不同分期慢性腎臟疾病患者憂鬱狀態及健康相關生活品質之研究

he Depressive Symptoms and Health-related Quality of Life of Patients at Different Stages of Chronic Kidney Disease

本研究目的在探討不同分期慢性腎臟疾病患者的憂鬱狀態與健康相關生活品質的相關性。採橫斷式研究設計，以結構式問卷立意取樣方式，於北部某教學醫院慢性腎臟疾病衛教門診進行資料收集，獲得有效問卷219份。研究工具包括基本資料、貝克憂鬱量表及健康相關生活品質量表。研究結果發現:（1）CKD患者分期較早期者之健康相關生活品質優於分期較晚期者。（2）不同分期CKD患者，環境範疇之生活品質皆優於其他範疇（3）CKD患者中，有12.3％的患者有憂鬱狀態。（4）CKD患者健康相關之生活品質與憂鬱狀態呈顯著負相關，即患者憂鬱得分越低，健康相關之生活品質越好。（5）不同分期CKD患者，其工作有無、心臟病及婚姻狀況等變項，與健康相關之生活品質有顯著差異（p＜.05）。（6）預測慢性腎臟疾病患者生活品質的因子有憂鬱、心臟病及CKD第II期，共可解釋57.1％變異量。本研究結果可提供護理護人員臨床照護時之參考，評估有憂鬱傾向之病患，給予個別性的護理照護；病患也能增加對疾病的適應，進而提升其生活品質。

The purposes of this study were to explore the depressive symptom and health-related quality of life in patients at different stages of chronic kidney disease (CKD). Using a cross-sectional research design, purposive sampling survey was conducted with structured questionnaires. A total of 219 responses from chronic kidney disease outpatients at a teaching hospital in northern of Taiwan were collected. Study tools include basic profile, depression inventory and health related quality of life scale. The result of the study is showed that: (1) Health-related quality of life in patients at earlier stages of CKD was superior to those at later period stages. (2) For patients at all stages of CKD, the environmental category of quality of the life surpassed all other categories. (3) The prevalence of depression was 12.3%. (4) Depression in CKD patients correlated negatively with health-related quality of life so a patient with lower depression score enjoyed a higher health-related quality of life high score.(5) For patients at all stages of CKD, employment, heart disease and marital status had significant correlation with health-related quality of life (p＜.05). (6) Factors that predicted the quality of life for CKD patients factors were depression, heart disease and CKD II stage, accounting for 57.1% of explained variance. The result of the study provided a greater understanding of clinical nursing when assessing patients with depression and provide individual care. The results can also help CKD patients adapt to the disease and improve their quality of the life.