以健康信念模式探討影響慢性腎臟病患保健行為之相關因素

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Title:	以健康信念模式探討影響慢性腎臟病患保健行為之相關因素 Investigate the factors affecting the health behaviors of patients with Chronic Kidney disease using Health Belief Model
Authors:	賴宜貞;Yi-Zhen Lai
Contributors:	醫務管理學系碩士班
Keywords:	健康信念模式;慢性腎臟病;腎臟保健行為;Health beliefs model;Chronic kidney disease;Kidney Health behaviors
Date:	2013-07-25
Issue Date:	2013-10-16 14:48:27 (UTC+8)
Publisher:	中國醫藥大學
Abstract:	背景與目的：腎炎、腎症候群及腎病變為國人十大死因之一，國人慢性腎臟病(chronic kidney disease, CKD)盛行率為11.9%，全國約有2百多萬名患者。腎臟保健行為可預防慢性腎疾病的惡化並改善健康相關生活品質。本研究以健康信念模式為理論基礎，欲瞭解慢性腎臟病患者之慢性腎臟病的相關健康信念對其腎臟保健行為之影響，相關知覺信念變項包括自覺疾病威脅(嚴重性與罹患性)、自覺行為可能性(有效性與障礙性)與行動線索，希望透過研究結果使慢性腎臟病患者增強有關慢性腎臟病之健康信念，並進而提升腎臟保健行為之重要性認知，增進自我健康管理之意願。方法：採橫斷式研究，透過文獻探討及信效度檢定，以自行設計之結構式問卷為研究工具，針對慢性腎臟病衛教門診之第一期到第五期的慢性腎臟病患者為研究對象，以便利取樣(Convenience sampling)的方式至不同層級醫療院所進行問卷調查。回收有效問卷共300份，有效回收率為91%；利用SPSS 18.0統計軟體進行描述性統計與複迴歸分析。研究結果：300位研究對象平均年齡為67.27歲，多為男性(53.7%)、無職業(76.3%)，教育程度國小以下(含)佔59%，主要資訊管道為醫護人員(99.3%)；複迴歸分析結果顯示「腎臟病期別」、「自覺行為有效性」、「自覺行為障礙性」變項對「腎臟保健行為」均有顯著的解釋力。結論與建議：慢性腎臟病患者之保健行為與其健康信念具相關性，其中自覺行為有效性與障礙性較為顯著；期有關單位能增強其履行腎臟保健行為之正向動機，減緩慢性腎臟病患者腎功能持續惡化或提早進入透析階段，進而提升慢性腎臟病患者照護與生活品質，減輕健保醫療負擔。 Background: Chronic kidney disease (CKD), including nephritis, nephritic syndromes and nephrosis, is one of ten leading causes of death in Taiwan and has 11.9% of the prevalence. Kidney health behaviors prevent the exacerbation of CKD and improve quality of life. The study should be based on health belief models to understand the related health belief (including perceived susceptibility, perceived severity, perceived benefit, perceived barriers of taking action and cue to action) for CKD patients against their kidney health behaviors. We further wish to enhance the awareness belief for CKD patients from this study, and then upgrade important knowledge of kidney health behaviors and the wishes of the self-health management. Methods: The cross-sectional method including literature investigation, reliability and validity verification was used. The used sampling method is convenience sampling that provides structured questionnaires to CKD patients in CKD outpatient health education. We further analyze the three hundred valid questionnaires (effective recovery percentage is 91%) followed by descriptive statistics, multiple regression with SPSS 18.0. Results：Average age of studied samples is 67.27. Majority is male (53.7%), no occupation (76.3%) and under elementary education (59%). Mainly information channel is health care staff (99.3%). Multiple regression result showed that there is significance between issues of kidney diseases, perceived benefit, perceived barriers of taking action and kidney health behavior. Discussion and Suggestion: Health belief of CKD patients Related their health behaviors, especially perceived benefit and perceived barriers of taking action. We suggest that relevant health authority promote positive motivation of CKD patients on fulfilling their kidney health behaviors. This action shall slow the continued exacerbation of kidney functions of CKD patients. We also wish to promote patient care and quality of life for CKD patient and reduce the burden of health insurance through this result.
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