近年來慢性腎臟病(Chronic Kidney Disease, CKD)逐漸被重視,國內外研究顯示CKD病患體能活力較不佳且精神健康較差。然而CKD病患的體能活力與精神健康兩者的相關聯目前仍尚待釐清。本研究主要目的為探討CKD病患體適能與精神健康狀況及其相關性。 本研究採橫斷面的對照研究設計(cross-sectional case control design),收案對象包括晚期的CKD 3b-5期個案組131人及對照組67人,受試者進行體適能評估,包括兩分鐘原地踏步、手部抓握肌力、30秒連續坐椅站立及身體組成分析等;精神健康評估則使用華人健康量表(Chinese Health Questionnaire, CHQ)。比較兩組間體適能與精神健康評估的差異及相關性。 研究結果顯示,CKD病患的體適能表現,在心肺適能項目-二分鐘原地踏步,個案組101.4 ± 19.7次比對照組115.3 ± 31.8次差(p<0.01);精神健康評估CHQ≧3分個案組21位(16%),對照組3位(4.5%),顯示個案組精神健康狀況較差(p=0.018);個案組在體適能兩分鐘原地踏步項目中CHQ≧3分為93.8 ± 24.1次低於CHQ≦2分為102.8 ± 18.4次 (p=0.05);兩組在手部抓握肌力及30秒連續坐椅站立則無顯著差異,而CKD第5期的手部抓握肌力比對照組及CKD第4期差(p=0.044),個案組手部抓握肌力與身體質量指數(r=0.272)、身體精瘦質量(r=0.309)及血清白蛋白(r=0.181)成正相關,30秒連續坐椅站立與血比容(r=0.246)及血清磷離子(r=0.189)成正相關。 本研究結果指出,CKD病患的兩分鐘原地踏步的體適能表現及精神健康狀況均較對照組差,而合併精神健康評估狀況較差的CKD病患在心肺適能的表現亦較差。 本研究建議臨床照護者應能注意到CKD病患的體適能與精神健康狀況,並了解兩者相關性。將會有助於提供適當維持身體功能的計畫,以達到較好的全人照護狀態。
Introduction: Chronic Kidney Disease (CKD) is a global public health issue. Accumulating evidence shows patient with CKD has worse physical activity and mental health. However, there is still inadequate data from Taiwan. Hence, this study aimed to evaluate physical fitness and mental health of patients with CKD in Taiwan. Methods: This study adopted a cross-sectional design. One hundred and thirty-one patients with CKD stages 3b-5 and 67 healthy comparisons were enrolled from February to September 2013. Physical fitness were represented with (1) cardiopulmonary fitness: 2 minutes step test (2) upper limb muscle endurance: grip endurance (3) lower extremity muscle endurance: 30 seconds chair standing test. Body composition was measured using Body-Composition-Monitor (BCM).Mental health was evaluated using Chinese health questionnaire (CHQ). Results: CKD subjects had poor performance in 2 minutes step test and higher score of CHQ than the comparisons (101.4 ± 19.7 vs. 115.3 ± 31.8; p<0.01).There was no significant difference of activity of grip endurance and 30 seconds chair standing test between these two groups. Additionally, CKD subjects with higher CHQ scores had worse performance of 2 minutes step test than the counterparts (CHQ≦2 102.8 ± 18.4 vs.CHQ≧3 93.8 ± 24.1; p=0.05). Conclusions: Our results indicated that patients with CKD had lower activity of physical fitness than the comparisons. More attention should be paid on physical fittness and mental health to prevent adverse outcome in CKD.
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