腎臟移植病人生活品質及其相關因素

Quality of Life and Related Factors of Kidney Transplantation Recipients

本研究之目的在瞭解腎臟移植病人生活品質及其相關因素，採橫斷性相關性研究，研究對象為中部兩所醫學中心之92位腎臟移植病人，以「生活品質」、「症狀困擾」、「社會支持」與「自我照顧行為」等量表收集資料。主要結果如下：整體來看，腎臟移植病人具有中等以上生活品質，其中健康因素得分最高，心理社會因素得分最低。不同腎臟移植時期與移植地點，其出現症狀頻率與症狀困擾程度有顯著差異。社會支持功能之情緒支持得分最高，實質支持最低；支持來源方面，配偶是情緒支持、評價支持、實質支持，以及整體社會支持來源首位；醫師是訊息支持來源之首位，護理人員居第四位。不同腎臟移植時期、移植地點、性別與婚姻狀態，在整體社會支持或其四層面的得分有顯著差異。整體而言，腎臟移植病人自我照顧行為執行良好，以定期追蹤得分最高，預防感染得分最低。不同移植時期與腎功能穩定性與否，在自我照顧行為得分有顯著差異。腎臟移植病人出現症狀頻率、症狀困擾程度與整體生活品質呈顯著負相關；整體社會支持及其各層面與整體生活品質呈顯著正相關；整體自我照顧行為與整體生活品質未達顯著相關。根據研究結果，期望能做臨床護理之參考，作為提升腎臟移植病人生活品質之依據。

The purpose of this study was to explore the quality of life and related factors of kidney transplantation recipients. This was a cross-sectional and correlative research. Ninety-two kidney transplantation recipients were recruited from nephrology outpatient service of two medical centers in Taichung. The instruments of the study used were "Quality of Life Index", "Symptom Distress Scale", "Social Support Scale", and "Self Care Behaviors Scale". Data were statistically analyzed by means of descriptive analysis, t test, One way ANOVA, Pearson product moment correlation and multiple regression.The major findings of this study were as follows: The mean of the quality life of kidney transplantation recipients was 24.32. The mean score on the healthy factor dimension subscale was the highest; the psychosocial factor dimension subscale was the lowest. The differential durations after transplantion and transplanting places of recipients had significant differences on the frequency of symptoms and the distressed degree of symptom. On the part of social support of kidney transplantation recipients, according to differential supportive functions, emotional support was the highest, then information support, appraisal support, and then instrumental support. According to sources of support, one's spouse was the first of emotional support, appraisal support, instrumental support and overall sources of support; doctors were the first source of information support, nurses were the fourth. Overall, the kidney transplantation recipients well comply with self-care behaviors, "regular follow-up" was the highest," prevent infection" was the lowest. The differential duration after transplantion and graft kidney function stability of recipients had significant differences on the self-care behaviors.Their quality of life had no difference in terms of the characteristics of recipients. Symptom frequency or symptom distress were negatively correlated significantly with the quality of life (p<.05). Social support score was positively correlated significantly with the quality of life score (p<.05). Self-care behaviors score was not positively correlated significantly with the quality of life score (p>.05). The quality of life of kidney transplantation recipients could be predicted by their emotional support, frequency of symptom, and diet control behavior. The total variance was 29.1%, The major effect factor was emotional support.We expect the results of this study to be applicable in clinical nursing practices and to promote the quality of life of kidney transplantation recipients.