心律調節器病患身心社會調適及其相關因素之探討

Bio-Psychosocial Adjustment and Associated Factors in Pacemaker Patients

本研究為一橫斷式描述性相關研究，主要目的為心律調節器病患出院返家之身心社會調適及其相關因素之探討，以立意取樣法（purposive sampling）於台北市二所醫學中心心臟科門診針對100位病患，採結構式問卷進行資料的收集。本研究結果顯示：（1）心律調節器病患身心社會調適介於「輕度障礙」至「無障礙」之間，最難調適的生理困擾項目為「用力時呼吸困覆」，在心理社會調適中以心理困擾調適最佳，性生活調適最差；（2）心律調節器病患之社會支持與生理困擾調適無顯著相關，但與整體心理社會、健康照顧、家庭生活和非共居家人調適均呈顯著相關；（3）心律調節器病患之生理困擾調適與整體心理社會、健康照顧、家庭生活、社會環境和心理困擾調適均呈顯著相關；（4）心律調整病患之心理社會調適的重要預測變項為「症狀困擾頻率和程度」及「評價支持」。本研究結果可提供臨床照護心律調節器病患出院衛教計畫和持續性護理之參考。

The purpose of this descriptive cross-sectional survey study was to investigate bio-psychosocial adjustment and associated factors in pacemaker patients after their discharge from hospitals. This study consisted of 100 patients with implanted pacemakers who were selected by purposive sampling from outpatient departments of two medical centers in Taipei City. The results were as follows: (1) The degree of bio-psychosocial adjustment in pacemaker patients was mild disturbance to none. Dyspnea on exertion was the most difficult item of physical distress adjustment in the pacemaker patients. Psychological distress adjustment was the easiest aspect of psychosocial adjustment, and adjustment in sexual relationships the most difficult. (2) The relationship between social support and physical distress adjustment in pacemaker patients was not significant. Social support and overall psychosocial adjustment, health care orientation, family life and extended family relationships were significantly correlated. (3) Physical distress adjustment in pacemaker patients and overall psychosocial adjustment, health care orientation, family life, social environment and psychosocial distress were significantly correlated. (4) The important associated factors of psychosocial adjustment were frequency and degree of symptom distress, and appraisal support. The results of this study may provide guidance for designing discharge education plans and continuous nursing interventions in pacemaker patients.