冠狀動脈疾病婦女罹病危險因子、症狀與疾病嚴重程度、及生活品質之探討

Risk Factors, Symptoms, Disease Severity and Quality of Life Among Women With Coronary Artery Disease

席美玲(Mei-Ling Hsi)

指導教授 ： 蔡仁貞

臺北醫學大學/護理學院/護理學研究所/碩士(2003年)

摘要

心臟疾病是國人近十年一直高居十大死因的第四位，其中冠狀動脈疾病佔最多數，因此控制的罹病危險因子造成疾病與症狀嚴重程度，以提昇冠狀動脈疾病患者的生活品質是非常重要。本研究目的選取冠狀動脈疾病婦女，探討罹病危險因子、疾病嚴重程度、症狀嚴重程度及生活品質之間相關性，病瞭解生活品質之預測因子。 本研究設計採橫斷式相關性之研究，經由立意取樣法選取冠狀動脈疾病患者為研究對象，並以結構式問卷量表包括人口學特質調查表、罹病危險因子量表、疾病嚴重度量表、症狀嚴重度量表，以及SF-36之生活品質量表進行冠狀動脈疾病患生活品質之調查。資料分析採百分比、平均值、標準差、皮爾森積差相關 (Pearson Correlation)、斯皮爾曼等級相關性 (Spearman Correlation)及逐步回歸(stepwise regression)分析。 研究結果發現：(一) 危險因子平均得分為8±2.57分，且至少存在著有三個危險因子，以停經居多91.9%，其次是自覺有壓力與高血壓各佔74.3%為第二位，以及缺乏運動佔73%為第三位。(二)年齡分佈以≧65歲居多，有95.9%是未抽煙者，血中膽固醇值平均為215mg/dl，有74.3%患有高血壓，44.6%有糖尿病史，體重過重者佔55.4%，缺乏運動佔68.9%，且74.3%自覺生活有壓力。(三) 冠狀動脈疾病婦女之疾病嚴重度平均得分為26.53±36.03，(四)症狀嚴重程度平均得24.78±7.90，以疲倦症狀為最常出現，且出現頻率最多，多發生於用力活動時，採停止原先活動來緩解疲倦感。(五)生活品質在生理健康層面平均得分為56.08±25.42分，心理健康層面平均得分為58.50±23.90分。(六)危險因子得分與生活品質之心理健康層面「因情緒使角色受限」呈負相關 (r＝-0.23、p＝0.04)，疾病嚴重程度與生活品質之生理健康層面「因生理功能使角色受限」呈負相關 (r＝-0.30、p＝0.01)，症狀嚴重程度與生活品質8項次概念均呈現負相關。(七) 冠狀動脈疾病婦女生活品質，不論在生理健康層面或心理健康層面，其胸痛及疲倦症狀二個變項可做為預測冠狀動脈疾病婦女生活品質重要指標。

關鍵字

危險因子 ； 疾病嚴重程度 ； 症狀嚴重程度 ； 生活品質

並列摘要

Heart disease remained the fourth rank of 10 major death caused reasons in the last decade and coronary artery disease is the most common one of those. As a result, it is very important to increase the life quality for coronary artery disease patients’ by controlling the possible pathogenic elements which can make the disease more serious. The purpose of this research is focused on sampling the coronary artery disease females, probing into the relationships between the possible pathogenic elements, how serious the disease and condition are and the life quality, and therefore finding out forecasting elements of life quality. The method of this research is cross-sectional correlative design. The purposive sampling is adopted and samples are selected from the females with coronary artery disease. Structured questionnaire with several forms is used to collect data. Percentage, mean, standard variation, Pearson Correlation, Spearman Correlation and Stepwise Regression are adopted to analyze the data. Results：(1) The average score of dangerous elements is 8±2.57 and there are at least three of them. 91.9%, which is menopause, is at the first rank. Stressful and high blood pressure are both 74.3%, which are at the second rank. The third one, which is lack of exercises, covers 73%. (2) Most of the samples are over sixty-five in age, 95.9% are non-smokers, average cholesterol is 215 mg/dl, 74.3% are high blood pressure, 44.6% are diabetes, 55.4% are over weight, 68.9% are lacking of exercises and 74.3% feel that they are under stress. (3) Average score of disease severity for females with coronary artery disease is 26.53± 36.03. (4) The average score of symptoms severity is 24.78± 7.90. Fatigue symptom is the most frequently symptom seen. It happens mostly at strong exercises and the tiredness feeling is released by terminating the strong exercise. (5) The average score of life quality in physical healthy face is 56.08 ± 25.42 and mentally healthy face is 58.50 ± 23.90. (6) The score of possible elements and the mentally healthy aspect of life quality “the role is limited because of emotion” are negative related. Disease severity and the physical healthy aspect of life quality “the role is limited by physical function” are negative related. Symptoms severity and the 8 sub-idea of the life quality are all negative related. (7) Chest pain and fatigue symptom can be used as the important index to forecast the life quality of coronary artery disease female on both physical and mentally aspect.

並列關鍵字

risk factor ； disease severity ； symptoms severity ； quality of life

參考文獻

王曼溪(2000)?住院老年人生活品質之探討?榮總護理，16(4)，409-417。

蔡仁貞(1999)?心臟病患對心臟復建工作的認知與實施需求之探討?新台北護理期刊，1 (1), 59-66。

王榮德、游正芬、鍾智文、姚開屏(2000)?二十一世紀之健康照護效性評量:生活品質量與生活品質量調整後之存活分析?台灣醫學，4 (1)， 65-67。

黃耀宗、季力康(1998)?客觀和主觀的運動能力在中等強度的運動下對於知覺身體疲勞程度及正負面情緒反應的影響?中華民國體育學會體育學報，25，239-248。

高毓秀、黃奕清 (2000)?成年人運動行為影響因素之路徑分析?護理研究，8(4)，435-445。