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研究生: 蔡婉儀
Tsai, Wan-Yi
論文名稱: 慢性腎臟病人健康素養與自我管理行為相關研究—以台北市北投區某醫院腎臟科門診為例
Study on the relationship between health literacy and self-management behaviors of chronic kidney disease patients of a regional hospital in Beitou District, Taipei City
指導教授: 胡益進
Hu, Yih-Jin
口試委員: 胡益進
Hu, Yih-Jin
陳政友
Chen, Cheng-Yu
林昭光
Lin, Chao-Kuang
口試日期: 2021/12/31
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系健康促進與衛生教育碩士在職專班
Department of Health Promotion and Health Education_Continuing Education Master's Program of Health Promotion and Health Education
論文出版年: 2022
畢業學年度: 110
語文別: 中文
論文頁數: 150
中文關鍵詞: 慢性腎臟病健康素養自我管理
英文關鍵詞: chronic kidney disease, health literacy, self-management
研究方法: 調查研究
DOI URL: http://doi.org/10.6345/NTNU202200126
論文種類: 學術論文
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  • 本研究主要在探討慢性腎臟病人健康素養與自我管理的相關性。收案期間110年10月到11月,研究對象為連續3個月被醫師診斷為慢性腎臟病個案,尚未進行血液透析或腹膜透析的個案,共收集116份有效問卷。根據研究結果提出以下幾點結論:
    1.研究對象的健康素養屬「有限」程度,在「理解健康資訊」層面得分最高,「評估健康資訊」得分最低。
    2.研究對象的自我管理,在「自我整合」層面得分最高,在「遵從推薦方案」得分最低。
    3.教育程度為大專大學、有工作、近一年平均有月收入,健康素養較佳、相較於初期慢性腎臟病(Stage 1~3a),末期腎臟病前期(Stage 3b~5)的患者健康素養較差。
    4.年齡層在70歲以下自我管理行為較佳。
    5.健康素養各個面向與自我管理行為無相關性,但健康素養總分與自我管理的三個面向:自我整合、解決問題以及尋求社會支持有顯著相關。
    6.年齡、合併症、溝通與互動的健康素養面向對自我管理行為具預測力。
    高齡、教育程度低之慢性腎臟病人者健康素養較差,依本次研究結果建議加強年長及教育程度偏低之患者健康素養及自我管理能力,以提升生活品質,延緩腎臟病程進展。

    This study mainly explores the correlation between the health literacy and self-management of patients with chronic kidney disease. During the acceptance period from October to November 110, the research subjects were diagnosed as chronic kidney disease cases by physicians for 3 consecutive months and did not undergo hemodialysis or peritoneal dialysis. A total of 116 valid questionnaires were collected. According to the purpose of this research, research results and discussion, the following conclusions are put forward:
    1. Research object have a "limited" level of health literacy, with the highest score on the level of "understanding health information" and the lowest score on "evaluating health information".
    2. The self-management of research object is "moderate", with the highest score on the level of "self-integration" and the lowest score on the "compliance with the recommended plan".
    3. Patients who have a college education, have a job, have an average monthly income in the past year, and have better health literacy, compared with patients with early stage chronic kidney disease (Stage 1~3a) and end stage renal disease (Stage 3b~5) Poor health literacy.
    4. Self-management behaviors are better for people under 70.
    5. There is no correlation between health literacy and self-management behavior, but the total health literacy score is significantly related to the three aspects of self-management: self-integration, problem solving, and seeking social support.
    6. The health literacy of age, comorbidities, communication and interaction is predictive of self-management behavior.
    Patients with chronic kidney disease who are elderly and low-educated have poor health literacy. According to the results of this study, it is recommended to strengthen patient health literacy and self-management ability to improve the quality of life and delay the progression of kidney disease.

    第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的 6 第三節 研究問題 7 第四節 研究假設 7 第五節 名詞定義 7 第六節 研究限制 10 第二章 文獻探討 11 第一節 慢性腎臟病流行病學 11 第二節 慢性腎臟病人健康素養之探討 17 第三節 慢性腎臟病人自我管理行為之相關因素探討 29 第四節 慢性腎臟病健康素養與自我管理行為之關係 40 第三章 研究方法 49 第一節 研究架構 49 第二節 研究對象 50 第三節 研究工具 51 第四節 研究步驟 54 第五節 資料處理與分析 55 第六節 研究倫理 57 第四章 研究結果與討論 59 第一節 慢性腎臟病人背景變項資料分析 59 第二節 慢性腎臟病人健康素養與自我管理行為的分布情形 63 第三節 慢性腎臟病人背景資料與健康素養之關係 77 第四節 慢性腎臟病人背景資料與自我管理行為之關係 79 第五節 慢性腎臟病人健康素養與自我管理行為之關係 83 第六節 慢性腎臟病人背景變項健康素養預測自我管理行為 84 第七節 討論 88 第五章 結論與建議 97 第一節 結論 97 第二節 建議 99 參考文獻 102 附錄 143

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