冠壯動脈心臟病患憂鬱程度和自我照顧效能之相關研究

The Relationship of Depression and Self-Care Efficacy in Patients with Coronary Artery Disease

池汾玫(CHIH FEN MEI)

指導教授 ： 賴香如

國立臺灣師範大學/教育學院/衛生教育學系/碩士(2001年)

摘要

本研究之目的主要是在探討冠狀動脈心臟病患憂鬱程度和自我照顧效能之相關。研究採用結構式問卷訪談，以立意取樣搜集某教學醫院之住院冠狀動脈心臟病患為研究對象。於90年6月至10月間進行第一次調查，共搜集180位樣本，調查內容包括病患之背景因素、自我照顧認知、社會支持、支持滿意度、憂鬱程度和自我照顧效能。另外，於病患出院三個月後進行第二次電話調查，此時僅調查憂鬱程度和自我照顧效能問卷，共追蹤到126位。搜集之資料以描述性統計、t檢定、pair-t、卡方檢定、ANOVA及複迴歸等統計方法進行分析。
研究結果如下：
一、 研究對象整體自我照顧認知良好，社會支持程度屬中上，對支持感到相當滿意。
二、 研究對象住院時的憂鬱程度多屬正常佔83.9﹪，輕度憂鬱佔15.5﹪，中重度憂鬱則為最少佔0.6﹪；出院三個月後憂鬱程度正常者佔87.3﹪，輕度憂鬱佔9.5﹪，中重度憂鬱佔3.2﹪；且兩次調查的憂鬱程度間有顯著相關。
三、 研究對象住院時及出院三個月後的自我照顧效能均屬良好，且兩次調查之自我照顧效能有顯著相關。
四、控制背景因素及相關變項後，住院時的憂鬱程度無法預測出院三個月後的自我照顧效能；而住院時的自我照顧效能亦無法預測出院三個月後的憂鬱程度。因此，憂鬱程度與自我照顧效能間沒有顯著因果關係。
五、自覺目前活動狀況是憂鬱程度的良好預測變項；而性別、自覺疾病嚴重度、左心室射出比和目前活動狀況是自我照顧效能的良好預測變項。
根據研究結果對冠狀動脈心臟病患衛生教育介入，以及未來研究提出相關建議。

關鍵字

冠狀動脈心臟病患 ； 自我照顧認知 ； 社會支持 ； 憂鬱 ； 自我照顧效能 ； 左心室射出比

並列摘要

The purpose of this study was to investigate the relationship of depression and self-care efficacy in coronary artery disease patients . A descriptive and correlation design was adopted . Data was collected by structured questionnaires , which included a “backgrounds” , a “perception of self-care”, a “social support scale” , a “support satisfaction scale” , a “Zung’S depression scale” and a “self-care efficacy scale” . The first investigate , a total of 180 subjects who met the selection criteria , were selected from cardiovascular medical units at teaching hospital by purposive sampling from June to October , 2001. After three month discharged , 126 subjects completing follow up . Descriptive statistics, t-test, pair-t test, Chi-square test, ANOVA, and hierarchical multiple regression were used to analyze the data.
The major findings of the study were as follows:
1. The perception of self-care of subjects were well. Social support were above middle class and support satisfaction were very well.
2. 83.9﹪of subjects have normal depression mood, 15.5﹪of subjects have mild depression . 0.6﹪of subjects have mod to severe depression during hospitalized . After 3 months discharged, 87.3﹪of subjects have normal depression mood , 9.5% have mild depression . 3.2﹪have mod to severe depression .At baseline and three month follow up , the data was showed significant correlation .
3. The self-care efficacy of subjects all were well at hospital and discharge . At baseline and three month follow up , the data was showed significant correlation .
4. Controlling for backgrounds and other variances , depression and self-care efficacy are not causality.
5. The patient’s Perception of activity was the most important predictor in depression . Sex, Perception of severity, left ventricular ejection fraction, and Perception of activity were important predictor in self-care efficacy.
Recommendations for coronary artery disease patients educational interventions were made . Future studies were also suggested.

並列關鍵字

Patient with Coronary Artery Disease ； perception of self-care ； social support ； depression ； self-care efficacy ； ejection fraction