血液透析病患之憂鬱狀態及生活品質滿意度相關性研究

The Depressive Symptoms and Satisfaction of Quality of Life in Hemodialysis Patients

本研究目的在探討接受血液透析治療之尿毒症患者的憂鬱狀態與生活品質滿意度的相關性。採橫斷式研究設計，以結構式問卷採立意取樣方式，於北部某教學醫院血液透析中心進行資料收集，獲得有效問卷146份。問卷包括憂鬱量表及生活品質滿意度量表。研究結果發現：（1）在生活品質滿意度所涵蓋範圍中，以家庭層面得分最高，健康層面最低。（2）生活品質滿意度會隨著年齡、經濟狀況、有無慢性病（不含高血壓及糖尿病）、有無糖尿病之不同而有顯著差異（p＜0.05）。（3）血液透析患者中，有45.9%的患者有憂鬱狀態。（4）血液透析患者的生活品質與憂鬱狀態呈顯著負相關，即患者憂鬱得分越低，生活品質滿意度越高分。(5)血液透析病患生活品質滿意度最大預測因子為憂鬱得分，可解釋總變異量22.0%，再加上有無慢性病及年齡，共可解釋29.6%變異量。本研究結果可提供護理護人員臨床照護時之參考，期能針對血液透析病患不同之需求，提供個別性的護理照護，進而提升透析病患之生活品質。

The purposes of this research were to explore the depression symptoms and the life quality degree of satisfaction in hemodialysis patients. The research was a cross-sectional design. A purposive sampling survey was conducted using structured questionnaires. A total of 146 hemodialysis patients, all at a hemodialysis center of a teaching hospital in northern Taiwan, comprised the study group. Questionnaires covered satisfaction of quality of life and depression inventory. The findings discovered: (1) In terms of the life quality degree of satisfaction, hemodialysis patients scored the highest on the family subscale and lowest on the health subscale. (2) All four parameters of age level, financial status, other chronic illness (diabetes and hypertension excluded), and having diabetes mellitus or not, differed significantly from satisfaction of quality of life (p＜0.05). (3) The prevalence of depression was 45.9%. (4) Depression in hemodialysis patients correlated negatively with the life quality degree of satisfaction. Namely, when the patient score of depression was lower, then the life quality degree of satisfaction was higher. (5) The analysis of regression indicated that the depression score could predict 22% of the satisfaction of quality of life variance. In addition, chronic illness and age could explain up to 29.6% of the amount of variance. The findings of this research provide useful information for the clinical care of the nursing staff, to focus on the hemodialysis patients' different demands, and to provide individualized nursing care to improve the quality of life in patients with maintenance hemodialysis.