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系統識別號 U0026-0812200911041859
論文名稱(中文) 探討接受心導管檢查病人心率變異與焦慮之關係
論文名稱(英文) Relationship Between Heart Rate Variability and Anxiety Among Patients Receiving Cardiac Catheterization
校院名稱 成功大學
系所名稱(中) 護理學系碩博士班
系所名稱(英) Department of Nursing
學年度 92
學期 1
出版年 93
研究生(中文) 唐善美
研究生(英文) Shan-Meei Tang
學號 T2690102
學位類別 碩士
語文別 中文
論文頁數 106頁
口試委員 召集委員-蔡惟全
指導教授-顏妙芬
指導教授-駱麗華
中文關鍵字 冠狀動脈心臟病  心導管檢查  心率變異  焦慮 
英文關鍵字 Coronary Artery Disease (CAD)  Cardiac catheterization  Anxiety  Heart Rate Variability (HRV) 
學科別分類
中文摘要 心率變異為自主神經系統調控與預測心血管疾病預後或致死率的一個生理指標,並可評價護理介入措施後成效。本研究目的在辨認接受心導管檢查病人的心率變異及焦慮間之關係。本研究方法為相關性研究,於台灣南部某醫學中心採方便取樣在取得參與研究同意書後,共收案42位接受心導管檢查的病人。在心導管檢查前2至12小時採用具信效度的兩個工具測量,分別是情境特質焦慮量表及心律掃描器,並利用SPSS 10.0版之微軟軟體進行皮爾森積差相關及t考驗統計方法進行研究結果分析。本研究結果發現心導管檢查前心率變異的低頻與特質焦慮量表得分呈正相關(r = -.30, p = .03)。t考驗分析呈現女性之低頻(交感神經指標)及高頻(副交感神經指標)皆高於男性,且具統計上差異(分別為t = -2.43, -2.29; p < .05);在特質焦慮量表得分方面女性顯著高於男性(t = -2.44, p = .019),而在情境焦慮量表方面則無統計上顯著差異。因此,在本研究中接受心導管檢查的病人有較高的交感神經調控及特質焦慮,具統計上顯著意義,所以,未來適時提供護理介入措施是重要的,以降低病人心導管檢查前的焦慮及其自主神經系統之調控。
英文摘要 Heart rate variability (HRV) is an indicator of autonomic nervous system and a predictor of prognosis or mortality among patients with cardiovascular disease. It can be used as an outcome indicator of nursing interventions. The purpose of the study was to identify the relationship between HRV and anxiety among patients receiving cardiac catheterization. A correlation study was conducted in a cardiovascular unit at a medical center of southern Taiwan. Forty-two subjects were recruited by convenience after the written consent was given. Two valid and reliable instruments, State-Trait Anxiety Inventory (SATI) and Heart Rhythm Scanner, were used 2-12 hours pre-cardiac catheterization. Data were analyzed through Pearson’s product-moment correlation coefficients and t-tests using SPSS/W 10.0. There were significantly positive correlation between low frequency of HRV and scores of trait anxiety pre-cardiac catheterization (r = -.30, p = .03). The results of t-tests indicated that low frequency (an indicator of sympathetic activity) and high frequency (an indicator of parasympathetic activity) of HRV in female were significantly higher than in male (t = -2.43 and -2.29, all p < .05). The scores of trait anxiety in women were significantly higher than in men (t = -2.44, p = .019), but the scores of state anxiety were not (t = -0.37, p = .713). It meant that patients receiving cardiac catheterization had significantly higher sympathetic activity and trait anxiety. Therefore, prompt interventions are crucial to reducing patients’ anxiety pre-cardiac catheterization and modulating their autonomic nervous system.
論文目次 中文摘要 .............................i
Abstract .............................ii
誌 謝 .............................iv
目 錄 .............................vi
圖目錄 .............................viii
表目錄 .............................ix
第一章 緒論 ....................1
第一節 研究動機及重要性 ...........2
第二節 研究目的 ....................3
第二章 文獻查證 ....................4
第一節 心導管檢查及經皮治療介入措施 ..4
第二節 心率變異 ....................6
一、時域分析 ....................8
(一)統計法(Statistical methods) ..8
(二)幾何法(Geometric methods) ..9
二、頻域分析 ....................10
第三節 冠狀動脈心臟病與心率變異 ..12
第四節 焦慮與心率變異 ...........14
第三章 研究方法 ....................16
第一節 研究設計及研究架構 ...........16
第二節 研究假設 ....................18
第三節 名詞界定 ....................18
第四節 研究對象 ....................18
第五節 資料收集 ....................20
一、資料收集流程 ....................20
二、前趨研究(Pilot study) .........22
三、正式施測過程 ....................22
第六節 研究工具及信效度 ...........26
一、研究者 ........................26
二、心率變異測量儀器 ...............26
三、病人基本資料 ....................27
四、情境特質焦慮量表 ...............27
五、統計分析 ........................29
第七節 資料分析 ....................29
第八節 倫理考量 ....................29
第四章 研究結果 ....................31
第一節 基本人口學資料 ..............31
第二節 情境特質焦慮與心率變異之相關 ..40
第三節 其他結果發現 ................44
一、過去病史與心率變異之差異 ........44
二、家族病史與心率變異之差異 ........46
三、血中生化值與心率變異之相關性 ...48
四、心導管檢查前後心率變異之差異 ....50
五、心導管檢查結果與心率變異之差異 ...56
第五章 討論 ........................58
第一節 基本人口學特性 ..............58
第二節 情境特質焦慮與心率變異 ......58
第三節 其他 ..........................59
一、過去病史與心率變異 ..............59
二、家族病史與心率變異 .............59
三、血中生化值與心率變異 ...........60
四、心導管檢查前後之心率變異 .......61
五、心導管檢查結果與心率變異 ........62
第六章 結論 .........................64
第七章 研究限制及未來建議 ...........66
參考資料 .............................68
一、中文部分 .......................68
二、英文部分 .........................70
附錄 ...............................91
附錄一 人體試驗委員會同意臨床試驗證明書91
附錄二 參與研究同意書 ..............92
附錄三 病人基本資料 ................93
附錄四 情境焦慮量表使用同意書 .......94
附錄五 情境焦慮量表 ................95
附錄六 特質焦慮量表 ................96

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