規律運動訓練對二尖瓣脫垂女性患者運動自我效能、運動耐力及症狀困擾之探討

The effects of regular exercise training on self-efficacy for exercise, exercise tolerance and symptom distress in female patients with mitral valve prolapse

張雅茹(Ya-Ju Chang)

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(2011年)

https://doi.org/10.6831/TMU.2011.00133

摘要

二尖瓣脫垂是心臟科中相當常見的疾病，國外盛行率為5-15％，好發於年輕女性，症狀的不適長期的困擾著病人，除了使用藥物治療來緩解其症狀外，許多研究皆提出規律運動有助於二尖瓣脫垂症狀困擾之改善，但有關運動自我效能及運動耐力分析的探討著墨較少，因此本研究目的在探討規律運動訓練對二尖瓣脫垂女性患者運動自我效能、運動耐力及症狀困擾之影響。本研究於北部某醫學中心收案，採前後測實驗法，以隨機抽籤方式分組，以 35位接受門診追蹤治療之二尖瓣脫垂女性病患爲對象，分為運動組17人，對照組18人。運動訓練為期12週、每週三次、每次三十分鐘，兩組於運動訓練計畫第一週及第十二週收集相關資料，包括運動跑步機測試運動耐力及填寫問卷，問卷包括運動自我效能量表、僧帽瓣脫垂症狀量表。並以Mann-Whitney U test、Spearman Correlation、Generalized estimating equation、Intention-To-Treat Analyses等檢定法分析資料。結果顯示：未實施運動訓練計畫前，所有個案之運動自我效能平均分數偏低，為34.6 ± 25.6分（總分120分）；運動耐力偏低為8.7 ± 1.9分；症狀困擾平均得分為20.0 ± 8.3分（總分55分）。運動訓練計畫前，所有個案運動自我效能、運動耐力與症狀困擾皆未有顯著相關。運動組運動自我效能相對於對照組明顯增加27.5分（p = .01）；運動組運動耐力於規律運動訓練後由9.4 ± 2.3 METs提升為12.8 ± 2.6 METs，經運動訓練計畫後運動組較對照組增加3.0 METs（p＜ .001）；症狀困擾方面，雖然運動組與對照組的比較，在統計上未有顯著差異（p = .05），但就運動組於運動訓練後，其症狀困擾由19.4 ± 8.3分降為10.5 ± 8.3分，可發現二尖瓣脫垂女性患者經運動訓練後，症狀困擾有緩解的趨勢。因此建議醫護人員協助二尖瓣脫垂女性患者養成規律運動的習慣，以每週三次、每次三十分鐘，運動強度為60-80 %最大運動心率之運動模式為原則，來協助提升患者之運動自我效能、運動耐力及症狀困擾的緩解。

關鍵字

運動自我效能 ； 運動耐力 ； 症狀困擾 ； 運動訓練

並列摘要

Mitral valve prolapse is very common in cardiac disease, several abroad studies report prevalence rate that range from 5 to15%. It is likely to occur in young women. The symptoms distress for the patients is a long-term problem. In addition to use of medication to relieve their symptoms, many studies indicate that regular exercise could improve the distress of mitral valve prolapse symptoms. However, the exercise self-efficacy and exercise tolerance was rarely discussed. The purpose of this study is to investigate the effect of exercise training in patients with mitral valve prolapse in female exercise self-efficacy, exercise tolerance and symptom distress . The study was designed with pre-test and post-test experimental, randomized assignment in northern part of a medical center. The study included 35 female patients with mitral valve prolapse. 17 subjects were in exercise group, and the other 18 in control group. The exercise training included 30-minute session for each time, three times per week, lasting for 12 weeks. The relative data were collected on the baseline and last week, that is the twelveth week, including treadmill exercise testing and questionnaires. The questionnaire included exercise self-efficacy scale and mitral valve prolapse symptoms scale. The statistics are analysized with the Mann-Whitney U test, Spearman Correlation, Generalized estimating equation and Intention-to-treat analysis . The results shows that before the exercise training program, the scores in different categories of all cases were somewhat low: self- efficacy scores for 34.6 ± 25.6 points (total scores 120 points); exercise capacity for 8.7 ± 1.9 METs; symptom distress and the average for 20.0 ± 8.3 points (total scores 55 points). No significant relationships among exercise self-efficacy, exercise tolerance and symptom distress was observed. Exercise self-efficacy in exercise group significantly increased 27.5 points (p = .01) compared with the control group. After exercise training, exercise tolerance in exercise group increased from 9.4 ± 2.3 METs to 12.8 ± 2.6 METs. Exercise group was significantly improved compared to the control group, the exercise tolerance increased 3.0 METs (p <.001). Although symptom distress in the exercise group compared with the control group revealed no significant overall improvement (p = .05), the score of exercise group symptom distress decreased from 19.4 ± 8.3 points to 10.5 ± 7.0 points. Result of this study suggests that health care workers may help patients develop the habit of regular exercise, which means three times a week, thirty minutes for each time, at intensity of 60-80% maximum heart rate . According to the principles mentioned above, it could enhanced exercise self-efficacy, exercise tolerance, and possibly symptom distress relieve in female patients with mitral valve prolapse.

並列關鍵字

self-efficacy for exercise ； exercise tolerance ； symptom distress ； exercise training

參考文獻

黃婉茹（2003）應用跨理論模式於職場女性運動行為之研究 未發表

蔡佳宏（2002）應用跨理論模式於老人運動行為之研究：以台北市中

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

范姜群信、梁子賢（1999）僧帽瓣脫垂 基層醫學。14，63。

陳明豐（2005）二尖瓣脫垂是什麼東西 ?G 健康世界，230，8-10。