探討血液透析病患社會支持、自我照顧行為、生活品質現況及其影響因素

Factors Associated with Social Support, Self-care Behavior, and the Quality of Life among Hemodialysis Patients

10.6540/NTJN.202003_22(1).0004

陳沛其(Pei-Chi Chen)；盧國城(Kuo-Cheng Lu)；李碧霞(Pi-Hsia Lee)；苗迺芳(Nae-Fang Miao)

血液透析 ； 社會支持 ； 自我照顧行為 ； 生活品質 ； hemodialysis ； social support ； self-care behavior ； quality of life

新臺北護理期刊

22卷1期（2020 / 03 / 01）

33 - 46

繁體中文

本研究旨在了解血液透析病患之社會支持、自我照顧行為、生活品質現況及其影響因素，研究對象為新北市某區域醫院血液透析中心144位血液透析病患；採橫斷式研究設計，以結構式問卷收集資料，包括：個人背景資料、社會支持量表、自我照顧行為量表及生活品質量表，並以描述性分析、t檢定、單因子變異分析、薛費氏事後比較、皮爾森積差相關及複迴歸進行資料分析。研究結果發現，研究對象的社會支持得分，醫護人員高於家人親友，自我照顧行為得分最高的是藥物使用、最低的是日常生活照護，生活品質以環境範疇得分最高、心理範疇得分最低；研究對象的生活品質會因為工作狀況及經濟狀況的不同而有顯著差異。研究對象的社會支持、自我照顧行為與其生活品質之間呈現顯著正相關（r=.176～.391, p＜.01），亦即社會支持越多、自我照顧行為越好其生活品質越好。研究對象的工作狀況、經濟狀況、自覺復原時間、社會支持及自我照顧行為等變項為生活品質的預測因子，可解釋生活品質總變異量的26.9%，其中以自我照顧行為（p＜.01）解釋力最強。建議定期評估和追蹤病患的自我照顧行為，適時衛教正確的自我照顧方式，以加強血液透析病患社會支持及自我照顧行為，來提升其生活品質。

The purposes of this study were to understand social support, self-care behavior, and the quality of life among hemodialysis patients, and furthermore to explore relevant factors affecting their quality of life. 144 Hemodialysis patients were recruited at the hemodialysis center of a hospital in a certain area of New Taipei City. This study used cross-sectional design and structured questionnaire, including demographic characteristics, social support scale, self-care behavior scale, and the quality of life scale. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Scheffe's posteriori, Pearson's correlation and Stepwise regression. The finding of present study indicated social support from medical staff higher than that from their family and relatives. Self-care behavior regarding medicine use received the highest score and daily life care was reported the lowest. Environmental domain ranked the highest and the mental domain received the lowest average score in quality of life. The education level, marital status and number of households were associated with social support significantly. The gender and whether to use self-funded drugs were associated with self-care behavior significantly. The work status and economic status were associated with the quality of life significantly. The social support, self-care behavior and quality of life of the subjects all showed a positive correlation (r=.176-.391, p＜ .01), meaning that the more social support they acquired, the better self-care behavior they performed and the higher quality of life they enjoyed. The subjects' job status, economic conditions, self-rated recovery time, social support, and self-care behavior were variables that serve as the predictors of quality of life, which could explain 26.9% of the total variance of quality of life, among which self-care (p＜ .01) had the strongest explanation. In accordance with the study results, we suggested that patients' self-care behavior should be evaluated and tracked and that hemodialysis patients should receive appropriate health education about the proper ways of self-care. Improving in-service education of quality of life among hemodialysis patient for health care professionals, hosting study sessions and case study seminars, as well as sharing insights into the problems of hemodialysis patient care contribute to enhancing the quality of patient care.

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