血液透析病患其控握信念、心理困擾與健康促進行為之初探

Preliminary Study of the Relationship between Health Locus of Control, Psychological Distress and Health Promotion Behavior in a Group of Hemodialysis Patients

本研究主要探討血液透析病患控握信念、心理困擾與健康促進行為關係，為橫斷式相 關性研究，採立意取樣的方式，以桃竹苗地區某區域醫院洗腎中心的血液透析病患為研究 對象，共選取40 位病患，有效樣本為36 位。以「多層面健康控制重心量表」、「醫院焦慮 與憂鬱量表」、「健康促進行為量表」等問卷收集資料。結果顯示：(1)整體研究對象的控 握信念傾向內在控制重心。(2)焦慮與憂鬱的樣本盛行率分別為36.1%及47.2%。(3)健康 促進行為的平均分數為62.73（SD= 9.76，range= 0-100）。(4)內在控握信念分別與焦慮 、憂鬱呈負相關(p < .01)；強而有力他人的控握信念及機運控握信念分別與焦慮、憂鬱 呈正相關(p < .01)。(5)健康促進行為與焦慮、憂鬱呈負相關(p < .01)，與內在控握信 念呈正相關(p < .01)，與強而有力他人的控握信念及機運控握信念呈負相關(p < .01) ；年齡60 歲以上者比60 歲以下者有較好的健康促進行為(p < .01)。(6)在預測因素方面 ，焦慮與憂鬱能顯著預測健康促進行為，有80-82%的解釋變異量。

This study examined the relationship between the health locus of control, health promotion behavior and psychological distress in a group of hemodialysed patients. The study used a cross-sectional design. A total of 40 hemodialysed patients participated in this study at the North District Regional Medical Center in Taiwan. However, only 36 valid questionnaires were used for data analysis. The dependent variables were comprised of the sum scores obtained on the modified version of the Multidimensional Health Locus of Control Scale (MHLC), Hospital Anxiety and Depression Scale (HADS) and Health Promotion Behavior Scale. Findings show that: (1) internal dimensions of control are inclined to all participants; (2) 36.1% demonstrated a clinically relevant level of anxiety, and 47.2% showed clinically relevant depression; (3) health promotion behaviors scores averaged 62.73%; (4) higher internal dimensions of control increased anxiety and depression (p＜.01) , loss of powerful attribution decreased the chance of anxiety and depression [mjs1](p＜.01); (5) higher rates of anxiety and depression health promotion behavior corrected significantly with low degrees of health promotion behavior, which were associated with greater internal control and lower powerful others and chance; [mjs2] (6) participants over 65 have greater health promotion behavior; (7) regression equation predicting shows that anxiety and depression were the strongest predictors claiming 80-82% of variance in health promotion behavior.