長期血液透析病患之身體功能狀況及其相關因素探討

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標題:	長期血液透析病患之身體功能狀況及其相關因素探討 Factors Associated with the physical function for Long term Hemodialysis Patients
作者:	朱麗美
貢獻者:	曾淑芬嘉南藥理科技大學：醫療資訊管理研究所
關鍵字:	長期照護身體功能血液透析 Hemodialysis Physical function Long-term care
日期:	2009
上傳時間:	2010-06-09 09:17:53 (UTC+8)
摘要:	本研究目的為對長期血液透析病患身體狀況及其相關因素之探討，血液透析患者整體上身體功能活動度是偏低的，應鼓勵血液透析患者增加身體功能活動度以降低死亡率。本研究採橫斷式研究設計(cross-sectional study design)，研究場域是台灣地區南部某地區醫院血液透析中心，研究對象是針對長期血液透析患者，進行資料收集。研究工具參考台灣腎臟醫學會採用之科氏量表(Karnofsky scale) 做為評估依據。共收集214位長期血液透析患者，平均年齡為64.35歲，已婚人數居多（86.9 %），教育程度無接受教育佔多數（52.3 %），身體質量指數（BMI）正常值18-24kg/m2居多（64%），血清鈣(Ca) 正常值8.5mg/dl-10.5 mg/dl居多（68.7%），血球比容超過30%居多（72.9%），鐵蛋白（Ferritin）正常值300~800 ng/ml居多（65.4%），運鐵蛋白飽和度百分比（TSF%）超過20%居多（82.2%），身體弁鄍肮′※妗?Karnofsky score)分數平均值為69.3分，輕度（70~80分）居多（48.1%）。研究結果發現：多元迴歸分析結果顯示，年齡、跌倒危險傾向、教育程度、經濟狀況（每月收入）、原發疾病病因，等變項，與身體弁? 狀況呈顯著相關。其中年齡、跌倒危險傾向與身體弁鄋洩p的關係呈顯著負相關，而教育程度、經濟狀況（每月收入）、原發病為非糖尿病或腎臟疾病等變項，則與身體弁鄋洩p呈顯著正相關。至於性別、家中排行、婚姻狀況、職業狀況、身體質量指數（BMI）、朋友支持、宗教支持、鈣質(Ca)、鐵蛋白(Ferritin) 血球比容（Hct）與身體弁鄋洩p則呈現無相關。影響身體弁鄋洩p的顯著預測因子為年齡、教育程度、每月收入、原發疾病病因、跌倒危險傾向，可有效解釋變異數為43%。結論：研究發現影響身體弁鄋洩p重要因子有年齡、跌倒危險傾向、教育程度、經濟狀況（每月收入）、原發疾病病因、等變項，以上結果可協助護理人員提供病患不同需求之個別護理依據，並作爲照顧血液透析病患的參考準則。 The purpose of this study factors associated with the physical function for the patients of extended hemodialysis. In generally, the physical function of hemodialysis patients may declined because of the long period renal medical treatment, so that should be encouraged to increase physical activity to reduce their mortality rate. This study design was cross-sectionally. The study subjects were from a hemopdialysis clinic in Southern Taiwan , all of this clinic’s patients were recruited in the research. Data were collected from the patients’medical records of the clinic.. The Karnofsky performance scale(KPS) was the measurements tools of physical function in this study. The study was composed of 214 patients . Samples mean age was 64.35 years . There were over half of the married (86.9%) and without access to education (52.3%) were majority. The body mass index (BMI) of the normal range (18-24kg/m2) were 64%, serum calcium (Ca) of normal range 8.5mg/dl-10.5 mg / dl were 68.7%, hematocrit (Hct) more than 30% were majority (72.9%), ferritin (Ferritin) normal range 300 ~ 800 ng / ml were 65.4%, and the transferrin saturation percentage (TSF%) more than 20% were higher than eighty percent (82.2%). The average score of physical function were 69.3 which means the majority of sample’s dialy activity status were not bad. The results of multiple regression analysis showed the variable of age, fall risk conditions, education status，economic conditions (income for monthly), the primary disease cause of hemodialysis, and hematocrit (Hct) were related with rhe pfisical function significantly. By the way, the physical function was negative relationship with the age and fall risk conditions, That is the physical function not only decline with ageing process but also related with the highly fall risk of elder. Meanwhile, the study results showed that the higher education status, economic conditions (income for monthly), and hematocrit (Hct), the physical function was better. It was probably related with the more healthy life style in highly social economic status peoples .Finally, The results of this study can become a important reference to taking care of hemodialysis patients for the clinical staffs and nurse, and to prevent the hemodyalisis patient early get into the long-term care stage.
關聯:	校內外均一年後公開，學年度：97， 80 頁
顯示於類別:	[醫務管理系(所)] 博碩士論文

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