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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 張媚(Mei Chang) | |
dc.contributor.author | Pen-Chen Kung | en |
dc.contributor.author | 龔本珍 | zh_TW |
dc.date.accessioned | 2021-06-15T02:52:42Z | - |
dc.date.available | 2015-10-07 | |
dc.date.copyright | 2011-10-07 | |
dc.date.issued | 2011 | |
dc.date.submitted | 2011-08-16 | |
dc.identifier.citation | 中文部分
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/44353 | - |
dc.description.abstract | 本研究以健康信念模式中的四個基本概念來分析影響腎移植後病患執行正確服藥以及感染預防行為的影響因素,屬橫斷性研究,以立意取樣,選取台北某醫學中心接受腎臟移植滿六個月,定期於腎移植門診追蹤之腎移植病患為對象,共收案122份有效問卷。以自擬結構式問卷收集資料,包括:「基本資料」、「排斥與感染之健康信念問卷」、「腎移植病友正確服藥及感染預防之行為問卷」三部分。所得資料將以描述性統計、獨立樣本t 檢定、單因子變異數分析、皮爾森相關、複回歸分析等統計方法進行分析。研究結果如下:
一、 研究對象正確服藥行為及排斥相關健康信念 研究對象自行報告的正確服藥行為平均得分4.52;其中以「我能服用正確劑量的抗排斥藥」得分最高,平均值4.91,而以「我曾忘記服用抗排斥藥」為執行較差的項目。研究對象之正確服藥行為與移植時間呈現統計顯著負向相關性。排斥相關健康信念影響因素方面:曾接受透析治療者及曾發生排斥經驗者於自覺排斥罹患性的信念較強;移植地點在台灣、藥物引起之症狀困擾數目越多、過去曾發生嚴重感染或非常嚴重感染的個案其正確服藥障礙性信念較大。預測因子方面,移植時間較長、藥物引起之症狀困擾數目較多、排斥罹患性信念較低、正確服藥利益性信念較低者,正確服藥行為較差。 二、 研究對象感染預防行為及感染相關健康信念 研究對象自行報告整體感染預防行為平均得分4.23;以「我會注意口腔保健及衛生」得分最高,而「出入公共場所時,我會記得戴口罩」為執行較差的項目;而「忘記」是多數個案感到不易執行感染預防行為的主要原因。女性於感染預防行為執行上顯著優於男性。個案過去透析時限水遵從度越高者其感染預防行為遵從度也越好。感染相關健康信念影響因素方面:當自覺感染預防障礙性信念越強則感染預防行為越差;年齡越高以及過去透析治療為期較短的個案其自覺感染罹患性信念較低;年齡越高者其自覺感染嚴重性信念較低;無工作者其自覺感染嚴重性大於兼職者又大於退休者,而全職工作者其自覺感染嚴重性大於退休者;在台灣接受移植者自覺感染預防行動障礙信念較強。預測因子方面,自覺感染預防障礙性越高、透析時限水遵從度越差者感染預防行為較差。 結論:腎移植個案的服藥行為及預防感染行為受到其健康信念等因素的影響。移植時間較久、藥物引起之症狀困擾數目較多、排斥罹患性信念較低、正確服藥利益性信念較低的腎移植個案,正確服藥行為相對較差。自覺感染預防障礙性較高、過去透析時限水遵從度較低的腎移植個案,感染預防行為相對較不積極。 | zh_TW |
dc.description.abstract | This study employs the four basic concepts of the Health Belief Model to investigate the factors influencing the medication adherence and infection prevention behaviors of kidney transplant recipients. Using purposive sampling, this cross-sectional study distributed questionnaires at a medical center in Taipei to patients that had received kidney transplants more than six months previously. A total of 122 valid questionnaires were retrieved. A structural questionnaire was drawn up and employed to collect data in three areas: personal information, health beliefs regarding transplant rejection and infection, and medication adherence and infection prevention actions. The obtained data was analyzed using descriptive statistics, an independent t-test, one-way ANOVA, Pearson’s correlation, and multiple regression. The results of the study are as follows:
1. Health beliefs involving medication adherence and transplant rejection The average score of the responses from study subjects on correct medication adherence was 4.52. Among the items in this construct, taking the correct dosage of immunosuppressive drugs, scored the highest with an average of 4.91; taking medicine on time, however, was an item implemented less well. The relationship between medication adherence of the study subjects and time elapsed since transplant showed a negative correlation. In regards to factors influencing health beliefs in transplant rejection, patients that had received dialysis treatment or had encountered rejection perceived susceptibility to rejection more strongly. Transplant recipients who had undergone transplants in Taiwan, had suffered more drug-induced symptoms, or had contracted severe to extremely severe infections in the past encountered more barriers in observance of medication adherence. The number of instances of time elapsed since transplant, drug-induced symptoms, perceived susceptibility to rejection, and perceived benefits of medication adherence were the major factors influencing medication adherence. 