- 期刊
血液透析病人透析效率、焦慮及生活品質之相關因素探討
Association Between Depression, Anxiety, and Quality of Life in Patients on Hemodialysis: A Cross-Sectional Study
摘要
本研究旨在探討血液透析病人的透析效率、焦慮與生活品質之間的相關性，並分析影響生活品質的主要因素，研究方法為橫斷式研究設計，採方便取樣以北部醫療院所接受血液透析3個月以上的病人為研究對象，招募期間自2019年7月1日至2023年9月30日，使用醫院焦慮憂鬱量表及腎臟疾病生活品質問卷測量病人焦慮症狀、憂鬱症狀與生活品質，總收案104位，平均年齡為61.67歲（SD=12.92），合併症指數平均為5.63分（SD=1.87），血清白蛋白平均為3.98gm/dL（SD=0.32），血液透析效率平均為1.33（SD=0.20），焦慮症狀平均得分4.54分（SD=1.64），生活品質量表總平均得分為57.19分（SD=0.95），五個範疇中腎臟疾病引起的症狀／問題範疇表現最佳，平均得分為79.77分（SD=8.69），而腎臟疾病引起的負擔範疇得分最低，平均為34.46分（SD=21.83），相關性分析顯示靜態身體活動量、焦慮症狀為生活品質之相關因素，進一步以多元迴歸分析得知生活品質的相關變項為血液透析效率（spKt/V）（p< .010）及焦慮症狀（p< .001），這兩個變項達統計上顯著差異（p< .001），可解釋28.0%的變異量。本研究發現高血液透析效率、低焦慮症狀及增加身體活動量為血液透析病人提升生活品質的重要相關因子，未來照護可鼓勵加入病友團體，建立社會支持網絡，讓病人獲得所需之支持及資源，使其能在日常生活中落實自我照護，提升生活品質。
並列摘要
This cross-sectional study explored the correlation between dialysis efficiency, anxiety, and quality of life in patients on hemodialysis and explored the main factors affecting quality of life. Convenience sampling was used to recruit patients who have been receiving hemodialysis for more than 3 months at medical facilities in northern Taiwan from July 1, 2019, to September 30, 2023. The Hospital Anxiety and Depression Scale and the Kidney Disease Quality of Life Questionnaire were used to evaluate patients' anxiety, depression, and quality of life. A total of 104 patients were included for analysis, with an average age of 61.67 years (standard deviation [SD] = 12.92). The mean comorbidity index was 5.63 (SD = 1.87), the average efficiency of blood dialysis was 1.33 (SD = 0.20), the mean anxiety score was 4.54 (SD = 1.64), and the total average score for quality of life was 57.19 (SD = 0.95). Among a total of five categories, the highest score was obtained for the symptoms/problems of kidney disease category, with an average score of 79.77 (SD = 8.69). By contrast, the lowest score was obtained for the burden of kidney disease category, with an average score of 34.46 (SD = 21.83). Correlation analysis revealed that physical activity levels and anxiety symptoms affected quality of life. In addition, multiple regression analysis revealed that dialysis efficiency (spKt/V, p < .01) and anxiety symptoms (p < .001) were predictive factors of quality of life, explaining 28.0% of the total variance (p < .001). In conclusion, high dialysis efficiency for blood urea nitrogen, decreased anxiety symptoms, and increased physical activity are key predictive factors of quality of life. Strategies incorporating these factors can improve quality of life in patients on hemodialysis. Patient participation in support groups should be encouraged to establish social support networks. These networks can enable patients to receive necessary support and resources to implement self-care in daily life, thereby enhancing care quality and improving quality of life.