規律運動訓練對僧帽瓣脫垂女性患者症狀困擾與生活品質成效之探討

The Effects of Regular Exercise Training on Symptom Distress and Quality of Life in Female Patients With Mitral Valve Prolapse.

林育霜(YU-SHUANG LIN)

指導教授 ： 蔡仁貞

臺北醫學大學/護理學院/護理學研究所/碩士(2006年)

摘要

僧帽瓣脫垂為臨床常見的瓣膜性心臟疾病，盛行率為5－15%，好發於年輕女性。僧帽瓣脫垂患者常被胸痛、手臂痛、心悸、呼吸短促、疲憊、頭痛、焦慮、情緒不穩、頭暈、意識短暫喪失及肌肉震顫等症狀所困擾並影響其生活品質。因此改善僧帽瓣脫垂患者的症狀困擾程度並提升生活品質是非常重要的。 本研究旨在探討規律運動訓練對僧帽瓣脫垂女性患者症狀困擾與生活品質之成效。本研究採前後測實驗法，以立意取樣法選取20－50歲僧帽瓣脫垂之女性患者，再隨機分為運動組與對照組，運動組17位及對照組18位共35位婦女。運動組個案進行每週3次，每次30分鐘，共為期12週之規律跑步機運動訓練，對照組個案保持原來生活型態。於研究計畫前後收集個案的人口學特性基本資料表、僧帽瓣脫垂症狀量表、SF-36生活品質量表及跑步機運動測試等資料，並以統計軟體SPSS 11.0 for Windows進行分析，如百分比、平均值與標準差、卡方檢定（Chi-Square test）、曼－惠特尼檢定（Mann-Whitney U test）、斯皮爾曼等級相關性（Spearman Correlation）及魏克森訊號（Wilcoxon Sign Rank test）等檢定法。 研究結果發現：（1）所有個案平均年齡36.0 ± 8.1歲，平均身體質量指數為20.2 ± 2.1kg /m2，平均運動耐力則為8.5 ± 2.3 METs。（2）個案於計畫前之症狀困擾以疲憊平均得分最高，而肌肉震顫之得分最低。（3）個案於計畫前生活品質8項次概念中，以身體生理功能平均得分最高，而活力平均得分最低。（4）個案的症狀困擾與生活品質之「身體生理功能」、「一般健康」及「社會功能」等次概念呈負相關（p < .05）。（5）運動組個案經12週運動訓練計畫後，其整體症狀困擾、胸痛、疲憊、頭痛、情緒不穩及頭暈等症狀困擾具顯著改善。（6）在生活品質方面，經運動組經規律運動訓練計畫後，其身體疼痛、一般健康、活力及心理健康等生活品質次概念等得分具顯著提升。 本研究結果顯示，僧帽瓣脫垂女性患者經 12週跑步機規律運動訓練後，可協助改善其症狀困擾並提升生活品質。

關鍵字

規律運動訓練 ； 僧帽瓣脫垂 ； 症狀困擾 ； 生活品質

並列摘要

Abstract Title of Thesis: The Effects of Regular Exercise Training on Symptom Distress and Quality of Life in Female Patients With Mitral Valve Prolapse. Institution: Graduate Institute of Nursing, Taipei Medical University Author: Yu-Shuang Lin Thesis directed by: Jen-Chen Tsai, Professor The Mitral Valve Prolapse is the most common valvular disorder. It affects 5-15﹪adults, with a frequency in women approximately twice that of men. Mitral Valve Prolapse is associate with symptoms of chest pain, arm pain, palpation, shortness of breath, fatigue, headache, anxiety, mood swing, dizziness, passing out spells , muscle cramp and more. As a result, it is very important to increase the life quality for mitral valve prolapse patients by controlling the symptoms. The purpose of the study were to evaluate the effects of regular exercise training on symptom distress and quality of life in female patients with mitral valve prolapse. A experimental design were used in this study. The subjects are female with mitral valve prolapse and symptoms, aged between 20-50. They were randomized assigned into either exercise or control groups, 17 in the exercise and 18 in the control, the exercise group participated in a 12-weeks treadmill exercise program, three times a week, 30 minutes each time. The control group were remained their living pattern. Date on the personal data chart, MVP symptom check list, SF-36 (Short-Form 36 Health Survey), treadmill exercise testing of each subject were collected prior to the study, and the 12th week of the study. The date were analyzed by using percentage, mean, standard deviation, Chi-Square test, Mann-Whitney U test, Spearman Correlation and Wilcoxon Sign Rank test. Results: (1) The average age of the subjects are thirthty-six years, average body mass index is 20.2 ± 2.1kg /m2，average exercise tolerance is 8.5 ± 2.3 METs. (2)Fatigue is the most frequently symptom, and the less is muscle cramp. (3)The total score of symptom distress and the subscores of life quality “physical functioning”, “general health” and “social functioning” are negative related. (4)Patients who attended the regular exercise training program had significant improvement in the subscores of chest pain, fatigue, headache, mood swing, dizziness and total symptom scores on the MVP symptom check list after the program. (5)The exercise group had significant improvement in the subscores of “body pain”, “general health”, “vitality” and “mental health” on the SF-36 compared with control group. Based on the results of this study, regular exercise training program may help Mitral Valve Prolapse female patients improving their symptoms and quality of life. Keyword: Regular Exercise Training, Mitral Valve Prolapse, Symptom Distress, Quality of Life

參考文獻

陸圴玲(1998)?台灣地區生活品質研究概況?中華公共衛生雜誌，17(6)，442-457。

張天鈞(2000)?運動、荷爾蒙與健康?當代醫學，27(12)，955-958。

楊梅香(2001)?充血性心臟衰竭患者運動耐力對其生活品質影響之探討?新臺北護理期刊，3(2)，21-36。

季力康(2004)?運動對心理健康的益處?科學月刊，35(7)，518-522。

參考資料 中文部分: 王榮德、游正芬、鍾智文、姚開屏(2000)?二十一世紀之健康照護效性評量:生活品質與生活品質調整後之存活分析?台灣醫學，4(1)，65-74。