長期血液透析患者身體功能狀態及其影響因素之探討

Factors Affecting Physical Performance Status in Long-Term Hemodialysis Patients

韓湘芳(Hsiang‐Fan Han) ； 陳意超(Yi‐Chao Chen) ； 葉美玲(Mei‐Ling Yeh) ； 鍾玉珠(Yu‐Chu Chung)

《護理暨健康照護研究》 10卷3期 (2014/09) Pp. 211-219

https://doi.org/10.6225/JNHR.10.3.211

摘要

背景：末期腎病變患者長期血液透析治療造成肌肉與神經病變，導致肌肉耗損及過度疲憊而有較高的死亡率。目的：本研究旨在確認長期血液透析患者之身體功能狀態及其相關影響因素。方法：採用橫斷式描述相關性研究設計，共計141份資料以結構式問卷收集。問卷包括身體功能狀態量表、營養指標、貝氏憂鬱量表、疲憊量表及運動自我效能量表等。結果：研究結果顯示，身體功能狀態平均得分為73.9±24.6分，而個案中38.3%活動正常、19.1%輕度障礙、16.4%中度障礙、26.2%重度障礙。對身體活動狀態之最佳預測變項，依序為跌倒危險傾向、年齡、運動自我效能及憂鬱，此可解釋45.1%總變異量。身體功能狀態與運動自我效能呈正相關，但與跌倒危險傾向、年齡及憂鬱呈負相關。結論／實務應用：血液透析患者運動自我效能得分越高者、跌倒危險傾向得分越低者、年紀越小者、憂鬱得分越低者，其身體功能狀態就愈佳。本研究結果可提供醫護人員研擬長期血液透析患者之身體功能狀態改善措施之參考。

關鍵字

血液透析 ； 功能狀態 ； 憂鬱 ； 自我效能 ； 跌倒危險傾向

並列摘要

Background: End‐stage renal disease patients on long‐term hemodialysis are at a relatively high risk of myopathy and neuropathy, which are factors associated with muscle wasting, excessive fatigue, and increased mortality. Purpose: The purpose of this study was to determine the factors affecting physical performance status in patients on long‐term hemodialysis. Methods: A cross‐sectional descriptive and correlational study design was used. A questionnaire comprising instruments including the physical performance status scale, nutrition index, Beck Depression Inventory‐II, fatigue, and exercise self‐efficacy scale was used to collect data from 141 participants. Results: The mean score of participants for physical functional status was 73.9 ± 24.6. Nearly two‐fifths of participants (38.3%) self‐reported having no physical disability. Among those reporting physical disabilities, 19.1% reported their condition as mild, 16.4% as moderate, and 26.2% as severe. Risk of falling, age, exercise self‐efficacy, and depression were important predictors of physical performance status, collectively explaining 45.1% of total physical performance status variance. Exercise self‐efficacy correlated positively with physical performance status, while risk of falling, age, and depression correlated negatively with physical performance status. Conclusions/Implications for Practice: Better exercise self‐efficacy, lower falling risk, being of a younger age, and lower levels of depression were each associated with better physical performance status. This study provides evidence‐based support to healthcare professionals responsible for developing interventions that physical activity improves the physical performance status of long‐term hemodialysis patients.

並列關鍵字

hemodialysis ； performance status ； depression ； self‐efficacy ； risk of falling