首次接受血液透析後病人焦慮程度與生活品質之追蹤探討

本研究探討首次接受血液透析病人之焦慮程度及生活品質的變化趨勢及影響因素。採縱貫性研究設計，研究對象為北部某醫學中心首次接受血液透析病人，於2018年3月14日至2019年12月31日，於病人接受血液透析滿一、三及六個月時分別以基本資料問卷、特質／情境焦慮量表（State Trait Anxiety Inventory）及臺灣版世界衛生組織生活品質量表（WHOQOL-BREF）進行資料收集，共收案78人。研究結果發現，首次接受血液透析病人的特質焦慮與其血液透析後一、三及六個月時的情境焦慮呈現中度相關（r=.785, p<.001; r=.758, p<.001; r=.574, p<.001），與其生活品質呈現中度負相關（r=-.482, p<.001; r=-.409, p<.001），即特質焦慮越高的病人在接受血液透析後情境焦慮程度也越高，生活品質得分則越低，但在六個月時則無差異。再以GEE（generalized estimating equation）進行多變項分析，在控制病人的年齡、性別、特質焦慮及每週透析次數後，時間與病人的情境焦慮有顯著相關，病人的情境焦慮會隨著時間而增加；建議未來應定期追蹤首次血液透析病人之情境焦慮與生活品質，並適時轉介社工或病友團體，積極輔導其調適過程。

關鍵字

血液透析；焦慮；生活品質

並列摘要

This study explored changes in and factors affecting the anxiety levels and quality of life of patients undergoing hemodialysis for the first time. A longitudinal research design was adopted, and the study participants comprised 78 patients undergoing hemodialysis for the first time at a medical center in northern Taiwan. Data on the participants from March 14, 2018, to December 31, 2019, were collected using a basic information questionnaire, the State Trait Anxiety Inventory, and the Taiwanese version of the World Health Organization Quality of Life 1, 3, and 6 months after hemodialysis began. The trait anxiety of the participants was moderately correlated with their situational anxiety 1, 3, and 6 months after starting hemodialysis (1 month, r= .785, p< .001; 3 months, r= .758, p< .001; 6 months, r= .574, p< .001), indicating a moderate negative correlation with their quality of life (r= -.482, p< .001; r= -.409, p< .001 ). The participants with higher trait anxiety levels exhibited higher levels of situational anxiety and lower quality of life scores after hemodialysis. However, no difference was identified at 6 months. A generalized estimating equation was employed to conduct multivariate analysis. After the patients' age, gender, trait anxiety, and weekly dialysis schedule were controlled for, time was significantly correlated with their situational anxiety levels, which increased over time. These findings suggest that the situational anxiety and quality of life of patients undergoing first-time hemodialysis should be regularly tracked; they also suggest that timely referrals to social workers or patient groups should be made to guide the adjustment process of these patients.

並列關鍵字

hemodialysis ； anxiety ； quality of life

參考文獻

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