代謝症候群病患接受冠狀動脈繞道術後之生活品質及其相關因素

Quality of Life and Related Factors in Metabolic Syndrome Patients Who Underwent Coronary Artery Bypass Grafting Surgery

背景：代謝症候群的盛行率全球與日俱增，在台灣其盛行率男性約為16.1－20.4%女性13.3－15.3%。再者心血管疾病為台灣十大死因之第二位，有代謝症候群者發生冠狀動脈疾病的風險會增加1.5至3倍。冠狀動脈繞道術能有效緩解冠心病患症狀困擾，在台灣2007年約有6,300人接受冠狀動脈繞道手術。
目的：國內針對冠狀動脈繞道術後病患之生活品質研究已有不少，但卻缺乏對於代謝症候群病患於冠狀動脈繞道術後生活品質之探討，本研究旨於探討代謝症候群病患於冠狀動脈繞道術後之生活品質。
方法：採橫斷性研究方法，以立意取樣方式收集資料，研究工具為生活品質問卷和基本資料問卷，樣本來自於台灣北部某醫學中心冠狀動脈繞道手術病患共70名。資料以SPSS 17.0電腦套裝軟體進行分析，統計分析包括百分比、平均數、標準差、獨立樣本t檢定、單因子變異數分析和皮爾森相關分析。
結果：本研究結果顯示病患之生活品質方面自覺一般健康狀況和社會功能較好，且因情緒問題角色功能受限也較少；因身體生理問題造成之角色受限程度（平均數49.30分）和活力（平均數49.26分）則較常模（平均數50分）低，手術後疼痛情形和心理健康也得分較低，然而病患自覺身體生理功能明顯較差。性別、年齡、婚姻狀況、準備三餐者及喝酒習慣與生活品質中身體生理功能（平均數46.09分）、身體疼痛（平均數48.45分）和一般健康狀況（平均數52.50分）等面向具有顯著差異。
結論：本研究結果可幫助護理人員了解代謝症候群病患於冠狀動脈繞道術後之生活品質，經由研究對此特殊族群之生活品質有更進一步了解，研究結果期許護理人員於臨床工作時可針對病患之個別性設計相關健康照護措施，提升生活品質。

Background: Metabolic syndrome is a high-prevalence health problem worldwide. In Taiwan, some 16.1~20.4% of males and 13.3~15.3% of females have been diagnosed with metabolic syndrome. Cardiovascular disease is the second leading cause of death in Taiwan, and metabolic syndrome is a recognized risk factor for coronary artery disease. Coronary artery bypass grafting (CABG) is currently the most recommended treatment for coronary artery disease. In Taiwan, approximately 6,300 individuals underwent CABG surgery in 2007.
Purpose: Research has found metabolic syndrome to be associated with poor outcomes following CABG. However, research focusing on quality of life in metabolic syndrome patients who have undergone CABG is lacking. The purpose of this study was to explore the quality of life of such patients in order to address this gap in understanding.
Methods: The cross-sectional quantitative research design with purposive sampling used for this study employed two instruments, including the Short Form 36-Health Survey and a demographic questionnaire. Seventy patients were recruited from a medical center in northern Taiwan. Data were analyzed using SPSS, Version 17.0 software. Data analysis addressed percentages, means, standard deviations, independent t-tests, one-way ANOVAs and Pearson correlation coefficients.
Results: With regard to SF-36 Taiwan version scores, results showed participant mean scores for general health and social functions to be higher than those of the general population, and, in keeping with this, the mean scores for limited role function due to emotional problems and physical pain due to the operation were lower. Nevertheless, overall, the mean score for physical functions was lower than that for the general population, as were mean scores for vitality and mental health. Metabolic syndrome indicators were significantly associated with gender, age, education level, and religious affiliation. In addition, quality of life differed significantly by gender, marital status, meal arrangements, and alcohol consumption. Finally, lower blood pressure was correlated with vitality and mental health.
Conclusions: It is hoped that study findings will increase awareness among healthcare providers regarding quality of life in metabolic syndrome patients who have undergone CABG. Based on study results, healthcare providers may design specific interventions for this particular population in order to achieve optimal quality of life.