病人脫離呼吸器後症狀困擾與日常活動功能之相關性研究

The Relationship between Symptom Distress and Activities of Daily Living for Patients Who Have Been Weaned From a Ventilator

白玉珠(Yu-Chu Pai) ； 張霜蘭(Shuang-Lan Chang) ； 蔡玉鳳(Yu-Feng Tsai) ； 鄒怡真(Yi-Chen Tsou) ； 蔡欣玲(Sing-Ling Tsai)

《實證護理》 2卷1期 (2006/03) Pp. 61-72

https://doi.org/10.6225/JEBN.2.1.61

摘要

本研究目的為探討病人脫離呼吸器後之症狀困擾及日常活動功能相關性，研究採縱斷性追蹤研究法，於病人出院當天、一週、一個月及三個月後，分別以結構式問卷，採立意取樣調查，共收集91位脫離呼吸器後病人之資料，研究工具為：病人基本資料表、症狀困擾量表及巴氏量表。效度檢定係採專家效度，量表之信度Cronbach's α，分別為.841、.897。研究結果以描述與推論性分析發現：病人於四個時間點之症狀困擾均有顯著差異，且以呼吸與腸胃系統之症狀困擾程度最大。而基本屬性中意識狀況、語言表達、依賴程度及身上管路等項與日常活動功能均有顯著差異，病人脫離呼吸器後症狀困擾之最佳預測因子分別是年齡、教育程度、意識狀況、身上管路及依賴程度，整體症狀困擾可解釋46.8%之變異量。本研究結果有助於醫護人員瞭解病人脫離呼吸器後之症狀困擾與日常活動功能之相關性及照護之參考，並建議可與居家護理指導及出院準備服務計劃相配合應用，以提昇醫療服務品質。

關鍵字

脫離呼吸器 ； 症狀困擾 ； 日常活動功能

並列摘要

The purpose of this study was to examine symptom distress, activities of daily living (ADL), and related factors in patients who have been weaned off a ventilator. Patients were examined at discharge, and at one week, one month and three months after discharge. This was a vertical breaks type of tracing research. Convenience sampling was employed to select the subjects. A total of 91 patients were successfully investigated. Three instruments were used to collect data, including the Demographic Data Form, Symptom Distress Scale, and Activities of Daily Living Scale. The questionnaires were validated by expert validity and Cronbach's a reliability test (.841, .897). The results showed that the symptom distress at the four different examination times were significantly different. The symptom distress of the respiratory and gastrointestinal systems was the most significant. In addition, patient's consciousness, linguistic expression, level of dependence and body cannula were closely related to activities of daily living function, but with significant statistical differences. Age, educational level, conscious, tubing and dependence level are important predictor variables to assess symptom distress for patients who have been weaned off a ventilator. The total symptom distress might be explained by the variation quantity of 46.8%. The results of this study might assist health-care providers clinicians to gain a comprehensive understanding of symptom distress and related factors in patients who have been weaned from a ventilator. The study recommends the combining of home care with patient education and patient discharge planning, to improve medical service capability and save limited resources.

並列關鍵字

ventilator weaning ； symptom distress ； activities of daily living ADL