末期腎臟病前期患者之復原力及其相關因素探討

Resilience and Related Factors Among Patients with Pre- End Stage Renal Disease

背景：慢性腎臟病是台灣地區重要的健康議題，若疾病控制不佳，將導致患者尿毒症透析治療，但國內顯少針對此族群的復原力及相關因素探討。 目的：探討pre-ESRD 患者復原力及其相關因素。 方法：採橫斷式研究設計，以中區某醫學中心門診pre-ESRD 照顧方案患者為對象，採結構式問卷包括人口學特性、因應行為量表、自我效能量表及復原力量表。 結果：201 位患者平均年齡63.95 歲，男性居多。結果顯示整體復原力為中等程度。月收入狀況、腎臟病分期、問題取向因應和自我效能為復原力預測變項，具有58%解釋力。 結論/實務應用：月收入狀況、腎臟病分期、問題取向因應和自我效能為preESRD 患者復原力重要影響因子。CKD 護理人員宜重視pre-ESRD 患者復原力及相關因素，建議將復原力理論納入在職教育（如復原力工作坊），提供護理人員學習如何增進患者因應技巧和自我效能的策略，有效促進患者執行居家自我照顧。

 

Background: Chronic kidney disease is an important health issue in Taiwan. If the disease is not well-controlled, it will lead to dialysis treatment for patients with uremia. However, there is little discussion on the resilience and related factors of this ethnic group in Taiwan. Purpose: To explore the resilience and related factors among patients with pre-ESRD stage renal disease. Methods: This was a cross-sectional correlation study. Target patients were in the preESRD care program at a medical center in the Central District. The research tools consisted of demographic characteristics, Revised Ways of Coping checklist, chronic kidney disease self-efficacy instrument, and the Resilience scale. Result: A total of 201 patients who averaged 63.95 years of age and predominantly male were recruited. The result of the study showed that: (1) The overall patient had moderate resilience. (2) Monthly income status, kidney disease stage, problem-solving behaviors, and self-efficacy were predictive variables for resilience, and accounted for 58% of the total variation in resilience. Conclusion /Implications for Practice: Monthly income status, kidney disease stage, problem-solving behaviors, and self-efficacy were identified as the crucial predictive factors of resilience in pre-ESRD patients. CKD nursing staff should pay attention to the resilience and related factors of pre-ESRD patients. It is recommended that in-service education could incorporate resilience theory (such as resilience workshop) to provide nurses with communication skills in improving coping behaviors and self-efficacy among CKD patients, who then could effectively adapt positive strategies at home.