影響慢性腹膜透析病人生活品質的因素

Factors that Impact on Quality of Life for Chronic Peritoneal Dialysis Patients

台灣慢性腎衰竭的盛行率居世界排名第一位，透析患者的年齡、工作、經濟、接受透析治療的時間等皆會影響生活品質。本研究目的為了解影響腹膜透析病人生活品質的相關因素，比較病人接受腹膜透析前後的生活品質、透析型態、感染與檢驗值之相關性。研究採取縱貫式研究設計，以立意取樣方式選取南部某醫學中心80位腹膜透析病人為對象，以SF-36生活品質量表為研究工具。研究結果發現（1）病人的身體功能得分最高，心理健康得分最低。（2）病人接受腹膜透析治療後，身體功能、身體角色、身體疼痛、一般健康狀態、活力、社會功能及情緒角色都有進步（p ＜ .05）。（3）65歲（含）以下、有工作、不曾發生腹膜炎、自己執行換液的病人及高血清白蛋白者有較好的生活品質（p ＜ .05），換液者為腹膜透析病人生活品質的預測因子（r^2.129）。本研究結果可作為臨床護理人員照護腹膜透析病人之參考，以提升患者之生活品質。

Taiwan has the highest prevalence of chronic renal failure in the world. The age, economic condition, and duration of dialysis of dialysis patients all influence their life quality. The purpose of this study is to investigate the factors that influence quality of life among chronic peritoneal dialysis (PD) patients. The study was designed as a longitudinal study. Variables such as quality of life, PD mode, infection and blood test readings were compared pre- and post-PD therapy. SF-36 health survey questionnaires were used for the quality of life assessment. A total of 80 chronic PD patients were enrolled in the study. The results showed revealed higher scores from the physical component compared to the mental component in the SF-36 health survey among the study subjects (p ＜ .05). The scores for physical function, physical role, physical pain, general health, vitality, social function and emotional role all improved after the start of PD (p ＜ .05). PD patients less than 65 years old, in employment, no peritonitis history, had executed PD therapy themselves and had high serum albumin levels all saw improvements in the quality of life (p ＜ .05). The operator of PD solution exchange served as a predictor on the quality of life of patients undergoing peritoneal dialysis (r^2.129). In conclusion, this study can be used as reference by nursing staff in clinical care of patients undergoing peritoneal dialysis to enhance the patient's quality of life.