- 期刊
初期血液透析病人自我管理及其影響因素之初探
The Predictor Factors of Self-Management in Patients with First-Time Hemodialysis
摘要
前言：血液透析是末期腎病首選治療方式，但在接受透析之初，病人對照護方式不熟悉，加上治療帶來不適症狀，易導致病人身心失衡。倘若初期透析病人能對照護有正確認識與學習，就能確實執行自我管理，將可提升治療效果減少合併症的發生，進而確保長期透析後的生活品質。研究目的：了解初期血液透析病人自我管理的現況以及影響因素。研究方法：本研究為橫斷式研究設計，採立意取樣以北部醫療院所接受血液透析6個月內的病人為研究對象。研究結果：總收案271位，平均年齡為65.46歲（標準差為13.53）；自我管理總得分為49.97分（標準差為12.88），次量表中以執行自我照顧活動得分為最高分，而伙伴關係得分最低；多元迴歸分析顯示，初次透析病人「年齡」、「教育程度」、「健康識能」、「社會支持」為「自我管理」之相關因素，總解釋力為36%。結論：未來照護應依據初期血液透析病人的健康識能程度，針對需求與特性，以病人為中心設計適性的自我管理指導計畫，提升照護能力之外，並且善用社會支持網絡資源，協助病人落實自我管理。
並列摘要
Introduction: Hemodialysis is the main line of treatment for patients with end stage renal disease (ESRD). Before starting dialysis, the patients are unfamiliar about the treatment and care process. Patients with ESRD can experience physical or mental discomfort while adapting to hemodialysis. We aim to introduce a self-management program through education to help prepare the patients for dialysis, thereby improving treatment efficiency, maintaining quality of life, and lowering complication rates in patients with ESRD undergoing long-term dialysis. Purpose: To evaluate hemodialysis status and implications of self-management program during dialysis. Methods: This cross-sectional study was conducted using purposive sampling. We enrolled patients who receive hemodialysis within six months in multiple sites of medical hospitals and clinics in Northern Taiwan. Results: A total of 271 patients were recruited with an average age of 65 years (65.46 ± 13.53 years, mean ± standard deviation [SD]). Overall self-management score was 49.97 points (49.97 ± 12.88). Of the four domains evaluated, implementation of self-care activities had the highest score and partner's relationship the lowest. Multiple regression analysis revealed that age, education level, health literacy, and social support had a significant association with selfmanagement in patients undergoing first-time hemodialysis. The total explanatory power was 36%. Conclusion: We recommend that healthcare providers consider the demand of the patient when introducing the self-management program. Training programs must be designed according to the health literacy level of the patient undergoing hemodialysis for the first time. To improve care quality, we recommend using social support and network resources to implement self-management in daily life.