接受類固醇脈衝治療自體免疫疾病病人之症狀困擾及相關因素

Symptom Distress and Related Factors in Autoimmune Disease Patients Receiving Methylprednisolone Pulse Therapy

本研究目的在探討影響接受類固醇脈衝治療自體免疫疾病病人之症狀困擾及其相關因素，採描述性研究設計及立意取樣，研究對象為自體免疫疾病接受脈衝治療病人，以結構式量表訪談63位病人，研究工具為症狀困擾量表，量表Cronbach's α為.91。經統計分析，研究結果發現病人在接受脈衝治療前、治療後一週及二週之三個時間點各項症狀困擾，均達顯著差異（p<.001）；而病人之性別、合併症、體重變化、藥物劑量、診斷、住院天數等均與症狀困擾相關，皆達顯著差異（p<.01）；類固醇脈衝治療後之整體症狀困擾最佳預測因子為合併症、體重變化及過去病史，可解釋總變異量45.3%。建議護理人員在訂定此類病人治療後自我照顧計劃時，須配合病人之症狀困擾優先次序安排護理指導內容，以滿足病人需求，達到自我照顧以維持最佳身體狀況之目標。The purpose of this study was to investigate the symptom distress and its related factors in autoimmune disease patients while receiving the methylprednisolone pulse therapy. Subjects were recruited from autoimmune disease patients who were treated with methylprednisolone pulse therapy. A structured questionnaire of symptom distress was used as an instrument to collect data. The questionnaire was validated by using expert validity and reliability test with Cronbach's α .91. The results revealed that there were significant differences in symptom distress at three time points, before therapy, 1 week and 2 week post-therapies (p<.001). In addition, the factors of sex, complications, body weight, treatment dose, diagnosis and length of hospital stay were significantly correlated with symptom distress (p<.01). Complications, body weight change and previous disease history were three most important variables to predict symptom distress for patients with methylprednisolone pulse therapy. These variables explained 45.3% of the variation of total symptom distress. The study results indicated that nurses had to concern about the priority of the care and contents of patients' symptom distress for satisfying patients' demand to achieve the goal of self-care and maintain optimal physical condition in the self-care instruction.