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  • 學位論文

慢性腎臟病患的自我效能、自我管理與生活品質之探討

Self-efficacy, self-management, and the quality of life for patients with chronic kidney disease.

指導教授 : 張鳳琴 呂昌明 吳淑芳
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摘要


本研究目的在探討某醫學中心慢性腎臟病患的自我效能、自我管理與生活品質之現況與相關性。收案期間自民國100年2月至101年3月,研究對象為由醫師確定診斷為慢性腎臟病,未進行腎臟替代療法,共收集120份有效問卷。根據本研究目的、問題與研究結果與討論,提出下列幾項結論: 一、 受試腎臟病患者的自我效能屬中上程度,以「藥物治療」層面得分最高,最低分為「運動」層面。 二、 受試腎臟病患者的自我管理也屬中上程度,以「遵醫囑」層面得分最高,最低分「自我照顧」。 三、 受試腎臟病患者對生活品質現況屬中上程度,受試對象的SF-36生活品質中以「社交功能」得分最高,最低的為「一般健康狀況」的部分;在腎臟病生活品質中以「社會互動品質」得分最高,最低分為「病人健康滿意度」的部分。 四、 受試腎臟病患者月收入2萬以上其自我效能程度較月收入2萬以下者佳。 五、 受試腎臟病患者自我效能越佳,其自我管理程度較好;教育程度高中以上者其自我管理程度較國中以下者好;同時有高血壓合併症者其自我管理程度較沒有高血壓合併症者好。 六、 受試腎臟病患者的SF-36生活品質與腎臟病生活品質呈現顯著相關。 七、 受試腎臟病患者的生活品質在不同社會人口學變項、自我效能、自我管理皆呈現無顯著差異,然這些變項對生活品質部分次向度有顯著差異。 依本研究結果,建議進行慢性腎臟病患的自我管理介入教育時,要同時強化其自我效能;對於教育程度較低、無高血壓合併症者的患者更要協助其做好自我管理。

並列摘要


The purpose of this study was to investigate the self-efficacy, self-management and quality of life among patients with chronic kidney disease. The questionnaires were collected from February, 2011 to March, 2012. A nephrologist diagnosed these patients as having chronic kidney disease. There were a total of 120 valid questionnaires obtained. The main results were as follows. 1. The participants reported a middle level of self-efficacy. The highest score was the "medication" component, while the lowest score was the "excercise" component. 2. The participants reported a middle level of self-efficacy. The highest score was the "medication adherence" component, while the lowest score was the "self-care" component. 3. The participants reported a middle level of quality of life. The highest score was the "social function” component, while the lowest score was the "general health" component. 4. The participants with a monthly income of more than twenty thousand dollars had better self-efficacy. 5. Self-efficacy was significantly associated with self-management. The patients with an education level above senior high school and hypertension had better self-management. 6. The participants’ SF-36 quality of life was significantly associated with their quality of life with chronic kidney disease. 7. The paticipants’ demographic characteristics, self-efficacy, and self-management were not significantly associated with quality of life. However, there was a significant difference between demographic characteristics, self-efficacy, and self-management with the sub-component of quality of life. It is suggested that care-givers enhance participants’ self-efficacy and self-management.

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畫:流行病學研究及危險因子監測計畫(國科會專題研究計畫成

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