慢性阻塞性肺疾病病人健康內外控與呼吸困難自我管理策略之相關性研究

The correlation study between health locus of control and self-management strategies of dyspnea for the patients with chronic obstructive pulmonary disease

張迺馨(Nai-Hsin Chang)

指導教授 ： 邱啟潤

高雄醫學大學/護理學院/護理學系研究所/碩士(2011年)

https://doi.org/10.6832/KMU.2011.00059

摘要

背景：慢性阻塞性肺疾病是全世界第四大死因，呼吸困難的症狀經常會伴隨著疾病的惡化而產生，故有效的自我管理策略及其相關因素的探討就顯得很重要。
目的：探討慢性阻塞性肺疾病患者之呼吸困難自我管理策略、健康內外控特性，及健康內外控與呼吸困難自我管理策略之關係。
方法：採描述性相關研究法，以高雄縣某醫學中心及地區醫院胸腔內科門診之慢性阻塞性肺疾病患者為研究對象， 99年8月~10月收案200人。研究工具為結構式問卷，包括（1）呼吸困難介入措施中文量表，量表信度Cronbach’s α .92、（2）多層面健康控制信念量表–B版本，次量表信度Cronbach’s α 分別為：內控 .92、機運 .88、權利在他人.75、（3）肺功能狀態及呼吸困難問卷調查修訂版–中文版、Cronbach’s α .95、（4）個人基本資料表。五位專家效度的CVI值為.94~.96。
結果：1.呼吸困難自我管理策略的使用頻率最高及最有效的策略為：（1）緩慢移動；（2）維持靜止不動。2.本研究對象以傾向權力在他人最多，其次為內控，機運最低，得分指標分別為78；70；58。3.內控與呼吸困難介入措施使用頻率及使用效果呈現正相關；機運及權利在他人與呼吸困難介入措施使用頻率及使用效果呈現負相關。
結論：1.呼吸困難自我管理策略最有效的策略為：（1）緩慢移動；（2）維持靜止不動。2.健康內外控的特性與呼吸困難自我管理策略是有相關的。未來可將此結論運用在臨床實務上，以增加自我管理的效益。

關鍵字

慢性阻塞性肺疾病 ； 健康內外控 ； 呼吸困難 ； 自我管理策略

並列摘要

Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world, and dyspnea often occurs as the disease deteriorates. Study of effective self-management strategies and related factors is therefore clearly very important. Objective: Study the nature of dyspnea self-management strategies and health locus of control in COPD patients and the correlation between health locus of control and dyspnea self-management strategies.
Methods: A descriptive correlation study was conducted on COPD patients from the thoracic medicine outpatient department of a medical center and regional hospital in Kaohsiung County (Southern Taiwan). In the period from August to October 2010, 200 subjects were recruited. The research tool consisted of a structured questionnaire, including (1) a Chinese Scale for Dyspnea Intervention with a scale reliability of α = .92; (2) a Multidimensional Health Locus of Control Scale (version B) with a scale reliability of α = .92 for internal control, α = .88 for chance, and α = .75 for powerful others; (3) a Chinese version of the Revised Pulmonary Function and Dyspnea Questionnaire with a reliability of α = .95; (4) a Personal Basic Data Form. The expert content validity index (CVI), based on the opinion of five experts, was .94~.96.
Results: 1.The dyspnea self-management strategies that were used most and most effectively were (1) moving slowly and (2) staying still. 2. Most subjects in this study tended to have a powerful others locus of control orientation, with an internal and chance locus of control orientation coming second and third. The score indexes were 78, 70 and 58, respectively. 3. A positive correlation was found of internal locus of control with use frequency and effect of dyspnea intervention. A negative correlation was found of chance and powerful others locus of control with use frequency and effect of dyspnea intervention. Conclusion: 1. The most effective dyspnea self-management strategies were (1) moving slowly and (2) staying still. 2. There is a correlation between health locus of control and dyspnea self-management strategies. This conclusion may be utilized in clinical practice in order to increase the effects of self-management.

並列關鍵字

Chronic Obstructive Pulmonary Disease ； Health Locus of Control ； dyspnea ； self-management strategies

參考文獻

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