糖尿病腎病變患者心理健康、自我照顧行為與生活品質之相關性

Correlations Between Mental Health, Self-care Behavior, and Quality of life in Patients with Diabetic Nephropathy

目的
本研究探討糖尿病腎病變患者心理健康、自我照顧行為與生活品質的相關性。
方法
採橫斷式相關研究設計，以方便取樣於北部某醫學中心內分泌新陳代謝科門診收案共163位個案，問卷包含心理健康、自我照顧行為、生活品質等工具。統計方法包括描述性統計、獨立樣本T檢定、單因子變異數分析、皮爾森相關係數及逐步複迴歸分析法等。
結果
發現糖尿病腎病變患者之生理構面生活品質（PCS）優於心理構面生活品質（MCS）。心理健康（r=0.190, p=0.015）與自我照顧行為呈正相關，心理健康（r=0.605, p<0.001）、自我照顧行為（r=0.192, p=0.014）與整體生活品質呈正相關。此外，心理健康、查爾森共病症指數、糖化血色素、經濟狀況及養成運動習慣五個變項皆是預測整體生活品質的重要因子，總解釋變異量為48.7％；其中心理健康為最重要單一解釋因子，解釋變異量為36.6％。
結論
患者心理越健康及自我照顧行為越好，且整體生活品質程度也越好。其中，心理健康是影響糖尿病腎病變患者整體生活品質的重要因子，若能提升患者心理健康程度，將可提升其整體生活品質。研究結果可提供對糖尿病腎病變患者相關研究之文獻參考，建議臨床護理人員應評估心理健康與自我照顧行為情形，及時提供必要的協助。

Purposes
In this study, we investigated the correlations between mental health, self-care behavior, and quality of life in patients with diabetic nephropathy.
Methods
A cross-sectional correlational study design was adopted. One hundred and sixty-three cases admitted to the outpatient clinic of the department of endocrinology, diabetes, and metabolism of a medical center in northern Taiwan were recruited by convenience sampling, and a questionnaire, containing mental health, self-care behavior, and quality of life instruments, was administered. Statistical analyses included descriptive statistics, independent samples t-tests, one-way analysis of variance, Pearson's correlation coefficient, and stepwise regression analysis.
Results
Patients with diabetic nephropathy were found to have better physiological quality of life (physical component score, PCS) than mental quality of life (mental component score, MCS). Mental health (r=0.190, p=0.015) positively correlated with self-care behavior, and mental health (r=0.605, p<0.001) and self-care behavior (r=0.192, p=0.014) positively correlated with overall quality of life. Five variables were found to be significant predictors of overall quality of life: mental health, Charlson comorbidity index, glycated hemoglobin, socioeconomic status, and regular exercise, with a total explained variance of 48.7%. Among these variables, mental health was the single most important explanatory factor, with an explained variance of 36.6%.
Conclusions
Patients with better mental health and self-care behaviors exhibited better overall quality of life. Thus, mental health is an important factor affecting overall quality of life for patients with diabetic nephropathy. Thus, improving the mental health of patients can improve their overall quality of life. The present results may provide a reference basis for patients with diabetic nephropathy. We recommend that clinical nurses assess mental health and self-care behavior of these patients and provide timely assistance as needed.