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

Abstract

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 withpatients 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.