長期洗腎病患的主觀生活品質－－質性研究觀點

Subjective Quality of Life in Patients Undergoing Long-Term Maintenance Hemodialysis Treatment: A Qualitative Perspective

本研究旨在探討長期洗腎病患生活品質之主觀經驗，以質性研究法，深度訪談方式收集資料，在南部某地區醫院洗腎中心以立意取樣收案，利用錄音訪談14位長期洗腎病患。以內容分析法進行資料分析，最後歸納出病患的生活品質主觀經驗由五個主要主題與十個次主題所構成。主題與次主題分別為：（1）身體功能－－身體症狀干擾生活、體質虛弱有氣無力；（2）心理功能－－情緒起落意志消沉、自我形象殘缺不全；（3）社會功能－－病患角色依賴家人、生活社交囿困受限；（4）職業經濟狀態－－難尋工作影響經濟、健保給付得以生存；（5）整體生活品質感受－－幸福輪廓尚缺圓滿、安於現況珍惜僅有。本研究可提供醫護人員選擇介入措施時之參考，社會工作者建立血液透析工作實務之依據，及提供政府制訂健康保險及社會福利政策時的參考。

The purpose of this qualitative study was to explore the subjective ”quality of life” experience of patients undergoing long-term maintenance hemodialysis treatment at a southern Taiwan hospital. A purposive sample of fourteen patients was selected to participate in in-depth audio-taped interviews. Data were analyzed using the content analysis method. Findings delineated five quality of life themes and ten sub-themes for hemodialysis patients. These included: (1) Physical functions (normal life disrupted by physical symptoms, lack of vigor); (2) Psychological functions (emotional instability, impaired sense of self); (3) Social functions (dependence upon family, restricted lifestyle and social life); (4) Economic status (fewer work opportunities, financial needs covered by the National Health Insurance); and (5) Overall quality of life (perceived poor quality of life, reluctant acceptance of situation). Study findings may help health professionals implement appropriate interventions as well as provide a working outline for social workers. In addition, findings may be referenced in the revision and further development of national health insurance policies.