長期血液透析病患的生活品質

楊 樹昌, 王 榮德, Mai-Szu Wu, 郭 佩雯, 蘇 喜

Research output: Contribution to journalJournal Article peer-review

Abstract

測量血液透析病患的生活品質,與健康族群比較,並且分析血液透析病患生活品質的相關因素。方法:世界衛生組織生活品質問卷台灣簡明版共含28項目,分屬四範疇及整體性項目。以此問卷施測於台北和基隆地區13家醫院或診所的透析中心共512位接受長期血液透析的病患,計算出各題目及範疇之分數;和健康族群比較;並且以四範疇或整體生活品質項目為依變項,做逐步複迴歸分析以探討其影響因素。血液透析病患整體生活品質、生理、心理、及社會關係範疇之分數低於正常族群;環境範疇則和正常族群者差不多;(2)依人口學變項分組,其生活品質分數常有顯著不同;尤其是年齡分組者各組的整體生活品質、生理範疇、社會關係範疇、以及環境範疇分數有顯著不同(p<0.05)。十項人口學變項除了飲酒這一項目外,其餘各個項目分組的社會關係範疇分數彼此間有顯著不同(p<0.05);(3)臨床變項方面,依照白蛋白濃度分組或者依照鐵蛋白濃度分組,各組之生理範疇分數有顯著差別(p<0.05);以血比容值分組,其心理範疇分數有顯著差別(p<0.05);(4)在控制其他變項下,逐步複迴歸分析顯示出影響生活品質的主要相關因素,地區別對於四範疇均有顯著影響(partial R^2為0.14-0.22);家庭收入對於環境範疇分數(partial R^2=0.10),紅血生成素每週注射量對於心理範疇分數(partial R^2=0.050),以及抽菸與否對於社會關係範疇分數(partial R^2=0.050)也有較大影響。血液透析病患生理、心理、及社會關係三範疇及其層面∕項目的生活品質與正常族群相比是較為低下,環境範疇則差不多;影響血液透析病患各個範疇生活品質的因素繁多且有不同。
To measure the multi-profiled quality-of-life (QOL) in patients on maintenance hemodialysis (MHD), compare them with those in normal population, and uncover the associated factors of QOL among those patients. The generic questionnaire- World Health Organization Quality of Life, brief edition, Taiwan version [(WHOQOL-BREF(TW))-which composed of 4 domains and global items, was used to measure 512 MHD patients in Taipei and Keelung area. The domains and items of WHOQOL-BREF(TW) were compared between MHD patients and normal population. The stepwise regression analyses were performed with each domain or global QOL as dependent variable and demographical and clinical variables as independent variables to explore the associated factors of QOL on those MHD patients. (1)The scores of global QOL, physical, psychological, and social-relationship domain among MHD patients were inferior to general population. The score of environmental domain was not significantly different from the general population. (2)Occasionally QOL were significantly different with leveling of the demographical variables. The different age groups showed significantly different scores of global QOL, physical, social relationship, and environmental domain (p<0.05). Every demographical variable except "drinking" was shown to have significantly different score of social domain with different levels of this variable (p<0.05). (3) Different levels of albumin showed significantly different scores of physical domain (p<0.001), the same as those different levels of ferritin (p<0.01). Different levels of hematocrit showed significantly different scores of psychological domain (p<0.05). (4)Under the control of other variables, the stepwise regression analyses showed that area had significant impact (partial R^2 14-22%) on the four domains, the family income had significant impact (partial R^2 10%) on environmental domain, the erythropoietin injection amount per week had significant impact (partial R^2 5%) on psychological domain, and the smoking had significant impact (partial R^2 5%) on social-relationship domain. The QOL of HD patients were lower than those of general population in physical, psychological and social-relationship domains and their facet/items, but about the same as that in environment domain. The significantly associated factors of QOL domains in HD patients were diverse and different.
Original languageChinese (Traditional)
Pages (from-to)140-152
Journal臺灣醫學
Volume11
Issue number2
StatePublished - 2007

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