探討血液透析病人身體症狀困擾、睡眠品質與生活品質之相關性

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题名:	探討血液透析病人身體症狀困擾、睡眠品質與生活品質之相關性
其它题名:	Explore the correlation between physical symptoms, sleep quality and quality of life in hemodialysis patients
作者:	黃琳貴
贡献者:	劉月敏
关键词:	血液透析病人;身體症狀困擾;睡眠品質;生活品質;hemodialysis patient;physical symptom distress;sleep quality;quality of life
日期:	2021
上传时间:	2021-09-10T03:27:55Z
出版者:	經國管理暨健康學院;健康產業管理研究所
摘要:	研究背景:台灣末期腎病的發生率及盛行率均居全球之冠，末期腎臟病接受血液透析治療之健保費用的支出，為健保就醫花費之冠。漫長的治療過程中，伴隨疾病本身及治療中所產生的身體症狀困擾，進而影響血液透析病人睡眠品質及生活品質。研究目的:探討血液透析病人身體症狀困擾、睡眠品質與生活品質。研究方法:採橫斷式調查，使用結構式問卷資料收集。研究工具採用「身體症狀困擾量表」、「中文匹茲堡睡眠品質量表」、「台灣簡明版世界衛生組織生活品質問卷」。研究結果:本研究在人口學資料中，以男性、61歲以上、已婚、教育程度專科、無職業、除了本身疾病外有一種慢性病者、透析年數大於5年以上，佔最多數。血液透析病人身體症狀困擾依序前五名為睡眠困難、疲倦、便秘或腹瀉、皮膚癢、肌肉抽筋，且高達71.9%的病人有睡眠品質不佳的情形，在生活品質以四個構面依得分高低排序為：環境範疇（33.00±4.34）、生理範（22.31±4.21）、心理範疇（19.98±3.85）、社會範疇（12.37±2.71）。血液透析病人身體症狀困擾中「腸胃性症狀」、睡眠品質七大構面中「主觀睡眠品質」、「日間功能失調」都是血液透析病人生活品質重要的預測因子。研究結論與建議:研究對象的身體症狀困擾、睡眠品質與生活品質之間呈現負相關，亦身體症狀困擾越嚴重，其睡眠品質得分越高，表示睡眠品質越不佳，而血液透析病人身體症狀困擾越嚴重，其生活品質越差。建議臨床醫護人員需增加對身體症狀的相關知識，確實評估血液透析病人的身體症狀困擾，提供病人或家屬各身體症狀困擾相關衛教及緩解方式，同時也要關注睡眠品質，協助透過藥物或非藥物方式改善血液透析病人的睡眠品質，使血液透析病人能獲得更好的生活品質。 Backgrounds: Taiwan has the highest occurrence rate and prevalence of end-stage renal disease, which has contributed to the highest medical expense in public health insurance with the expenditure on hemodialysis treatment. Throughout the lengthy treatment process, the patients’ experienced physical symptom distress and the distress incurred by hemodialysis affects their quality of their sleep and life.Objective:To explore the relationship between the physical symptom distress of patients receiving hemodialysis and the quality of their sleep and life.Method:A cross-sectional study was conducted using structured questionnaires, namely the symptom distress scale, the Chinese edition of the Pittsburg Sleep Quality Index, and the Taiwan edition of the brief version of World Health Organization Quality of Life scale. Results:Of the participants, Most were male; aged 61 years or older; married; graduated from colleges; unemployed; diagnosed with one chronic disease, and had received hemodialysis for 5 years or longer. The five most common symptom distresses in the participants were sequentially sleep disorder, fatigue, constipation or diarrhea, itchy skin, and muscle cramps. Specifically, 71.9% of the participants had experienced poor sleep quality. The participants scored 33.00 ± 4.34, 22.31 ± 4.21, 19.98 ± 3.85, and 12.37 ± 2.71 in the environmental, physiological, psychological, and social aspects of quality of life, respectively. The critical predictors to the quality of these patients’ life include digestive symptoms, which constitute their symptom distress, and subjective sleep quality and daytime dysfunction, both which are included in the 7 dimensions of sleep quality.Conclusion and Suggestions: The symptom distress experienced by the participants negatively affected their quality of sleep and life. In other words, higher symptom distress causes poor quality of sleep and life. Clinical medical professionals must increase their knowledge on the physical symptoms of patients diagnosed with end-stage renal disease, thoroughly evaluate their experienced symptom distress, and provide patients and their family members with relevant health education and relieving methods for physical symptom distress. Additionally, they must pay attention to patients’ sleep quality and provide assistance in improve it through medication or nonmedication approaches, thereby enhancing the patients’ quality of the life.
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