题名

血液透析病人規律運動行為及預測因子之探討

并列篇名

Exploring Regular Exercise Behavior and Its Predictors in Hemodialysis Patients

DOI

10.6224/JN.63.1.78

作者

席美玲(Mei-Ling Hsi);沈永芳(Yung-Fang Shen);陳意超(Yi-Chao Chen);韓湘芳(Hsiang-Fan Han);鍾玉珠(Yu-Chu Chung)

关键词

血液透析 ; 規律運動 ; 憂鬱 ; 自我效能 ; hemodialysis ; regular exercise ; depression ; self-efficacy

期刊名称

護理雜誌

卷期/出版年月

63卷1期(2016 / 02 / 01)

页次

78 - 86

内容语文

繁體中文

中文摘要

背景 血液透析病人因身體功能的限制,會影響身體活動、心理健康、健康有關之生活品質及預後差。目的 本研究旨在探討血液透析病人之規律運動行為及預測因子。方法採用橫斷式描述相關性研究設計,以方便取樣選取一所地區教學醫院血液透析中心,共計122人參與本研究。結果 研究結果顯示,只有29人(23.8%)從事規律運動,目前有規律運動者,其六分鐘走路距離及運動自我效能顯著高於無規律運動者,以及憂鬱和疲憊狀態也顯著低於未規律運動者。以邏輯式迴歸分析發現,憂鬱及運動自我效能二個變項能有效預測長期血液透析病人規律運動行為,其勝算比分別為0.93及1.45。結論/實務應用 本研究發現血液透析病人能從事規律運動,其重要預測因子為低憂鬱狀態及高運動自我效能。本研究結果可提供醫護人員研擬推行長期血液透析病人規律運動與相關研究之參酌。

