心臟手術後老年人生活品質及其相關因素之探討

本研究旨在探討心臟手術後老年患者的生活品質現況，並進一步探討在不同背景變數下對其生活品質是否會有顯著影響。為達本研究目的，本研究採用問卷調查法，並以EQ-5D問卷為研究工具，以台中榮總嘉義分院門診就醫且其過去三年間有在院內接受過心臟手術者為研究對象。於2018/3/1~2018/4/30 共計收集149筆心臟手術門診病人EQ-5D問卷資料。在資料分析方法上，包含敘述性統計分析、獨立樣本t檢定及單因子變異數分析，並將資料以SPSS統計軟體進行分析與檢驗。研究結果發現：一、在EQ-5D指標及EQ-VAS分數上，大多數心臟手術後患者都是屬於中度到良好的生活品質，除了在疼痛/不舒服稍低外，其餘構面皆有不錯的生活品質。二、以人口學屬性資料對EQ-5D個別與整體指標進行差異性分析，結果顯示在行動指標分數上，行動指標分數會因不同性別、婚姻狀況、經濟狀況、自覺健康狀況達顯著性差異。另外EQ-5D 自我照顧指標分數上則會因運動習慣不同達顯著性差異。最後在EQ-5D 疼痛/不舒服指標分數上會因年齡不同達顯著性差異。三、不同背景變項之心臟手術後老年患者在自覺健康狀況上對於EQ-VAS分數上有顯著的影響，自覺健康良好者的生活品質明顯比自覺健康普通或差者來的好。　　　根據上述研究結果，本研究建議對於自覺健康狀況差或普通的患者，應強化其健康認知，使其能堅定建康信念，以促進術後復健運動的執行。例如可提供系統性的衛生教育服務及健康促進活動，營造出健康促進環境的氣氛，讓患者能夠更快的康復。

關鍵字

生活品質；老年人；心臟手術

並列摘要

This study aimed to investigate the quality of life of elderly patients after heart surgery, and further explore whether there would be a significant impact on their quality of life under different background variables. For the purpose of this study, this study adopted a questionnaire survey method and used the EQ-5D questionnaire as a research tool. The subject of the study was an outpatient patient who had undergone heart surgery in the Chiayi Branch of Taichung Veterans General Hospital. A total of 149 EQ-5D questionnaires were collected from 2018/3/1 to 2018/4/30 heart surgery outpatients. In the analysis method, including descriptive statistical analysis, independent sample t test and analysis of variance, and analysis and test with SPSS software.The study founded that: On the EQ-5D and EQ-VAS scores, most heart surgery patients had a moderate to good range of quality of life. In addition to the low EQ-5D index of pain, the rest of the facets had a good quality of life. The demographic attribute data was used to analyze the individual and overall indicators of EQ-5D. The results showed that the action indicator scores showed significant differences in gender, marital status, economic status and conscious health status. In addition, the EQ-5D self-care indicator score were significantly different due to different exercise habits. Finally, there was a significant difference in the EQ-5D pain/discomfort index scores due to age. Patients with different conscious health conditions after heart surgery had a significant impact on the EQ-VAS score. The quality of life that was perceived as having a good health condition was better than that of a normal or pool health condition. 　　　Based on the above findings, this study suggests that for patients with poor health or general health, their health cognition should be strengthened to promote rehabilitation after surgery. For example, systemic health education activities can be provided to create an health environment , and promoted faster recovery of patients.