下肢運動與呼吸調節改善血液透析病人負向情緒之成效

Leg Exercises with Breathing Improve Negative Emotions in Hemodialysis Patients

黃馨頤(Hsin-Yi Huang) ； 王美華(Mei-Hua Wang) ； 葉美玲(Mei-Ling Yeh)

《榮總護理》 35卷2期 (2018/06) Pp. 126-135

https://doi.org/10.6142/VGHN.201806_35(2).0002

摘要

末期腎臟病人透析治療及無法預期的合併症造成不可避免的情緒問題。本研究針對末期腎臟病人給予下肢運動與呼吸調節之護理指導，以改善其血液透析期間之負向情緒。本研究採實驗性設計，於2017年3月至6月針對北部某醫學中心血液透析病人，共收案86名，以隨機分配為實驗組和對照組。實驗組接受12週的下肢運動(含抬腿、股四頭肌收縮及屈膝)與呼吸調節。全部個案都接受常規護理照護，並於收案前、第4週及第12週進行三次的資料收集。負向情緒測量工具為醫院焦慮憂鬱量表。本研究納入統計分析計有83人，包括實驗組40人(平均53.70歲，男性72.5%)及對照組43人(平均61.19歲，男性65.1%)。負向情緒成效：(一)實驗組自第4週後呈現緩慢下降趨勢，對照組則持續上升；(二)GEE結果顯示實驗與對照組之間達統計顯著差異(β=-2.40，p=.04)。本研究指出接受下肢運動及呼吸調節的病人，可有效改善其血液透析期間的負向情緒。此運動持續執行至少12週對透析病人能達到改善情緒成效。本研究發現可提供護理實務專業者對血液透析病人個別性照顧之參酌。

關鍵字

運動 ； 呼吸 ； 焦慮 ； 憂鬱 ； 血液透析

並列摘要

Negative emotions and thoughts often occur in patients with end-stage renal disease. Studies have concluded that regular exercise might improve negative emotions in such patients. This study aimed to evaluate the effects of regular exercise in hemodialysis patients. A randomized controlled trial was used. From March to June 2017, 86 patients under the maintenance of hemodialysis were prospectively recruited and randomly assigned into either control or exercise groups. The control group received routine nursing care, whereas the exercise group received an additional 12-week breathing exercise program. Data were collected at baseline, week 4, and week 12 of the study. Outcomes were measured using the Hospital Anxiety and Depression Scale (HADS). The data were collected and analyzed with IBM SPSS version 22.0. Inferential statistical analyses included the chi-square test, t-test, and generalized estimation equation (GEE) model. Finally, 83 participants completed the study and were included in the data analysis, including 40 in the exercise group (mean age 53.7, male 72.5%) and 43 in the control group (mean age 61.19, male 65.1%). HADS scores gradually descended since the 4th week of the initiation of exercise training in the exercise group, while the scores persistently increased in the control group. The result of the GEE model showed significant differences in HADS scores between the two groups (β = - 2.40, p = .04). Leg exercises with breathing were safe during the period of hemodialysis. The findings of this study indicate that a 12-week regimen of breathing exercise program was effective in improving the negative emotions of hemodialysis patients. This study provides a reference for nursing practitioners regarding care of hemodialysis patients.

並列關鍵字

exercises ； breathing ； anxiety ； depression ； hemodialysis

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