慢性腎病患者健康行為之探討

The Health Behaviors in Patient With Chronic Kidney Disease

謝瓊香(Chiung-Hsiang Hsieh)

指導教授 ： 陳品玲

臺北醫學大學/護理學院/護理學研究所/碩士(2008年)

摘要

慢性腎病的早期症狀不明顯且不易發現，大多數的患者也缺乏對腎臟保健及疾病防治的觀念，未能採取促進健康的行為以致慢性腎病持續惡化。在台灣因末期腎病接受透析治療的患者之盛行率居全球之冠，對國家社會經濟及個人造成極大的負擔與衝擊，因此尋求防止慢性腎病持續惡化的策略，已成為當前重要課題。故本研究目的為評估慢性腎病患者日常生活中健康行為的執行現況；並探討其基本屬性、健康行為與腎功能間彼此之關聯，並與全體國民之健康行為做比較，以作為日後醫護人員對慢性腎病患者推動腎臟保健計畫時的參考。研究採橫斷式調查研究法，以方便取樣台北市某醫學中心之腎臟科門診中符合取樣標準之293位慢性腎病患者為研究對象，採結構式問卷收集資料。本研究結果顯示：
1.年齡與肌酸酐廓清率值呈顯著負相關，腎功能會隨年齡增長而下降。
2.約二成慢性腎病患者目前仍有喝酒習慣，其中二成三者每次喝酒會有半醉以上的現象。
3.四成六之慢性腎病患者曾經吸菸，但戒菸率也高達八成。
4.六成八之慢性腎病患者目前並未體重控制，但有體重控制的肌酸酐廓清率值顯著高於沒有的個案。
5.三成五之慢性腎病患者沒有運動的習慣。
6.約七成之慢性腎病患者至少曾經習慣使用中/草藥、成藥、止痛藥、健康食品等任一種、甚至多種藥物的情形。
根據本研究提出下列建議：慢性腎病患者仍有二~三成個案仍有喝酒、不運動的習慣，醫護專業人員宜衛教患者採取健康之生活模式。未來研究應以新發生病例為研究對象，以避免健康行為已產生變化，無法探討健康行為與腎功能之因果關係。

關鍵字

慢性腎病 ； 健康行為

並列摘要

The early symptoms of chronic kidney disease (CKD) are unobvious and difficult to detect. Most patients with CKD are unaware of the concepts of health promotion and disease prevention, which may accelerate their disease progression. The prevalence rate of dialysis for end-stage renal disease in Taiwan is higher than that of most other countries in the world, leading to a great socio-economic impact to the individual and society, thus, a strategy to prevent the progression of CKD has become an important issue. The purpose of this study was to determine the distribution of health behaviors of CKD patients, the correlation of health behaviors with kidney function, and to compare the differences of health behaviors of CKD patients and healthy populations. The result of current study could be an important reference to the health care workers and the policy makers of health promotion program. This was a cross-sectional study, using a structured questionnaire to gather information. The 293 CKD patients were enrolled from the out-patient department of nephrology in a medical center in Taipei. The results of this study are shown as follows:
1.Creatinine clearance rate (Ccr) was negatively correlated with age, thus kidney function declines with aging.
2.About 20% of CKD patients still keep the habit of drinking, 23% of whom have experience of drunk in each drinking.
3.46% of CKD patients were smokers, but the rate of successful quitting of smoking was as high as 80%.
4.68% of CKD patients were under weight control; the patients under weight control had significant higher creatinine clearance rate than those not under weight control.
5.35% of CKD patients did not keep a habit of regular exercise.
6.About 70% of CKD patients had taken herb medicine, over-the-counter medication, pain killer, or health foods.
The following suggestions are made according to the research results. Since 20%-30% of the patients with chronic kidney disease maintain drinking habits and do not get regular physical exercise, health care professionals must educate patients and promote their healthy lifestyle. To accurately explore the relationship between health behavior and renal functions, future study should use new cases as research subjects to prevent the change of health behavior that may affect the research result.

並列關鍵字

Chronic Kidney Disease ； Health Behavior

參考文獻

地區成人的健康行為探討：分怖情形、因素結構和相關因素•

台灣地區糖尿病盛行率與住院率•臺灣公共衛生雜誌，21

年人健康行為之影響因素分析•台灣衛誌，22（6），441-

陳健文（2006）•以病例對照研究法探討成藥對腎功能影響•未發

丁志音、江東亮（1996）•以健康行為型態分類台灣地區之成年人