血液透析病人的疲憊及其相關因素探討

A Study of Fatigue and Associated Factors in Hemodialysis Patients

背景：疲憊是血液透析病人非常常見且嚴重的症狀之一，影響病人的生活品質，也增加死亡風險。國內對透析病人疲憊相關因素之研究，不但極少且年代久遠，臺灣洗腎的醫療品質更是優於過往，故值得針對此議題持續探究。
目的：探討血液透析病人的疲憊及其相關因素。
方法：採橫斷式、相關性研究設計，以血液透析病患疲憊量表、臺灣人憂鬱症量表，採結構式問卷訪談及病歷查詢收集資料。運用獨立樣本t檢定、單因子變異數分析、皮爾森積差相關分析、多元迴歸分析進行推論性統計。
結果：本研究以女性、無工作者居多，平均年齡63.59歲（SD = 10.29），透析時間平均為83.70個月（SD = 63.46）。疲憊分數平均為22.74分（SD = 12.34）。年齡（r = .185, p = .024）、白蛋白數值（r = -.245, p = .003）與疲憊程度呈現顯著相關，慢性疾病數（F = 7.48, p = .001）與疲憊程度具顯著差異。憂鬱情緒及白蛋白數值為與疲憊程度之顯著預測因素，可解釋68.5%的總變異量（F = 157.308, p = .001），且憂鬱情緒為主要預測變項。
結論／實務應用：可提供臨床醫護人員對評估血液透析疲憊高風險病人瞭解及照護依據，透過專業教育訓練，提供心理支持與資源應用於臨床照護中，並關注個案營養指標，提供個別性護理指導，以期研究結果作為臨床教學、研究及照護之參考。

Background: Fatigue, one of the most common and burdensome symptoms faced by hemodialysis patients, affects quality of life and increases mortality risk. Although previous studies in Taiwan have explored the factors associated with fatigue and its predictors in dialysis patients, they are limited in terms of number and are largely outdated and do not reflect recent advancements in dialysis care quality. Thus, further investigation is warranted.
Purpose: The aim of this study was to explore fatigue and its related factors in a population of hemodialysis patients.
Methods: A cross-sectional, correlational research design was used and data were collected from medical records and two structured questionnaires, namely the Hemodialysis Patient Fatigue Scale and the Taiwanese Depression Questionnaire. Inferential statistics were performed using independent sample t-tests, one-way ANOVA, Pearson’s correlation, and multiple regression analysis.
Results: The participants were primarily females and unemployed. The average age was 63.59 years (SD = 10.29), the mean dialysis duration was 83.70 months (SD = 63.46), and the average fatigue score was 22.74 (SD = 12.34). Significant correlations were found between fatigue level and, respectively, age (r = .185, p = .024) and albumin levels (r = -.245, p = .003). Fatigue levels differed significantly based on number of chronic diseases (F = 7.48, p = .001). Depressive mood and albumin levels were identified as significant predictors, explaining 68.5% of the total variance (F = 157.308, p = .001), with depressive mood being the primary predictor.
Conclusion/ Implications for Practice: The findings of this study provide assessment and care guidelines to clinical healthcare professionals for patients identified to be at high risk of hemodialysis-related fatigue. Through professional education and training, these professionals can gain the skills necessary to offer effective psychological support and clinical resources. In addition, monitoring the nutritional indicators of patients and providing them with individualized nursing guidance are similarly important. The findings of this study can inform clinical education and serve as a reference for future research in the field of patient care.