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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 孫秀卿(Shiow-Ching Shun) | |
dc.contributor.author | Yu-Jun Zhan | en |
dc.contributor.author | 詹羽君 | zh_TW |
dc.date.accessioned | 2021-05-16T16:19:33Z | - |
dc.date.available | 2017-02-25 | |
dc.date.available | 2021-05-16T16:19:33Z | - |
dc.date.copyright | 2014-02-25 | |
dc.date.issued | 2013 | |
dc.date.submitted | 2013-11-20 | |
dc.identifier.citation | 參考文獻
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/6023 | - |
dc.description.abstract | 台灣末期腎病變之盛行率始終高居世界第一,其中長期血液透析患者,最常見的症狀困擾之一就是疲倦。目前的研究發展,對透析患者產生疲倦的確切原因,以及預測因子,並無一致結論。文獻指出影響脂肪酸能量代謝之左旋-肉鹼的濃度,與此族群疲倦和肌力的變化有所關聯,血中肉鹼濃度受血液透析治療的影響甚鉅,當能量供應不足,肌力下降增加了疲倦發生的頻率與強度。因此本研究之目的為:(1)瞭解血液透析患者疲倦程度之現況 (2)分析血液透析患者之肌力、肉鹼濃度及疲倦之相關性 (3)瞭解血液透析患者之人口學特性、(醯基)肉鹼濃度與其他生化檢驗值、心理社會狀況、肌力以及疲倦之相關性,進一步探討疲倦預測因子。
本研究為橫斷性描述性相關性設計,以連續取樣(consecutive sampling)方式,於台灣北部某醫學中心血液透析單位進行收案,共88位患者參與。以儀器測量患者肌力(手部握力、30秒坐站)、血中生化數值(包含肉鹼濃度),以結構式問卷收集心理社會資料(憂鬱、焦慮、社會支持及疲倦程度)。收集的資料以描述性統計、獨立樣本t檢定、單因子變異數分析、皮爾森相關與逐步迴歸進行分析。 結果:血液透析患者疲倦盛行率高達77.3%,但自覺嚴重度較低,平均疲倦程度在輕度~中度之間。疲倦與慢性病數、左旋-肉鹼濃度(共66位完成抽血結果)、症狀困擾總數、症狀困擾嚴重度、憂鬱及焦慮等因子間存在正相關性,但唯「症狀困擾總數」及「憂鬱」可共同預測疲倦變異量達51.7%,並以症狀困擾總數最具影響力,當患者主訴症狀數超過4項以上,高度懷疑患者有疲倦症狀的可能,若能針對血液透析患者的症狀困擾採取有效措施,應能減輕疲倦。左旋-肉鹼與疲倦兩者,皆和肌力無顯著相關。而左旋-肉鹼與疲倦,在本研究中顯現正相關性,但進一步分析,發現兩者間可能存在非線性關係,其背後原因尚無明確的解釋,須待進一步研究,以釐清其角色定位。本研究可作為臨床疲倦初步評估之參考,未來研究亦可依據此結果,發展疲倦之客觀評估工具,以及疲倦改善策略。 | zh_TW |
dc.description.provenance | Made available in DSpace on 2021-05-16T16:19:33Z (GMT). No. of bitstreams: 1 ntu-102-R99426015-1.pdf: 1804508 bytes, checksum: feb5aae3df042573c5e06f60f1cdb526 (MD5) Previous issue date: 2013 | en |
dc.description.tableofcontents | 目錄
口試委員會審定書................................i 誌謝............................................ii 中文摘要........................................iii 英文摘要........................................iv 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................................ 3 第二章 文獻查證. ...............................4 第一節 末期腎臟病及其治療.......................4 第二節 血液透析患者常見的合併症.................5 第三節 疲倦.....................................7 第四節 血液透析與肌力...........................15 第五節 研究概念架構 .............................18 第三章 研究方法.................................19 第一節 研究設計.................................19 第二節 研究對象及場所...........................19 第三節 研究問題.................................20 第四節 名詞解釋與操作型定義.....................21 第五節 研究工具.................................23 第六節 資料收集過程 .............................26 第七節 資料分析.................................28 第八節 研究倫理考量 .............................29 第四章 研究結果.................................30 第一節 人口學特性及疾病治療特質.................30 第二節 疲倦現況.................................33 第三節 各身體因素現況...........................35 第四節 心理社會因素 .............................43 第五節 疲倦與人口學特性、疾病治療特質、身體及心理社會因素的相關性....46 第六節 影響血液透析患者疲倦程度之重要預測變項...48 第五章 討論.....................................51 第一節 疲倦現況探討 .............................51 第二節 疲倦與各相關因子間之探討.................53 第六章 結論與建議...............................59 第一節 結論.....................................59 第二節 護理的應用...............................61 第三節 研究限制.................................63 第七章 參考文獻.................................64 中文部分........................................64 英文部分........................................65 附件資料 附件一 DSI量表使用授權函 .......................77 附件二 ESSI量表使用授權函 ......................78 圖目錄 圖1 研究概念架構圖 .............................18 圖2 研究流程圖..................................27 圖3標準化殘差值之常態機率分布圖.................48 圖4 標準化殘差值及標準化預測值之交叉散布圖 .....49 表目錄 表1 血液透析患者之基本屬性 .....................31 表2 疾病治療特質................................32 表3 血液透析患者之疲倦現況......................34 表4 血液透析患者身體/心理/社會因素與之相關性....36 表5-1 血液透析患者之症狀盛行率..................38 表5-2 血液透析患者之症狀困擾嚴重度..............39 表6 血液透析患者握力現況及與人口學/身體/心理/社會因素之相關性...............41 表7 血液透析患者下肢肌力現況及與人口學/身體/心理/社會因素之相關性.......42 表8 焦慮及憂鬱程度與疲倦程度之相關性............43 表9 血液透析患者之社會支持情況..................45 表10 血液透析患者人口學特性、疾病治療特性與疲倦之相關性.............................46 表11 血液透析患者疲倦程度預測模式逐步多元迴歸分析摘要.............................50 表12 血液透析患者疲倦程度與左旋肉鹼濃度曲線估計迴歸分析摘要...................56 | |
dc.language.iso | zh-TW | |
dc.title | 血液透析患者疲倦盛行率及其相關因子之探討 | zh_TW |
dc.title | Prevalence of Fatigue and its Related Factors in Hemodialysis Patients | en |
dc.type | Thesis | |
dc.date.schoolyear | 102-1 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 洪冠予,郭錦樺 | |
dc.subject.keyword | 血液透析,疲倦,肉鹼,肌力, | zh_TW |
dc.subject.keyword | Hemodialysis,Fatigue,Carnitine,Muscle Strength, | en |
dc.relation.page | 79 | |
dc.rights.note | 同意授權(全球公開) | |
dc.date.accepted | 2013-11-21 | |
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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