心臟衰竭病人之生活品質及其相關影響因素

The quality of life and its associated factors in patients with heart failure

施孟綾(Meng-Ling Shih)

指導教授 ： 周汎澔

高雄醫學大學/護理學院/護理學系研究所/碩士(2009年)

https://doi.org/10.6832/KMU.2009.00047

摘要

本研究旨在探討心臟衰竭病人之生活品質及其相關因素，研究目的為：（1）探討心臟衰竭病人之功能狀態、症狀、憂鬱與生活品質情形；（2）分析心臟衰竭病人基本屬性、功能狀態、症狀、憂鬱程度與生活品質之相關性；（3）探討心臟衰竭個案生活品質之重要預測因子。採橫斷式、相關性研究設計，並以結構式問卷收集資料，問卷內容包含基本屬性、症狀量表、功能狀態量表、憂鬱量表及生活品質量表等五部分。以立意取樣，於南部某醫學中心及區域教學醫院之心臟血管內科病房及門診收案，選取年滿二十歲且診斷為心臟衰竭患者為研究對象，共200人。將所得資料以SPSS 14.0套裝軟體進行統計分析，以描述性統計分析人口學基本屬性資料、皮爾森積差相關、史比爾曼相關分析生活品質及其相關因素，並以逐步複迴歸分析生活品質的重要預測因子。
本研究結果發現：（1）研究對象生活品質指標得分為63.0，屬中等程度；（2）婚姻狀況、目前有無職業、家庭月收入、合併有糖尿病或高血壓、合併疾病數目、有無服藥、是否注射藥物及氧氣使用與否在生活品質上達顯著性差異；（3）研究對象症狀指標得分為54.1，屬中等程度，且症狀與生活品質及其四個範疇達顯著性正相關；（4）研究對象功能狀態以紐約心臟學會功能分級第II級為最多數，其程度屬較佳，功能狀態與生活品質及其四個範疇達顯著性負相關；（5）研究對象憂鬱指標得分為14.3，屬輕度，憂鬱與生活品質及其四個範疇達顯著性負相關；（6）憂鬱、症狀及家庭月收入為生活品質之重要預測因子，可解釋59.3%之總變異量，最重要之預測因子為憂鬱。
本研究結果可提供健康專業人員對於心臟衰竭病人之功能狀態、症狀、憂鬱情形與生活品質的相關性有更進一步的了解。亦可使健康照護專業人員具有足夠的實證性資料，作為有效地運用適切性的評估與照護之參考依據，以改善心臟衰竭病人之症狀、功能狀態及憂鬱情形，進而改善其生活品質。

關鍵字

心臟衰竭 ； 症狀 ； 功能狀態 ； 憂鬱 ； 生活品質

並列摘要

This research was to explore the quality of life (QOL) and its associated factors in patients with heart failure. The purposes of this study were to: (1) explore the condition of symptoms, functional status, depression and quality of life in patients with heart failure; (2) analyze the relationships among demographic characteristics, illness characteristics, symptoms, functional status, depression and QOL in patients with heart failure; and (3) identify the important predictors of QOL in patients with heart failure.
A cross-sectional, descriptive, and correlational research design was used. In addition to demographic data and disease characteristics, three structured questionnaires were used to collected data, including Kansas City Cardiomyopathy Questionnaire, Beck Depression Inventory-II, and The World Health Organization Quality of Life Assessment. A convenience sample of 200 patients aged 20 years old or above and diagnosed with heart failure were recruited from a medical center and a regional teaching hospital in southern Taiwan after consent forms were obtained. The collected data were analyzed with SPSS 14.0 software, including descriptive statistics, Pearson’s and Spearman’s correlation coefficient, and multiple regression analysis.
The results of this study showed that (1) the index score of QOL was 63.0, a moderate level; (2) patients marriage or not, occupation, family income per month, combined with diabetes or hypertension, complication numbers, and various treatments had a significant difference on QOL; (3) the index score of symptoms was 54.1, a relatively moderate level. They were significantly correlated with QOL; (4) the majority of the sample was in NYHA Class II, indicating patients’ functional status. The functional status was associated with QOL and the four dimensions of QOL; (5) the index score of depression was 14.3, a low level. Depression was significantly related to QOL; (6) depression, symptoms and family income per month were the important predictors of QOL, and the three variables explained 59.3% of the variance in QOL. Depression was the most important predictor of QOL in patients with heart failure.
The results of this study may help health professionals in understanding QOL, and the relationships among symptoms, functional status, depression and QOL in heart failure patients. It could also provide health care professionals evidence-based data for assessing and caring with using effective strategies to improve symptoms, functional status and depression of heart failure patients. Then, it might significantly improve QOL in patients with heart failure .

並列關鍵字

heart failure ； symptoms ； functional status ； depression ； quality of life

參考文獻

參考文獻

中文文獻

王榮德(2002)•特輯-健康相關的生活品質之新展•台灣醫學，6(2)，181-182。

王榮德、游正芬、鍾智文、姚開屏(2000)•廿一世紀之健康照護效性評量:生活品質與生活品質調整後之存活分析•台灣醫學，4(1)，65-74。

王麗惠、劉芹芳(2005)•生活品質概念分析於護理之應用•高雄護理雜誌，22(2)，41-50。