結腸造口患者之生活品質

Quality of Life in Patients with Colostomy

腸造口手術雖然延長存活時間，但對造口患者造成身體心像的改變，進而影響其生活方式和生活品質。患者為了因應造口所帶來的影響，他們必須學習有關於造口照顧方面的自我照顧知識和行為。目前國內相關研究不多，因此本研究的目的乃針對結腸造口患者探討其自我照顧能力與生活品質，並探究其關係。本研究為一描述性相關性研究，採橫斷式調查法，以臺北縣市的結腸造口患者 為研究對象，採立意取樣方式，以結構式問卷收集資料，共收90位個案。結果顯示l.自我照顧知識的答對率68%。2.自我照顧行為平均得分為44.48±12.41（量表總分76分），表示患者執行自我照顧行為的程度為中等程度。3.生活品質平均得分為20.11±3.56分（量表總分30分），表示生活品質為中等程度。4.患者自我照顧知識、自我照顧行為及生活品質兩兩之間皆呈顯著的正相關。5.以逐步迴歸方式來分析個人基本屬性、自我照顧知識、自我照顧行為對生活品質的預測，以「自覺健康狀況」、「教育程度」、「婚姻狀況」這三個變項可以解釋生活品質53.1%的總變異量，即當病患自覺健康狀況愈好、教育程度為大專以上、有配偶者，生活品質愈佳。對於造口患者，我們可能可以由這三方面來加強，改善生活品質。

Colostomy is necessary in treating certain diseases to prolong the patients’ life span, but it may cause changes in the body structure and the way of defecation. These patients have to learn about self care knowledge and skills of the colostomy to minimize the negative influences on quality of life. In Taiwan, few studies of the relation between the ability to perform self-care and quality of life in patients with colostomy have been done. This study investigated 90 patients in the Taipei area. Subjects were evaluated through purposive sampling and structural questionnaires. The study was conducted to explore the relations among knowledge of self care, behaviors of self care, and quality of life of patients with colostomy. Sixty eight percent of patients correctly answered the questions about knowledge of self care. The average score of self care behaviors was 44.48±12.4l(out of total score 76) and hence this average score indicated a moderate degree of self care implementation. The quality of life of patients with colostomy was measured with the Chinese quality of life index. The average score was 20.11±3.56, which meant these patients ranked among the “middle levels” of quality of life. The knowledge of self care, behaviors of self care, and quality of life had positive correlation with each other, showing that patients who had better knowledge of colostomy care were able to perform stoma self care better. These patients also had a better quality of life. Stepwise multiple regression analysis revealed that self care knowledge, and performance of self care was not retained in the model as a preditor of quality of life. Self perceived-health, education, and status of marriage could explain 53.1% of the variance of quality of life. patients who had better self-perceived health, higher education and a spouse had a better quality of life.