知識、態度、自我照顧行為和疾病嚴重度對氣喘病人生活品質的解釋模式－以參加氣喘疾病管理計畫之病人為例

Building Explanatory Model of asthma-specific Quality of Life an Analysis of Patients Enrolled in an Asthma Disease Management Program

10.6288/TJPH2006-25-02-05

羅中廷(Chung-Ting Lo)；翁慧卿(Hui-Ching Weng)

氣喘 ； 疾病管理計畫 ； 疾病相關生活品質 ； 結構方程式 ； Asthma ； Disease management program ； Disease-related quality of life ； Structural equation modeling

台灣公共衛生雜誌

25卷2期（2006 / 04 / 01）

125 - 134

繁體中文

目標：本研究旨在建立影響氣喘病患生活品質的解釋模式，並且檢驗該模式是否同時適用於小孩與成人。方法：研究對象為參加健保局氣喘疾病管理計畫的小孩與成人；有效問卷共669份，回收率29.4%，資料以LISREL 8.30版進行模式分析。結果：模式在小孩樣本(x^2/df=63.8/49, p=0.076, RMSEA=0.037)及成人樣本(x^2/df=78.9/60, p=0.052, RMSEA=0.026)均得到支持。分析結果顯示態度與自陳式氣喘嚴重度對生活品質有直接效果，而氣喘知識與態度會透過自我照護行為與嚴重度對生活品質產生間接且正向的效果。結論：氣喘知識乃是藉由影響其他因素子，而產生對生活品質的間接影響；主要的影響因素包括態度，自我照顧行為，以及疾病嚴重度。無論是小孩或是成人，在進行氣喘疾病管理介入時，應重視病患對疾病的態度，以及自我照顧行為的指導與敦促，以期提高生活品質。

Objectives: The aim of this study was to build an explanatory model in the quality of life (QOL) for patients with asthma by examining children and adults samples. Methods: The Study subjects were adults and children who participated in the asthma disease management program conducted by the Bureau of National Health Insurance (BNHI) of Taiwan. The total sample size was 669 with a response rate of 29.4%. We used structural equation modeling to examine the models by LISREL 8.30. Results: Both the children (x^2/df=63.8/49, p=0.076, RMSEA=0.037) and the adults (x^2/df=78.9/60, p=0.052, RMSEA=0.026) models were supported. Results indicated that both attitude and self-reported severity of illness had direct effects on QOL of asthmatics. Both knowledge and attitude had positive and indirect effects on QOL via self-care behavior and severity of illness. Conclusions: Asthma knowledge might affect QOL of asthma patients through the mediation from attitude, self-care behavior, and severity of asthma. We suggest that for both children and adults we should focus especially on building up a positive attitude, guiding and promoting of self-care behavior with the aim of improving patients' QOL during the intervention of asthma disease management program.

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