慢性腎臟病病人症狀困擾、幸福感與生活品質之相關因素探討

背景：台灣慢性腎臟病盛行率逐年增加，且穩居世界之冠。慢性腎臟病不僅造成我國沉重的醫療負擔，同時威脅其生命，導致生活品質受損。在慢性腎臟病病人中生活品質是重要議題。目的：探討慢性腎臟病病人症狀困擾、幸福感與生活品質之相關性。方法：採橫斷性立意取樣調查，以南部某醫學中心82 位慢性腎臟病病人為研究對象。研究工具採用症狀困擾量表、幸福感量表、世界衛生組織生活品質問卷（台灣簡明版）與基本屬性等四份問卷。分析方法為描述性與分析統計。結果：個案的平均年齡61.96 ± 12.66，大多數為男性(n=43, 52.4%)、已婚(n=52, 63.4%)、高中職學歷(n=26, 31.6%)、無工作(n=25, 30.5%)、與有運動(n=44, 53.7%)。症狀困擾平均分數17.5 ± 9.42、幸福感平均分數5.98 ± 2.59 及整體生活品質平均分數54.25 ± 9.35。最常見的症狀困擾為疲勞」最嚴重的為難以入睡。迴歸分析結果，教育程度(β= .24，p < .005)、婚姻(β= .19，p < .05)、有無慢性疾病(β= -.16，p< .05) 及幸福感(β= .46，p < .005)，可預測生活品質總分。結論：教育程度、婚姻、有無慢性疾病及幸福感為生活品質總分之預測因子。臨床應用：可將症狀困擾的相關測量與評估方式納入腎臟專科護理人員之在職教育課程，以增進專科性知能與技能，進而提升護理照護品質。未來研究建議可針對「疲倦」及「難以入睡」進行深入探討，檢驗相關與因果關係。

關鍵字

慢性腎臟病；症狀困擾；幸福感；生活品質

並列摘要

Background: The prevalence of chronic kidney diseases (CKD) is steadily increasing in Taiwan, which has the highest rate worldwide.The burden of CKD is a serious problem in Taiwan; it would increase the mortality and impair quality of life (QOL). Purpose: The purpose of this study was to examine factors associated with symptom distress,happiness, and health-related QOL in patients with CKD. Methods: This was a cross-sectional correlation study. A total of 82 participants were recruited from a medical centers hospital in southern Taiwan. Instruments included the Physical Symptom Distress Scale, Chinese Happiness Inventory, WHOQOL-BREF Taiwan version scale and participants’ demographics. Analytical methods include descriptive statistics and bivariate analyses. Results: The mean age of participants were 61.96 ± 12.66; many of them were male (n =43,52.4%), married (n=52,63.4%), high school education (n=26, 31.6%), currently not working (n=25, 30.5%), and had exercised (n=44, 53.7%) Participants reported a moderate level of symptom distress (M ± SD=17.5 ± 9.42),happiness (M ± SD=5.98 ± 2.59), and total QOL (M± SD=54.25 ± 9.35). The most common symptoms distress was difficulty in sleeping and most severe symptom distress was fatigue. The regression results showed that high school or higher education (β= .24, p < .005), married(β= .19, p < .05), chronic diseases (β= -.16, p < .05), and happiness (β= .46, p < .005) were predictors to QOL. Conclusion: Education level, marital status, having chronic diseases, and happiness were predictors to QOL. Recommendations: symptom distress should be included in the education agenda of nephrology nursing to enhance the professional knowledge and skills. Future study should examine the problem of sleeping and fatigue in CKD patients.

並列關鍵字

Chronic kidney disease ； symptom distress ； happiness ； quality of life

參考文獻

林志哲 (2014)．感恩、社會支持及幸福感之研究：中介效果模式之驗證．中華心理衛生學刊，27(3)，453–482。https://doi.org/10.30074/FJMH.201409_27(3).0005

Ferrans, C. E., & Powers, M. J. (1985). Quality of life index: Development and psychometric properties. Advances in Nursing Science, 8(1), 15–24. https://doi.org/10.1097/00012272-198510000-00005

一、中文部份