放鬆呼吸訓練於改善血液透析患者憂鬱症狀、睡眠品質及生活品質之成效探討

Relaxation Breathing Training for Improving Depressive symptoms, Quality of Sleep and Quality of Life in Hemodialysis Patients

蔡岫虹(Siou-Hung Tsai)

指導教授 ： 蔡佩珊

臺北醫學大學/護理學院/護理學研究所/碩士(2012年)

https://doi.org/10.6831/TMU.2012.00230

摘要

研究目的：旨在探討放鬆呼吸訓練於改善血液透析患者憂鬱症狀、睡眠品質及生活品質之成效探討。
研究方法:本研究收案對象收集台北地區某醫學中心，長期接受血液透析的末期腎臟疾病患者，共收案53位個案，經過隨機分配後分為兩組，分別為實驗組與控制組。兩組前測皆需接受中文版匹茲堡睡眠品質量表（CPSQI）、中文版貝氏憂鬱量表第二版（BDI-II）、SF-36生活品質量表測量，並說明放鬆呼吸訓練期的八次會面時間為每次洗腎前，每週兩次，共計四週，每次皆進行三十分鐘的放鬆呼吸訓練，四週呼吸訓練期後(第六週)再進行後測資料收集。實驗組在訓練期的第一次會面即開始教導放鬆式呼吸，而控制組於等候期前(第一週)及四週等候期後(第六週)接受測量，第七週再開始教導放鬆式呼吸，教學及進行方式則同於實驗組。此外，訓練過程中研究人員將安排安靜獨立的空間，請受試者開始依語音指導之內容引導進行呼吸訓練。
研究結果：在接受四週的放鬆呼吸訓練後，實驗組的後測BDI-II得分顯著低於控制組，於統計學上有顯著差異﹙p = 0.04﹚，實驗組BDI-II前後測得分在統計學上有顯著差異( p <.001)。實驗組的CPSQI得分顯著低於控制組，但實驗組CPSQI後測得分於統計學上無顯著差異( p = 0.50)，而實驗組CPSQI前後測得分，在統計學上有顯著差異( p <.001)。實驗組SF-36後測得分，在活力( p = 0.045)、因情緒問題角色受限( p = 0.035)，於統計學上有顯著差異，而實驗組SF-36前後測得分，在整體健康 ( p= .042) 、活力( p = 0.08)，於統計學上有顯著差異，但在生理健康（PCS）和心理健康（MCS）前後測總分得分，於統計學上無顯著差異( p皆 > 0.05)。
研究結論：本研究結果得知血液透析患者在接受放鬆呼吸訓練後，心理的憂鬱症狀達顯著改善。

關鍵字

放鬆呼吸訓練、血液透析患者、憂鬱症狀、睡眠品質、生活品質

並列摘要

Purpose: The purposes of this study was to examine the effects of breathing training on depressive symptoms, sleep quality and quality of life in hemodialysis patients.
Methods: Fifty-three patients with end-stage renal disease who received long-term hemodialysis were recruited from a teaching hospital in Northern Taiwan. The patients were randomly assigned into two groups, the experimental and waiting list control groups. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI), the Beck Depression Inventory-II (BDI-II), and the Medical Outcome Studies 36-Item short form (SF-36) Health Survey were assessed at pretest (Week 1) and posttest (Week 6) in both groups. The experimental group received a 30-minute breathing training before hemodialysis twice weekly for 4 weeks (Week 2, 3, 4 and 5) while the control group received no intervention until completion of posttest. The same breathing training protocol was provided for the control group starting from the seventh week. During the training sessions, the patients were provided with a quiet, isolated environment and trained to breathe slowly using an audio instruction.
Results: The posttest BDI-II was significantly lower in the experimental group than in the control group ( p = 0.04). The decreases in BDI-II, from baseline, at posttest were significantly greater in the experimental group as compared with the control group ( p <.001). The posttest CPSQI was significantly lower in the experimental group than in the control group，but there were no significant differences ( p = 0.50). The decreases in CPSQI, from baseline, at posttest were significantly greater in the experimental group as compared with the control group ( p <.001)。The posttest scores of vitality and role limitation due to emotional problems in SF-36 were significantly higher in the experimental group than in the control group ( p = 0.045 and p = 0.035, respectively)。The decreases in SF-36, from baseline, at posttest scores of overall health and vitality in SF-36 were significantly higher in the experimental group than in the control group ( p = 0.042 and p = 0.008, respectively). The posttest scores of PCS and MCS were no significant differences in either posttest or pretest-to-posttest changes of SF-36 between groups (all p > 0.05).
Conclusion: Breathing training is effective in reducing depressive symptoms in hemodialysis patients.

並列關鍵字

Key Words: breathing training、depressive symptom、sleep quality、quality of life

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