膝部骨性關節炎患者運動行為的相關因素與生活品質之探討－－跨理論模式之應用

The related factors of exercise behaviors and quality of life in knee osteoarthritis - An application of transtheoretical model

目的：擬藉跨理論模式，了解膝部骨性關節炎患者的運動行為，包括運動行為改變階段、運動自我效能、自覺運動利益與障礙及生活品質與其運動行為之關聯。方法：以121位膝部骨性關節炎患者為受訪對象，使用Western Ontario and MacMaster（WOMAC）Osteoarthritis Index問卷調查關節炎患者與疾病相關的生活品質，以運動行為改變階段量表及自行設計的知覺運動心理量表評估患者的運動行為改變階段、運動自我效能、自覺運動利益及自覺運動障礙。結果：女性的自覺運動障礙高於男性，年紀大者其自覺運動利益較低，運動自我效能及自覺運動利益有隨教育程度愈高而增加的趨勢。患者的生活品質隨教育程度及收入增加而增加，隨年齡增長而下降，與性別則無關聯。生活品質與運動自我效能成正相關，與自覺運動障礙成負相關，與自覺運動利益則無相關性。不同的運動行為改變階段的受試者，其性別、年齡、教育程度、收入、婚姻狀態及生活品質並無差異，但運動自我效能、自覺運動利益與自覺運動障礙則有不同。結論：膝部骨性關節炎患者的運動行為改變階段、運動自我效能、自覺運動利益及障礙與生活品質，運動行為改變階段處於行動期及維持期者有較高的自我效能及自覺運動利益，自覺運動障礙則較低，可作為運動介入治療時的參考。

Purpose: To investigate the exercise behaviors including the stages of change, exercise self-efficacy, perceived exercise benefits / barriers which were based on the transtheoretical model , and the relationship with health-related quality of life of people with knee osteoarthritis. Methods: There were 121 valid respondents. Health-related quality of life was assessed using Western Ontario and MacMaster (WOMAC) Osteoarthritis Index and a questionnaire was developed to evaluate stages of change, exercise of self-efficacy, perceived exercise benefits and barriers. Results: Females had more perceived exercise barriers; the older the patients were, the lower exercise benefits they perceived; the exercise self-efficacy and perceived exercise benefits were increased for those with a higher education level. The quality of life was perceived better with higher education and income level, worse with age increase and without correlation to gender. In addition, the quality of life was positively correlated to exercise self-efficacy, negatively to perceived exercise barriers and had no correlations to perceived exercise benefits. There was no difference between sex, age, education, income, marital status and quality of life in the stages of exercise change with the exception of exercise self-efficacy, perceived exercise benefits and barriers. Conclusions: This study revealed the related factors of exercise behaviors and quality of life in knee osteoarthritis patients and the relationship among these variances. There are higher exercise self-efficacy and perceived exercise benefits but lower perceived exercise barriers in the action and maintenance stages. The exercise intervention strategies could be referred to these results.