慢性腎臟病人生活品質與其相關因素探討

Quality of Life and Associated Factors in Patients With Chronic Kidney Disease

臺灣末期腎臟病發生率與盛行率高居全球前幾名，造成公共衛生及醫療上的重擔。雖然慢性腎臟病患的生命雖隨著醫學的進步得以延續，但病患在接受長期治療時，其身心安寧狀態是否隨醫學治療進步而隨之改善，則是常被忽略的問題。過去多數關於慢性腎臟病的生活品質研究都針對已接受長期透析治療或腎臟移植的病人，但對尚未進入透析治療的慢性腎臟病病人在長期治療中，影響其生活品質因素的研究仍有限。本研究目的在探討慢性腎臟病人生活品質與其相關因素。採橫斷性研究設計，立意取樣18歲以上之慢性腎臟病人(未進入透析者)，於南部某醫學中心腎臟內科門診病人共收案432人。以結構式問卷進行資料收集，問卷包括個人基本資料、生活品質量表(簡明版世界衛生組織生活品質問卷)。收集的資料以SPSS for windows 15.0版套裝軟體進行統計分析。結果顯示（1）研究對象的生活品質平均得分是53.4(±7.9) ，屬於中低等程度；（2）腎臟病第一、二、三期病人各範疇與題目的生活品質分數均顯著高於腎臟病四、五期病人；（3）慢性腎臟病人的教育程度、收入及平均血色素值、平均血清白蛋白值與整體生活品質具有顯著相關性，為生活品質之重要預測因子，可解釋10.9%之總變異量。本研究結果提供護理人員更多慢性腎臟病病人的生活品質相關資訊，希望能提升護理照護品質，進而改善慢性腎臟病病人的生活品質。

The number of patients with chronic kidney disease (CKD) in Taiwan has increased dramatically. The highest incidence of patients under dialysis implies huge burden of economy and threat to health care system. For these patients, improvement of life quality is as important as to prolonging life span. The purpose of this study was to explore quality of life (QOL) and its associated factors in patients withCKD. This cross-sectional study included 432 subjects aged 18 years or older and diagnosed as CKD not on dialysis at a medical center in southern Taiwan. The structural questionnaires, including demographic questions and the Taiwan version of World Health Organization Quality of Life (WHOQOL-BREF (TW)) were used. The results revealed (1) participants had an average QOL index score of 53.4(±7.9) (moderate); (2)patients at early CKD stage had higher score of QOL than those of late CKD stage did. (3) education, income, hemoglobin, and serum albumin level were significantly associated with QOL score, accounting for 10.9% of QOL variance. Our findings provide the valuable information of QOL in patients with CKD which might facilitate to improve the quality of nursing care and elevate patient’s quality of life.