精神科住院患者健康促進生活型態與生活品質相關因素之探討-以基隆市精神專科醫院為例

Abstract

本研究目的在於探討基隆市兩家精神專科醫院住院患者健康促進生活型態與生活品質相關因素，研究工具採用結構式問卷進行個案資料收集。問卷內容包括：「社會人口學屬性」、「自覺健康狀況量表」、「健康促進生活型態量表」、「生活品質問卷」等四個部分。本研究以立意取樣的方式，選取基隆市兩家精神專科醫院病房住院患者為研究對象，共發出112份問卷，取得有效問卷112份。資料分析以SPSS for Windows 23.0中文版進行建檔及統計分析。研究結果歸納如下：一、精神科住院患者之自覺健康狀況屬中上程度。二、精神科住院患者之健康促進生活型態整體屬中上程度，各層面量表得分排序以適當營養為最高，其他依序為人際關係、自我實現、壓力處理、健康責任，最低為運動。三、精神科住院患者之生活品質整體屬中上程度，各範疇得分排序以生理健康為最高，其他依序為心理健康、社會關係，最低為環境。四、健康促進生活型態與社會人口學屬性中的教育程度、參與治療活動頻率、障礙等級及疾病診斷有顯著差異；與自覺健康狀況有顯著差異。五、生活品質與社會人口學屬性中的障礙等級及疾病診斷有顯著差異；與自覺健康狀況有顯著差異。六、精神科住院患者社會人口學屬性、自覺健康狀況、健康促進生活形態與生活品質之相關性結果如下：(一) 社會人口學屬性與生活品質：「婚姻狀況」與「心理健康」結果呈現負相關，「參與治療活動頻率」與「環境」結果顯著正相關。(二) 自覺健康狀況與生活品質：「自覺健康狀況一」、「自覺健康狀況二」、「自覺健康狀況三」及整體自覺健康狀況與生活品質各範疇結果皆呈現顯著正相關。(三) 健康促進生活形態與生活品質: 「適當營養」、「健康責任」、「自我實現」、「人際關係」、「運動」、「壓力處理」及整體生活型態與生活品質各範疇結果皆呈現顯著正相關。七、精神科住院患者之生活品質複迴歸分析結果如下：(一) 生理健康範疇：最重要的預測因子為「壓力處理」，與「障礙等級」的聯合預測力共可解釋45.8%的變異量。(二) 心理健康範疇：最重要的預測因子為「自我實現」，與「婚姻狀況」、「宗教信仰」及「障礙等級」的聯合預測力共可解釋44.5%的變異量。(三) 社會關係範疇：最重要的預測因子為「壓力處理」，與「障礙等級」的聯合預測力共可解釋44.6%的變異量。(四) 環境範疇：最重要的預測因子為「壓力處理」，與「障礙等級」、「婚姻狀況」及「參與治療活動」的聯合預測力共可解釋57.6%的變異量。本研究結果期望可以藉由健康促進生活型態與生活品質相關影響因素的研究可於未來我國精神照護政策對於健康促進與衛生教育介入時的參考。The purpose of this study was to investigate the factors related to the health-promoting lifestyle and quality of life of inpatients in two psychiatric hospitals in Keelung City. The research tool used structured questionnaires to collect case data. The content of the questionnaire includes four parts:"Sociodemographic Attributes", "Perceived Health Status Scale", "Health Promotion Lifestyle Scale", and "Quality of Life Scale ". In this study, inpatients in two psychiatric hospital wards in Keelung City were selected as the research objects by means of intentional sampling. A total of 112 questionnaires were sent out, 112 valid questionnaires were obtained. Data analysis was performed with SPSS for Windows 23.0 Chinese version for documentation and statistical analysis. The research results are summarized as follows:1. The perceived health status of inpatients in the psychiatric department is at an upper-middle level.2. The overall health-promoting lifestyle of psychiatric inpatients is at an upper-middle level, with proper nutrition as the highest score in each dimension, interpersonal support, self-actualization, stress management, and health responsibility in order, and exercise as the lowest.3. The overall quality of life of psychiatric inpatients is at the upper-middle level, with physical health being the highest in each category, mental health and social relations in other order, and environment being the lowest.4. There are significant differences between the health-promoting lifestyle and socio-demographic attributes in education level, frequency of participation in treatment activities, level of obstacles, and disease diagnosis; there are significant differences in perceived health status.5. There are significant differences between the quality of life and the level of obstacles and disease diagnosis in the socio-demographic attributes; there are significant differences between the quality of life and the perceived health status.6. The correlation results of sociodemographic attributes, perceived health status, health-promoting lifestyle and quality of life of psychiatric inpatients are as follows:(1) Socio-demographic attributes and quality of life: “Marital status” was negatively correlated with “mental health” results, and “frequency of participation in therapeutic activities” was significantly positively correlated with “environmental” results.(2) Perceived health status and quality of life:"Perceived health status 1", "Perceived health status 2", "Perceived health status 3" and overall perceived health status and quality of life results in all areas showed a significant positive correlation. (3) Health-promoting lifestyle and quality of life: results in various areas of "appropriate nutrition", "health responsibility", "self-actualization", " interpersonal support ", "exercise", "stress management" and overall lifestyle and quality of life All showed a significant positive correlation. 7. The results of regression analysis on the quality of life of inpatients in the psychiatry department are as follows: (1) Physiological health category: The most important predictor is "stress processing ", and the joint predictive power with " level of obstacles " can explain 45.8% of the variance. (2) Mental health category: The most important predictor is "self-actualization", and its joint predictive power with "marital status", "religious belief" and "level of obstacles " can explain a total of 44.5% of the variance.(3) Social relationship category: The most important predictor is"stress processing ", and the joint predictive power with " level of obstacles " can explain 44.6% of the variance. (4) Environmental category: The most important predictor was "stress processing ", and the joint predictive power with "level of obstacles ", "marital status" and "participation in therapeutic activities" could explain 57.6% of the variance. The results of this study hope that the research on the influencing factors of health-promoting lifestyle and quality of life can be usedas a reference for the intervention of health promotion and health education in my country's mental care policy in the future.