2. Health beliefs and prevention behavior involving infection The average score of the overall responses from the study subjects on infection prevention actions was 4.23. Subjects paid the most attention to oral care and hygiene; remembering to wear surgical masks in public was a measure implemented less well. “Forgetting” was the primary reason that prevented transplant recipients from effective implementation of infection prevention measures. Female patients were better at infection prevention than male patients. Transplant recipients showing a higher degree of compliance with water restrictions during dialysis in the past also exhibited better compliance with infection prevention. In regards to factors influencing health beliefs in infection, subjects that perceived more barriers to infection prevention found it more difficult to implement; older subjects and subjects with a shorter dialysis treatment history perceived less susceptibility to infection, and older patients also possessed weaker perceptions of the severity of infection. Unemployed subjects perceived the severity of infection more strongly than those that worked part-time, who further perceived the severity of infection more strongly than retired subjects. Subjects that had a full-time job also perceived the severity of infection more strongly than retired subjects. Subjects that had received their transplants in Taiwan encountered more barriers to infection prevention. Perceived barriers of infection prevention and water restrictions in dialysis treatments in the past were the primary factors influencing actions to prevent infection. Conclusion: The medication adherence and infection prevention of renal transplant recipients were influenced by their health beliefs. Transplant recipients who received their transplants for a longer period of time, had more drug-induced symptoms, perceived less susceptibility to rejection, or perceived less benefits of medication adherence exhibited relatively poor medication adherence. Transplant recipients who perceived more barriers to infection prevention or exhibited a lower degree of compliance with water restrictions in dialysis treatments in the past were less active in preventing infection. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T02:52:42Z (GMT). No. of bitstreams: 1 ntu-100-R97426025-1.pdf: 500517 bytes, checksum: c5035aea359f7f50b8a10ce86e6e55ec (MD5) Previous issue date: 2011 | en |
dc.description.tableofcontents | 誌謝 i
摘要 ii Abstract iv 目錄 vii 圖目錄 ix 表目錄 x 第一章 緒論 1 第一節 研究動機及重要性 1 第二節 研究目的 2 第三節 研究問題 2 第二章 文獻查證 3 第一節 腎臟移植現況 3 第二節 腎臟移植後的生理、心理健康挑戰 3 第三節 腎臟移植術後排斥 5 第四節 腎臟移植術後感染 5 第五節 腎移植病患感染預防行為相關文獻 6 第六節 腎移植患者服藥遵從相關研究 8 第七節 健康信念模式 9 第三章 研究設計 13 第一節 研究架構 13 第二節 名詞界定 14 第三節 研究假設 15 第四章 研究方法 17 第一節 研究場所、對象及檢力分析 17 第二節 研究工具 18 第三節 研究工具信效度檢定 19 第四節 資料收集流程 20 第五節 資料分析 20 第六節 研究倫理考量 21 第五章 研究結果 22 第一節 基本資料分析 22 第二節 研究對象正確服藥行為及排斥相關健康信念 31 第三節 研究感染預防行為及感染相關健康信念 39 第六章 討論 47 第一節 研究對象正確服藥行為及排斥相關健康信念 47 第二節 研究對象感染預防行為及感染相關健康信念 50 第七章 結論與建議 53 第一節 結論 53 第二節 臨床應用 55 第三節 研究限制與建議 56 參考資料 58 附件一 腎移植病患術後執行正確服藥及感染預防行為問卷表 I 圖目錄 圖2-1 健康信念模式(Health Belief Model),資料來源:Rosenstock, I.(1974) 12 圖3-1 研究架構圖 13 表目錄 表4-1研究工具信度測試分析 20 表5-1 研究對象人口學資料分佈(N=122) 23 表5-2 研究對象過去移植的治療經驗之疾病相關變項資料分佈(N=122) 24 表5-3 研究對象感染預防行為相關知識得分情形(N=109) 26 表5-4 研究對象移植後之症狀困擾種類及分佈(複選題,N=115) 27 表5-5 研究對象之症狀困擾數目(N=122) 27 表5-6 研究對象自行報告的正確服藥行為得分(N=116) 28 表5-7 比對處方後判斷研究對象服藥情況(N=122) 28 表5-8 感染預防行為得分(N=109) 29 表5-9 定期回診執行不易原因(複選題,N=20) 30 表5-10 感染預防行為執行不易原因(複選題,N=24) 30 表5-11 基本變項與正確服藥行為總分及排斥相關健康信念之差異性分析表 32 表5-12 研究對象正確服藥行為與排斥之健康信念的相關性分析 35 表5-13 正確服藥行為及排斥之健康信念與基本變項之相關性分析 35 表5-14 正確服藥行為之複迴歸分析(依變項:正確服藥行為) 37 表5-15 正確服藥行為之迴歸分析(模式五) 38 表5-16 基本變項與感染預防行為總分及感染相關健康信念之差異性分析表 40 表5-17 研究對象感染預防行為與感染之健康信念的相關性分析 43 表5-18 基本變項與感染預防行為及感染之健康信念與基本變項之相關性分析 44 表5-19 感染相關知識與感染預防行為及感染之健康信念之相關性分析 44 表5-20 感染預防行為之複迴歸分析(依變項:感染預防行為) 46 表5-21 感染預防行為之複迴歸分析(模式五) 46 | |
dc.language.iso | zh-TW | |
dc.title | 以健康信念模式探討影響腎移植病患執行正確服藥及感染預防行為之相關因素 | zh_TW |
dc.title | A Study of the Factors Related to Medication Adherence and Infection Prevention Behaviors among Renal Transplant Recipients Based on the Health Belief Model | en |
dc.type | Thesis | |
dc.date.schoolyear | 99-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 賴明坤(Ming-Kuen Lai),劉雪娥(Hsueh-Erh Liu) | |
dc.subject.keyword | 腎臟移植,正確服藥行為,感染預防行為,健康信念, | zh_TW |
dc.subject.keyword | kidney transplant,medication adherence,infection prevention,health beliefs, | en |
dc.relation.page | 64 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2011-08-16 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 護理學研究所 | zh_TW |
顯示於系所單位: | 護理學系所 |
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