探討腹膜透析病人對透析認知之差異與影響因素

Factors Associated with Knowledge about Dialysis by Peritoneal Dialysis Patients

目的：本研究旨在探討對腹膜透析病人接受「末期腎衰竭病患治療模式」衛教後，對於腹膜透析與血液透析二種透析認知之差異以及影響認知的相關因素。方法：本研究採用橫斷性研究，以自擬結構式問卷為工具，其中血液透析認知10題、腹膜透析認知13題，針對97年8月10日至12月31日中部某醫學中心接受長期腹膜透析治療之門診病人收案，有效問卷為181份。結果：腹膜透析病人對於「腹膜透析認知」答對率較「血液透析認知」高，其中有2題「腹膜透析認知」與7題「血液透析認知」答『不知道』者超過10%。逐步複迴歸分析結果發現年齡、教育程度、衛教時機、合併糖尿病與腹部開刀為影響透析認知的重要變項，解釋變異量為介於6.6%到18.7%。結論：建議未來進行透析衛教時，考慮不同年齡、教育程度，提供個別性衛教，並且提供光碟或書面資料讓病人能返家後觀看，以加強透析相關知識。

Purposes: This study analyzed differences in knowledge about peritoneal dialysis and hemodialysis by peritoneal dialysis patients who had received health education about dialysis. Methods: This cross-sectional study used a self-designed structured questionnaire that was composed of 10 questions about hemodialysis and 13 questions about peritoneal dialysis. Between August 10 and December 31, 2008, all regular peritoneal dialysis patients followed up at a medical center in central Taiwan were enrolled, and 181 valid questionnaires were obtained for this study. Results: The results showed the peritoneal dialysis patients’ understanding about peritoneal dialysis was better than their understanding about hemodialysis. There were two questions about peritoneal dialysis and seven questions about hemodialysis for which more than 10% of the responses was “No idea”. Stepwise multiple regression analysis showed that patients’ age, level of education, timing of health education, and complications with diabetes mellitus or renal stones were significant factors influencing knowledge about dialysis. These factors could explain between 6.6% and 18.7% of the variance. Conclusions: We suggest that individualized health education should be provided for patients undergoing dialysis. Patients’ age, level of education, knowledge about dialysis and experience with their disease should all be taken into consideration. We recommend that patients be provided with health education information by using various media such as videos and leaflets, so that they can review them at leisure after returning home. This may improve patients’ understanding about the different kinds of dialysis modalities, which in turn may enhance patients’ quality of life and the quality of their care.