腹膜透析病患心理困擾、因應方式與生活品質相關研究

A Study on Psychological Distress,Coping Strategies and Quality of Life among Peritoneal Dialysis Patients

鄭雅方(Cheng Ya-Fang)

指導教授 ： 陳政友

國立臺灣師範大學/教育學院/健康促進與衛生教育學系在職進修碩士班/碩士(2010年)

摘要

本論文的研究目的在瞭解腹膜透析病患面對疾病衝擊下所產生的心理困擾、因應方式與生活品質間的相關性。採結構式問卷為工具，於北部某醫學中心腹膜透析門診以立意取樣方式，共收集有效問卷111份。本研究的重要結果如下：
一、研究對象心理困擾程度介於「正常範圍」至「輕度」之間，其中以「睡眠困難」困擾症狀分數最高。心理困擾會因「經濟狀況」、「腹膜透析主要執行者」的不同水準而有顯著差異。
二、因應方式多採用問題導向。且因應方式會因「性別」不同而有顯著差異。
三、研究對象以八個構面的生活品質來看，「身體疼痛」限制最少，生活品質分數最高；「活動限制」限制最多，生活品質分數最低。以生理、心理構面劃分來看，心理構面限制較少，生活品質分數高於生理構面。整體生活品質分數介於居中範圍，整體生活品質會因「職業」、「腹膜透析主要執行者」的不同水準而有顯著差異。
四、研究對象心理困擾與情緒導向因應方式呈顯著正相關。心理困擾與八個構面生活品質、整合成生理心理兩大構面生活品質及整體生活品質皆呈顯著負相關。不論採用問題導向或情緒導向因應方式與整體生活品質皆呈顯著負相關。
五、研究對象個人背景因素、心理困擾、因應方式能有效預測整體生活品質，並可以解釋總變異量的52.6%，其中主要預測變項為「心理困擾」、「因應方式」並以因應方式中的「情緒導向因應方式」影響最大。

關鍵字

腹膜透析 ； 心理困擾 ； 因應方式 ； 生活品質

並列摘要

The main purpose of this study was to understand the situations between psychological distress, coping strategies, and quality of life among peritoneal dialysis patients when facing this chronic disease. The targeted group of this study was patients in peritoneal dialysis clinic of one northern medical center which were tested by randomly collecting data with the self-edited structure questionnaires. There were 111 effective questionnaires returned. The major conclusions of this study were as follows:
1.Psychological distress among subjects was between normal ranges to mild distress. There were significant difference in the levels of financial status and operators of peritoneal dialysis.
2.Most subjects took problem-oriented coping strategies. There was significant difference between sexes.
3.Reviewing the eight domains of quality of life, the bodily pain had highest scores, and the activity limitation had the lowest scores. The mental quality of life had higher scores than physical domain. The score of overall quality of life was in middle ranges, and there was significant difference with different levels of occupations, and main operator of peritoneal dialysis.
4.The psychological distress among subjects had significant positive relationship with emotion-oriented coping strategies. There were significant negative relationship between psychological distress and eight domains of quality of life, both mental and physical domains of quality of life, and overall quality of life. Both problem- and emotion-oriented coping strategies had significant negative relationship with overall quality of life.
5.The demographic data, psychological distress, and coping strategies among subjects can effectively predict overall quality of life (adjust R2 = 52.6%). The primary predictors of quality of life were psychological distress and coping strategies, and the emotion-oriented coping strategies had most effect.

並列關鍵字

Peritoneal dialysis ； psychological distress ； coping strategies ； quality of life

參考文獻

王梅美、林美良（2003）。讓她洗得更舒適-照護一位腹膜透析患者之護理經驗。新臺北護理期刊，5（2），103-114。

呂理哲（2002）。腹膜功能測試。腎臟與透析，14（2），57-59。

吳佳純、呂至剛、江守山（2002）。全自動腹膜透析。腎臟透析，14（2），60-65。

吳珠枝、陳建和（2008）。不同運動環境中身體活動健康效益之研究--以臺北榮總護理人員為例。醫護科技學刊，10（2），119-132。

林季宏、曾冬勝、龍佛衛、郭泰松 （2000）。尿毒症患者合併有憂鬱症之文獻回顧。當代醫學，27，598-603。