探討慢性腎臟病患者衛教介入措施對其自我管理、生活品質及生理數值控制之長期追蹤

Effect of a prevention program on the self-management, quality of life, and disease control of patients with chronic kidney disease

目標：慢性腎臟病指腎功能逐漸且難以逆轉的衰退，為避免提早進入透析階段，目前醫療團隊提供慢性腎臟病患者疾病控制、飲食治療及日常保健等相關衛教，但病人是否能確實了解衛教內容及落實自我管理，最後得到良好的控制進而提升生活品質，實值得研究探討。方法：本研究採縱貫性研究設計，於南部某醫學中心腎臟科門診進行收案，共收集150位慢性腎臟病患者。以結構性問卷進行資料收集，於收案時、三個月及六個月時進行三次問卷填寫。資料以廣義估計函數式模式（GEE）進行相關資料分析。結果：腎臟病患者之照護與衛教計畫的實施後，隨著時間的增加，病人的自我管理、整體生活品質及eGFR皆有顯著改善情形。另每日規則運動、隨時間增加及eGFR的改善，與生活品質呈正相關。結論：本研究有助於瞭解腎臟病照護與衛教計畫的實施後，腎臟病患者自我管理、生活品質及eGFR的長期變化，建議醫療團隊可介入多元及適才的照護模式，運用衛教計畫的介入及良好的生理控制以提升慢性腎臟病患者之整體生活品質，延緩病人腎功能的惡化，避免提前進入透析階段。 Objectives: Chronic kidney disease (CKD) is a long-term disease, and to prevent it from developing from the early stage to the dialysis stage, patients follow the advice of their medical team. However, whether patients thoroughly understand the content of the health education that they are provided with and implement self-management to enhance their quality of life is worthy of research and investigation. Methods: This study employed a longitudinal research design and recruited 150 patients with CKD from a medical center in southern Taiwan. Structured questionnaires were used to collect their data a total of three times, and the data were analyzed using GEE. Results: The patients' average score on the short-form Mandarin Health Literacy Scale for CKD was 9.06 ± 3.205, and their self-management, overall quality of life, and eGFR demonstrated significant improvements over time. Conclusions: This study clarified long-term changes in the self-management and quality of life of patients with CKD. Medical teams are advised to provide diverse and proper care models to delay the deterioration of kidney function as well as prevent the need for dialysis in patients with CKD.