血液透析病患血磷控制遵從行為及其相關因素之研究

Factors Related to Adherence of Phosphate Control in Hemodialysis Patient

何雅芳

指導教授 ： 呂昌明

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(2011年)

摘要

本研究旨在探討血液透析病患血磷控制遵從行為及其與個人背景因素、社會支持、健康控握、自我效能、結果期待、血磷值等變項的關係。研究對象為苗栗縣某區域教學醫院及新竹市某綜合醫院血液透析中心的門診病患，共收集141份有效問卷，所得研究結果如下：
一. 血液透析病患的血磷控制遵從行為會因年齡、婚姻狀態、居住情形及自覺有無高血磷合併症的不同而有差異。年齡較大者、已婚或喪偶者、與配偶及子女同住者、無自覺高血磷合併症發生者，其血磷控制遵從行為較佳。
二. 血液透析病患的社會支持越好、自我效能越強、結果期待越正向、健康控握傾向內控者，其血磷控制遵從行為就越佳。
三. 血液透析病患獲得的情緒性支持及評價性支持愈多，其血磷控制遵從行為愈好。
四. 血液透析病患家人、醫護人員的社會支持愈強，其血磷控制遵從行為就愈佳，而家人的社會支持強度是決定透析病患是否遵從血磷控制行為的主要關鍵因素。
五. 家人的社會支持主要發揮在低磷飲食的支持上，醫護人員的社會支持則主要在磷結合劑的服用上。
六. 血液透析病患血磷控制遵從行為愈佳者，其血中血磷值就愈低。
七. 年齡、婚姻狀態、居住情形、自覺高血磷合併症以及社會支持、內控、自我效能、結果期待對血液透析病患整體血磷控制遵從行為的預測力為56.4％，其中自我效能為最重要之預測變項。

關鍵字

血液透析 ； 遵從行為 ； 血磷控制

並列摘要

The purpose of this study was to explore the adherence of phosphate control and associated factors of hemodialysis patient and personal background factors, social support, health locus of control, self-efficacy, outcome expectations, phosphorus value of the relationship between the variables. The subjects of Miaoli County regional teaching hospital and Hsinchu City general hospital outpatient dialysis center, a total of 141 valid questionnaires were collected. The results were as follows:
1. Adherence of Phosphate control due to age, marital status, living situation and perceived availability of hyperphosphatemia complications differ. Older age, married or widowed, living with spouse and children in households without complication who consciously hyperphosphatemia, their has better adherence of phosphate control.
2. Social support in hemodialysis patients better, stronger self-efficacy, more positive outcome expectations, health locus of control internal locus of control, their has more better adherence of phosphate control.
3. Hemodialysis patients receive emotional support and evaluation of support for the more, the better their Adherence of phosphate control.
4. Hemodialysis patients families, medical staff stronger social support, the adherence of phosphate control the more good. Family social support, dialysis patients is to determine whether the strength of the key factors in adherence.
5. Family social support play a major support in the low phosphorus diet, the medical staff of social support is mainly in the phosphate binder to take on.
6. Hemodialysis patients with serum phosphorus control of adherence the better, their blood to lower the serum phosphorus value.
7. Age, marital status, living situation, perceived complications of hyperphosphatemia, and social support, internal control, self-efficacy, outcome expectations for phosphate control in hemodialysis patient adherence behavior of the overall predictability of 56.4%, of which self-efficacy the most important predictors.

並列關鍵字

Hemodialysis ； Adherence ； phosphate control

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