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  • 學位論文

血液透析患者生命意義、死亡態度與生活滿意之相關性探討

Exploration of the Relationships among Life Meaning, Death Attitude and Life Satisfaction of Patients with Hemodialysis.

指導教授 : 徐尚為
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摘要


本研究為一橫斷式調查,以立意取樣針對苗栗縣、台中縣市、彰化市之血液透析患者進行研究,旨在探討其生命意義、死亡態度與生活滿意之現況及其關係,有效樣本為148份。採結構式問卷為基本資料表、生命意義量表、死亡態度量表、失能生活滿意量表、身體症狀困擾量表、社會支持量表進行資料收集。所測得之資料以SPSS 12.0進行描述性統計、獨立樣本t檢定、單因子變異數分析和皮爾森相關分析。主要研究發現: 一、生命意義感方面:血液透析患者的生命意義感普遍偏低,代表著其身心處於不健康狀態,可能有存在空虛之傾向;研究結果以子孫成就層面得分最高,其次為整體生命意義、個人價值層面得分最低;血液透析患者的所有背景變項在生命意義各層面皆無顯著差異。二、死亡態度方面:血液透析患者的中性接受傾向最高,逃離接受得分次高,趨近接受得分居中,死亡逃避得分較低,而死亡恐懼得分最低;血液透析患者的所有背景變項在死亡態度各層面都無顯著差異。三、生活滿意度方面:血液透析患者對生活的現況介於普通至高之間的滿意,以社會關係層面最好,其次為心理層面、居末為生理層面。就不同背景變項,僅有無子女之變項與生活滿意度之心理層面有顯著差異。 四、在相關方面:整體生命意義及其分層面之個人價值、子孫成就與死亡態度之死亡恐懼、逃離接受層面呈負相關;整體生命意義及其分層面之個人價值、子孫成就與整體生活滿意及其分層面之生理、心理、社會關係呈正相關;整體生活滿意、生理層面、心理層面、社會關係層面與死亡態度之死亡恐懼呈負相關;生活滿意之生理層面、社會關係層面與死亡態度之中性接受呈正相關;整體生活滿意與死亡態度之逃離接受呈負相關。五、身體症狀困擾方面:血液透析患者的症狀困擾情形介於輕微至中度之間。困擾項目為尿量減少得分最高,其次是疲倦、口乾、皮膚癢、失眠。六、社會支持方面:血液透析患者的社會支持情形介於中上程度。研究結果依序為情感性、訊息性、尊重、社會化及實質性支持。就社會支持來源而言,家人仍為主要的社會支持來源及對象,其次為醫護人員;其中,家人在情感性、實質性、社會化、訊息性、尊重等五個支持功能層面得分均高於其他三種支持來源,而腎友是居於四個支持來源中的最低分。 最後,根據研究發現作為血液透析患者的生命輔導與諮商以及未來相關研究之參考。

並列摘要


This is a cross-sectional study including 148 patients selected from Miaoli , Taichung and Changhua areas by purposively sampling. The purpose of this study was to investigate the relationships among life meaning , death attitude and life satisfaction of hemodialysis patients. The questionnaires included basic information, life meaning scale , attitudes toward death scale , life satisfaction scale , social support scale and symptom distress scale as tools. Data was analyzed by SPSS 12.0. Independent samples t test , ANOVA and Person correlation were used to test the relationship among life meaning, death attitude and life satisfaction of hemodialysis patients. The results were as follows: 1.life meaning: The average score of life meaning among the study samples was low. It represented the patients’ physical and psychological status were unhealthy. It might have the tendency toward the existence of empty.The aspects of the meaning of life belong to the lower degree. (1)the coming generations’ accomplishments , (2)the whole meaning of life , (3)the value of oneself. The hemodialysis patients’s meaning of life was not significant to gender , marital status , age , number of years in hemodialysis , education , physical condition , and religion , etc.2.death attitude: The research found that among the attitudes toward death that hemodialysis patients , Neutral Acceptance and Escape Acceptance are higher , Approach Acceptance is mediocre , Death Avoidance is lower , and Fear of Death is the lowest. The hemodialysis patients’s attitudes toward death were no significant differences on gender , marital status , having children or not , age , number of years in hemodialysis , education , physical condition , and religion , etc.3.life satisfaction: The satisfaction of life belongs to the upper-middle degree. (1)social relation , (2)mental health , (3)physical health. There are remarkable differences in the mental health level of childlessness or not.4. The correlation between the meaning of life and the attitude toward death. The research shows the whole meaning of life , the value of oneself and the coming generations’ accomplishments , the fear of death and Escape Acceptance are negative correlation. The correlation between the satisfaction of life and the meaning of life. The research shows the satisfaction of life , physiology health , mental health and social relation are positive correlation to the whole meaning of life , the value of oneself and the coming generations’ accomplishments. The research shows the satisfaction of life , physiology health , mental health and social relation are negative correlation to the fear of death. The research shows the satisfaction of life , physiology health and social relation are positive correlation to the Neutral Acceptance. The research shows the satisfaction of life are negative correlation to the Escape Acceptance.5.symptom distress: The distress of symptom belongs to the lower-middle degree. The most symptom distress in hemodialysis patients were urination change , fatigue , dry mouth , skin itching and insomnia.6.Social support: The distress of Social support belongs to the upper-middle degree. (1)Emotional support , (2)Information support , (3)Appraisal support , (4)Friendship support , (5)Instrumental support or Tangible support. In major social support by their family, than and medical providers. There are Emotional support , Information support , Appraisal support , Friendship support , Instrumental support or Tangible support of their family are higher and friends of hemodialysis patients are low. Based on the findings, this research offers a reference for hemodialysis patients of psychological counseling , and related institutions were provided for future researches.

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被引用紀錄


林庭如(2015)。糖尿病腎病變中年洗腎病患之生活經驗〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833%2fCJCU.2015.00116

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