis patients’ treatment outcomes could help policy makers constitute appropriate health care policies and help clinical healthcare providers develop related health promotion interventions. In order to improve patients’ treatment outcomes, the following strategies could be utilized: accomplishing related social welfare policy, providing professional personnel’s continuing training/education, conducting patient individual/group consult, constructing patient support groups, and delivering patients’ retraining program.

參考文獻


謝美芬、顏兆熊(2009-a)•老人貧血之評估與治療•家庭醫學與基層醫療, 24(10),340-344。
謝美芬、顏兆熊(2009-b)•老人貧血之臨床表現與病因•家庭醫學與基層醫療,24(9),310-314。
Kao, T. W., Tsai, D. M., Wu, K. D., Shiah, C. J., Hsieh, B. S., & Chen, W. Y. (2003). Impact of religious activity on depression and quality of life of chronic peritoneal dialysis patients in Taiwan. Journal of Formos Medical Association, 102(2), 127-130.
葉玲岑、林石化、朱柏齡(2006)•腹膜透析患者的營養維持評估與營養需求•腎臟與透析,18(1),33-39。
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被引用紀錄


陳玲守(2012)。血液透析與腹膜透析患者健康促進生活型態之比較〔碩士論文,中臺科技大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0099-0905201314435767
王沐昕(2017)。腹膜透析病患照顧行為與腹膜炎之病例對照研究〔碩士論文,長榮大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0015-3005201722224800

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