長期血液透析患者之身體功能狀況及其相關因素探討－－以南部某地區醫院為例

Exploring the Determinants of Physical Performance Function Status among Long-Term Hemodialysis Patients in Region Hospital of Southern Taiwan

有鑑於血液透析患者在日常生活中，可能有因病而降低身體活動，並因而影響其生活品質的問題，因此本研究目的乃在探討長期血液透析病患之身體功能狀況及其相關因素。本研究是以台灣地區南部某地區醫院血液透析中心長期血液透析患者為對象，並採用橫斷式之研究設計，資料來自於研究個案之臨床病歷資料及相關檢驗評估報告。本研究樣本醫院之個案數總共有230位，經篩選後符合本研究之樣本對象計214位，參與率達93.04%。本研究之依變項為個案之身體功能狀況，並以科氏量表（Karnofsky scale）為評估工具進行分析。研究結果顯示樣本個案在身體功能狀況評估之分數平均值為69.3分（標準差14.1），依身體功能狀況分級，身體活動功能正常者約佔14.5%，有近半數個案屬於輕度活動障礙（48.1％），顯示接受長期血液透析的病患能照顧自己，但無法從事正常活動或輕勞力之工作，若需要勞力工作時，則出現疾病之症狀。進一步分析與個案身體功能狀況相關的因素，其中年齡與跌倒危險傾向兩變項，與身體功能狀況呈現顯著的負相關，而教育程度、經濟狀況（家庭每月收入）、原發疾病為非糖尿病或腎臟疾病等變項，則與身體功能狀況呈顯著正相關。透過本研究可加強護理人員對血液透析患者強化身體功能活動之護理指導，並建議能全面性的評估其身體功能變化狀況，以作為未來估計長期照護服務需求之基礎。

The dialysis course may decrease the physical activity daily life and involving to affect their quality of life among hemodialysis patients. The study purpose was to probe into the physical performance status and its related factors. This study subject were the cases of hemodialysis that treated by the region hospital center of dialysis in southern Taiwan. The study was designed by cross-sectional and the data were collected form the clinical examine reports and nursing evaluation data of hospital chart. Total cases were 230 in hospital and there were 214 case samples which recruited were fit in this research, the responding rate was 93,04%. Independent variable was physical performance function that was evaluated by the Karnofsky scale. The results showed the mean score of physical performance function was 69.3(±14.1), there were 14.5% belong to the normal grade of physical performance function and had more then half were the mild grade handicap of physical performance function(48.1%), it reveal the hemidialysis cases had the ability to care by themselves, but difficult to deal with the general and light middleweight labor work. The results of physical performance function related factors analysis showed the both variables of age and fall risk tendency had negative relationship with their physical performance function, and the factors of educational degree, economic status, and primary disease were positive effect. This finding could enhance the dialysis patient's physical activity teaching by nursing staff. We also suggest that have overall evaluation of physical activity function in hemodialysis cases in the future and it would be a baseline data for estimate the need of long-term care.