參與肺部復健運動之慢性阻塞性肺病患者活動耐力與相關因素探討

Activity endurance and related factors of chronic obstructive pulmonary disease patients attending pulmonary rehabilitation

王慈菱(TZU-LING WANG)

指導教授 ： 鐘淑英

中臺科技大學/護理學院/護理研究所/碩士(2019年)

摘要

慢性阻塞性肺病（COPD）是一不可逆與漸進惡化的呼吸道阻塞性疾病，會降低患者的工作能力及生活品質，嚴重時會反覆住院治療，增加患者的死亡及失能率，造成患者及家屬的沈重經濟負擔。肺部復健運動能增加患者的活動耐力，進而緩解呼吸困難之感受，提升自我照護能力並改善整體生活品質。本研究目的在探討參與肺部復健運動COPD患者之活動耐力與相關因素。以橫斷式研究設計，採立意取樣，使用結構式問卷收集資料，研究場所為臺灣南部某區域教學醫院之胸腔內科門診，66位診斷COPD且完成6次肺部復健運動治療之患者為研究對象。測試六分鐘步行距離(6MWT)、自覺運動呼吸困難指數(mBorg)、呼吸困難指數(mMRC)、COPD症狀評估測試(CAT)、SpO2評估患者復健運動時呼吸困難程度、使用台灣活動量調查短版問卷(IPAQ)測量日常生活的活動量為研究工具，所得資料以SPSS 22.0 for Windows進行統計分析。研究結果顯示影響6MWT與IPAQ的變項為mMRC、CAT、居家運動習慣及居家運動頻率(p<0.05)。逐步迴歸分析顯示預測6MWT的影響因素為年齡、BMI、mMRC (p=0.000)，IPAQ的影響因素為mMRC、FEV1/FVC (p=0.000)，六分鐘步行距離預測值之百分比(6MWT%pred)的影響因素為mMRC、年齡 (p=0.001)。利用廣義估計方程式(GEE)分析GOLD分級患者在運動治療中生命徵象變化，GOLD=2、GOLD=3、GOLD=4對mBorg均具影響力(p=0.000~ 0.002)；GOLD=4則對DBP具影響力(p=0.016)。本研究結果呈現影響接受肺部復健運動COPD患者之活動耐力表現的因素，作為臨床醫療工作實務檢討之參考。

關鍵字

肺部復健運動 ； 活動耐力 ； 慢性阻塞性肺病

並列摘要

Chronic obstructive pulmonary disease (COPD) is a disease with irreversible and progressive deterioration of respiratory tract obstruction. Serious diseases will reduce the patient's ability to work and quality of life. In serious cases, hospitalization will be repeated and the patient's death and disability rate will be increased, resulting in a heavy financial burden on patients and their families. Pulmonary rehabilitation exercise can increase patient activity endurance, thereby alleviating the feeling of dyspnea, enhancing self-care ability and improving overall quality of life. The purpose of this study was to investigate the activity endurance and related factors of COPD patients attending pulmonary rehabilitation. A cross-sectional study by purposive sampling was designed. Data were collected using a structured questionnaire. The research site is the thoracic medical clinic in a teaching hospital in southern Taiwan. Sixty-six patients diagnosed with COPD and completely received 6 pulmonary rehabilitation exercises were recruited. The measurements were included six-minute walk test (6MWT), modified Borg scale (mBorg), modified medical research council dyspnea scale (mMRC), COPD assessment test (CAT), and SpO2 for assessing the degree of dyspnea when the patients were taking rehabilitation exercises, and the short version of the international physical activity questionnaire (IPAQ) in Taiwan for measuring daily living activity. The data collected were analyzed by SPSS 22.0 for Windows software. The results in the study were found that the variables affecting both 6MWT and IPAQ were mMRC, CAT, home exercise habits and home exercise frequency (p<0.05). Multiple regression analysis results showed that 6MWT was affected by education of BMI, Hb and mMRC (p=0.000). IPAQ was affected by mMRC and FEV1/FVC (p=0.000). 6MWT% pred was affected by mMRC and age (p=0.001). The generalized estimating equation (GEE) was used to analyze the changes of life signs in the GOLD grading patients during sport therapies. The grades of GOLD=2, GOLD=3, GOLD=4 had influenced on the mBorg score (p=0.000~0.002). The grade of GOLD=4 had an influence on DBP (p=0.016). The results of this study present factors affecting the activity endurance of patients with COPD who undergo pulmonary rehabilitation, as a reference for clinical practice review.

並列關鍵字

pulmonary rehabilitation ； activity endurance ； chronic obstructive pulmonary disease

參考文獻

中文部分

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