英文摘要

Background: Hemodialysis dialysis patients are restricted in their physical functions. These restrictions affect physical activity, psychological status, health-related quality of life, and medical prognoses. Purpose: The purpose of this study was to explore regular exercise behavior and its predictors in hemodialysis patients. Methods: A cross-sectional, descriptive, correlational study design was used, and 122 subjects were recruited. Convenience sampling was conducted at an outpatient hemodialysis center of a regional teaching hospital in northern Taiwan. Results: The results showed that only 23.8% of the participants engaged in regular exercise. There were statistically significant differences between the regular-exercise group and the no-regular-exercise group in terms of the 6-minute walk distance, exercise self-efficacy, fatigue, and depression. A logistic regression analysis indicated that depression (odds ratio = 0.93) and exercise self-efficacy (odds ratio = 1.45) were the significant predictors of regular exercise behavior for hemodialysis patients. Conclusions / Implications for Practice: The present study demonstrated that low depression and high exercise self-efficacy were predictors of regular exercise behavior. The findings provide healthcare professionals with information that may be used to develop interventions that target the effective improvement of patient exercise habits.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. 朱麗美、郭姵伶、曾淑芬(2011)。長期血液透析患者之身體功能狀況及其相關因素探討—以南部某地區醫院為例。嘉南學報,37,388-402。
    連結:
  2. 曾旭民、盧瑞芬、蔡益堅(2003)。國人生活品質評量(II):SF-36台灣版的常模與效度檢測。台灣公共衛生雜誌,22(6),512-518。
    連結:
  3. 國民健康署(2013,8月30日).成人健康體位標準.取自http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?id=201308300012&parentid=201109290001 [Health Promotion Administration, Taiwan, ROC. (2013, August 30). Body mass index (BMI) standards for adults. Retrieved from http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?id=201308300012&parentid=201109290001]
  4. 中央健康保險署(2013,7月).101 年門診透析總額專業醫療服務品質報告.台北市:作者。[National Health Insurance Administration, Taiwan, ROC. (2013, July). The dialytic cost and quality indicators of professional medical service, 2012. Taipei City, Taiwan, ROC: Author.]
  5. Annesi, J. J.(2011).Self-regulatory skills usage strengthens the relations of self-efficacy for improved eating, exercise, and weight in the severely obese: Toward an explanatory model.Behavioral Medicine,37(3),71-76.
  6. Bai, Y. L.,Lai, L. Y.,Lee, B. O.,Chang, Y. Y.,Chiou, C. P.(2015).The impact of depression on fatigue in patients with hemodialysis: A correlational study.Journal of Clinical Nursing,24(13-14),2014-2022.
  7. Bandura, A.(1977).Self-efficacy: Toward a unifying theory of behavior change.Psychological Review,84(2),191-215.
  8. Beck, A. T.、Steer, R. A.、Brown, G. K.、陳心怡譯(2000)。貝克憂鬱量表第二版(BDI-II)中文版。台北市=Taipei City, Taiwan, ROC:中國行為科學社=Chinese Behavioral Science。
  9. Biniaz, V.,Tayybi, A.,Nemati, E.,Shermeh, M. S.,Ebadi, A.(2013).Different aspects of fatigue experienced by patients receiving maintenance dialysis in hemodialysis units.Nephro-Urology Monthly,5(4),897-900.
  10. Bohm, C.,Stewart, K.,Onyskie-Marcus, J.,Esliger, D.,Kriellaars, D.,Rigatto, C.(2014).Effects of intradialytic cycling compared with pedometry on physical function in chronic outpatient hemodialysis: A prospective randomized trial.Nephrology Dialysis Transplantation,29(10),1947-1955.
  11. Bossola, M.,Luciani, G.,Giungi, S.,Tazza, L.(2010).Anorexia, fatigue, and plasma interleukin-6 levels in chronic hemodialysis patients.Renal Failure,32(9),1049-1054.
  12. Cohen, S. D.,Norris, L.,Acquaviva, K.,Peterson, R. A.,Kimmel, P. L.(2007).Screening, diagnosis, and treatment of depression in patients with end-stage renal disease.Clinical Journal of the American Society of Nephrology,2(6),1332-1342.
  13. Curtin, R. B.,Bultman, D. C.,Thomas-Hawkins, C.,Walters, B. A. J.,Schatell, D.(2002).Hemodialysis patients' symptom experiences: Effects on physical and mental functioning.Nephrology Nursing Journal,29(6),562-574.
  14. Curtin, R. B.,Mapes, D. L.,Petillo, M.,Oberley, E.(2002).Long-term dialysis survivors: A transformational experience.Qualitative Health Research,12(5),609-624.
  15. De Moura Reboredo, M.,Henrique, D. M. N.,De Souza Faria, R.,Chaoubah, A.,Baston, M. G.,De Paula, R. B.(2010).Exercise training during hemodialysis reduces blood pressure and increases physical functioning and quality of life.Artificial Organs,34(7),586-593.
  16. Goodman, E. D.,Ballou, M. B.(2004).Perceived barriers and motivators to exercise in hemodialysis patients.Nephrology Nursing Journal,31(1),23-29.
  17. Greenwood, S. A.,Lindup, H.,Taylor, K.,Koufaki, P.,Rush, R.,Macdougall, I. C.,Mercer, T. H.(2012).Evaluation of a pragmatic exercise rehabilitation programme in chronic kidney disease.Nephrology Dialysis Transplantation,27(3, Suppl.),iii126-iii134.
  18. Heiwe, S.,Jacobson, S. H.(2011).Exercise training for adults with chronic kidney disease.Cochrane Database Systemic Review,10,CD003236.
  19. Horigan, A. E.,Schneider, S. M.,Docherty, S.,Barroso, J.(2013).The experience and self-management of fatigue in patients on hemodialysis.Nephrology Nursing Journal,40(2),113-122.
  20. Ingle, L.,Cleland, J. G.,Clark, A. L.(2014).The longterm prognostic significance of 6-minute walk test distance in patients with chronic heart failure.BioMed Research International,2014,505969.
  21. Johansen, K. L.(2007).Exercise in the end-stage renal disease population.Journal of the American Society of Nephrology,18(6),1845-1854.
  22. Keskin, G.,Engin, E.(2011).The evaluation of depression, suicidal ideation and coping strategies in hemodialysis patients with renal failure.Journal of Clinical Nursing,20(19-20),2721-2732.
  23. Knight, E. L.,Ofsthun, N.,Teng, M.,Lazarus, J. M.,Curhan, G. C.(2003).The association between mental health, physical function, and hemodialysis mortality.Kidney International,63(5),1843-1851.
  24. Koh, K. P.,Fassett, R. G.,Sharman, J. E.,Coombes, J. S.,Williams, A. D.(2010).Effect of intradialytic versus home-based aerobic exercise training on physical function and vascular parameters in hemodialysis patients: A randomized pilot study.American Journal of Kidney Diseases,55(1),88-99.
  25. Kosmadakis, G. C.,Bevington, A.,Smith, A. C.,Clapp, E. L.,Viana, J. L.,Bishop, N. C.,Feehally, J.(2010).Physical exercise in patients with severe kidney disease.Nephron Clinical Practice,115(1),c7-c16.
  26. Kouidi, E.,Karagiannis, V.,Grekas, D.,Iakovides, A.,Kaprinis, G.,Tourkantonis, A.,Deligiannis, A.(2010).Depression, heart rate variability, and exercise training in dialysis patients.European Journal of Cardiovascular Prevention & Rehabilitation,17(2),160-167.
  27. Letchmi, S.,Das, S.,Halim, H.,Zakariah, F. A.,Hassan, H.,Mat, S.,Packiavathy, R.(2011).Fatigue experience by patients receiving maintenance dialysis in hemodialysis units.Nursing and Health Sciences,13(1),60-64.
  28. Li, M.,Li, L.,Fan, X.(2010).Patients having hemodialysis: Physical activity and associated factors.Journal of Advanced Nursing,66(6),1338-1345.
  29. Mapes, D. L.,Lopes, A. A.,Satayathum, S.,McCullough, K. P.,Goodkin, D. A.,Locatelli, F.,Pork, F. K.(2003).Health-related quality of life as a predictor of mortality and hospitalization: The Dialysis Outcomes and Practice Patterns Study (DOPPS).Kidney International,64(1),339-349.
  30. Nabolsi, M. M.,Wardam, L.,Al-Halabi, J. O.(2015).Quality of life, depression, adherence to treatment and illness perception of patients on haemodialysis.International Journal of Nursing Practice,21(1),1-10.
  31. Parker, K.,Zhang, X.,Lewin, A.,MacRae, J. M.(2015).The association between intradialytic exercise and hospital usage among hemodialysis patients.Applied Physiology, Nutrition and Metabolism,40(4),371-378.
  32. Peng, Y. S.,Huang, J. W.,Hung, K. Y.,Lin, B. S.,Lin, C. Y.,Yang, C. S.,Chen, W. Y.(2013).Women on hemodialysis have lower self-reported health-related quality of life scores but better survival than men.Journal of Nephrology,26(2),366-374.
  33. Rodgers, W. M.,Murray, T. C.,Selzler, A. M.,Norman, P.(2013).Development and impact of exercise self-efficacy types during and after cardiac rehabilitation.Rehabilitation Psychology,58(2),178-184.
  34. Sawant, A.,House, A. A.,Overend, T. J.(2014).Anabolic effect of exercise training in people with end-stage renal disease on hemodialysis: A systematic review with meta-analysis.Physiotherapy Canada,66(1),44-53.
  35. Sietsema, K. E.,Amato, A.,Adler, S. G.,Breass, E. P.(2004).Exercise capacity as a predictor of survival among ambulatory patients with end-stage renal disease.Kidney International,65(2),719-724.
  36. Smart, N.,Steele, M.(2011).Exercise training in hemodialysis patients: A systematic review and meta-analysis.Nephrology,16(7),626-632.
  37. Ugurlu, N.,Bastug, D.,Cevirme, A.,Uysal, D. D.(2012).Determining quality of life, depression and anxiety levels of hemodialysis patients.HealthMed Journal,6(8),2860-2869.
  38. Umpierre, D.,Ribeiro, P. A. B.,Kramer, C. K.,Leitão, C. B.,Zucatti, A. T. N.,Azevedo, M. J.,Schaan, B. D.(2011).Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: A systematic review and meta-analysis.JAMA: The Journal of the American Medical Association,305(17),1790-1799.
  39. Wu, A. W.,Fink, N. E.,Cagney, K. A.,Bass, E. B.,Rubin, H. R.,Meyer, K. B.,Powe, N. R.(2001).Developing a health-related quality-of-life measure for end-stage renal disease: The CHOICE Health Experience Questionnaire.American Journal of Kidney Diseases,37(1),11-21.
  40. Zhang, M.,Kim, J. C.,Li, Y.,Shapiro, B. B.,Porszasz, J.,Bross, R.,Kopple, J. D.(2014).Relation between anxiety, depression, and physical activity and performance in maintenance hemodialysis patients.Journal of Renal Nutrition,24(4),252-260.
  41. 李偵碧、黃彩薇、吳麗芬、陳夏蓮(2013)。長期血液透析病患健康生活品質相關因素之探討。護理暨健康照護研究,9(3),173-181。
  42. 林岱樺(2003)。台中市=Taichung City, Taiwan, ROC.,中山醫學大學醫學研究所=Chung Shan Medical University。
  43. 邱郁耘、林淑緩、張淑琴、李玲玲(2015)。社區老年人運動持續性之影響因素。護理暨健康照護研究,11(1),43-52。
  44. 陳乃榕、方文熙(2013)。血液透析患者休閒與體能活動參與之初探。臺灣腎臟護理學會雜誌,12(4),9-24。
被引用次数
  1. 戴培惠,蔡美玲(2021)。一位血液透析病人不遵從透析醫囑之護理經驗。若瑟醫護雜誌,15(1),70-82。
  2. 梁家榕,邱雅鈴,林仲祺(2023)。提升一位老年患者初接受血液透析自我照顧能力之護理經驗。臺灣腎臟護理學會雜誌,22(1),28-41。
  3. 劉紋妙,張世沛,汪碧雲,吳宏蘭(2020)。末期腎臟病前期患者之復原力及其相關因素探討。臺灣腎臟護理學會雜誌,19(1),1-19。
  4. 葉美玲、黃馨頤、王美華(2018)。下肢運動與呼吸調節改善血液透析病人負向情緒之成效。榮總護理,35(2),126-135。