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系統識別號 U0026-2701201921502300
論文名稱(中文) 探討慢性腎臟病患者持守健康行為之生活歷程
論文名稱(英文) Exploring the Life trajectory of Adherence to Healthy Behaviors among Patients with Chronic Kidney Disease
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 107
學期 1
出版年 107
研究生(中文) 陳又嘉
研究生(英文) Yu-Chia Chen
學號 T26054032
學位類別 碩士
語文別 中文
論文頁數 137頁
口試委員 指導教授-顏妙芬
口試委員-賴維淑
口試委員-曾進忠
中文關鍵字 慢性腎臟病  持守  健康行為  生活歷程 
英文關鍵字 Chronic Kidney Disease  adherence  health behaviors  life trajectory 
學科別分類
中文摘要 背景及重要性:持守健康行為可幫助慢性腎臟疾病患者延緩疾病進展且降低再住院率及死亡率,患者在罹病歷程,經由調整生活型態,能延遲末期腎病發生,而此生活經驗,是一動態的過程,隨時間來回起伏變化。
目的:探討成年慢性腎臟病患者持守健康行為的歷程。
方法:採質性敘事分析法,使用半結構式面對面訪談8位參與者,資料收集後,以「整體-內容」分析法進行個別受訪者文本分析並形成整體受訪者之核心主題,研究嚴謹度依Riessman學者 (1993)所提出的說服力、符合度、連貫性、實用性,為研究信效度參照標準。
結果:共訪談八位受訪者,男性佔5位、女性佔3位,個案平均年齡為47.85歲,教育程度碩士為2位、大學及大專為2位、高中職為3位、不識字為1位;婚姻狀態已婚者共6位,未婚者為2位;並依據整體-內容分析法,建構出一歷程故事,故事起因於個案因腎病與共病使身體受衝擊,意識健康受威脅而改變,從日常生活習慣開始調整,然而生活中許多內外在因素,可能削弱或強化行動執行程度,個案仍舊不斷嘗試各種解決問題策略,面臨挑戰不氣餒,偶而因特殊嗜好難捨離,當回診時看到客觀數據時則適時的示警病患需再注意生活型態,也因為生活中有重要他人伴行,才得以不斷突破難關增信心,最後展現生命之韌性,維持腎功能有利的行為且保持恆心。
結論:慢性腎臟病患者於生活歷程中,不斷克服內外在影響持守健康行為的因素,並尋求醫療人員及重要他人之幫助,可促進持守行為。
關鍵字:慢性腎臟病、持守、健康行為、生活歷程
英文摘要 Adherence to healthy behaviors may help patients slowing down kidney disease progression and decreasing hospital admission. The purpose of this study was to explore individual life experience of adherence to healthy behaviors among patients with Kidney Disease. A qualitative study was conducted with a narrative analysis method. A semi-structured interview guide was used in one-to-one interview. The text was analyzed based on holistic-content analysis method. The rigorous of the analysis was examined with persuasiveness, correspondence, coherence and pragmatic criteria. Total of eight patients were interviewed, 5 males and 3 females. The average age was 47.85 years old. Education qualification of study partcipants included master’s degrees (n = 2), bachelor degree (n = 2), high school (n = 3), illiterate (n = 1). Six patients were married. A story was constructed using six themes found in the data. The story began with a patient perceiving threats from warning signs and co-morbidity of kidney disease. He tried to change his life style. Daily activities were influenced by internal and external factors. He kept trying various problem-solving strategies with persistence. He might ocasionally face difficulties with getting rid of unhealthy habits. Understanding blood test results might provide as a motivator to remind him for keeping healthy behaviors in daily life. With the accompany of significant others, he was able to continue breaking through the difficulties, thus, to increase confidence in keeping healthy lifestyle. Resillience and adherence to healthy behaviors could be realized.
Key words:Chronic Kidney Disease, adherence, health behaviors, life trajectory
論文目次 目錄
中文摘要 I
Abstract II
第一章 緒論 1
第一節 研究動機及重要性 1
第二節 研究目的 3
第三節 研究問題 3
第四節 名詞解釋 3
第二章 文獻查證 5
第一節 持守健康行為的定義 5
第二節 持守健康行為的特質 6
第三節 影響慢性腎臟病人持守健康行為之因素 10
第四節 跨領域行為模式 13
第三章 研究方法 14
第一節 研究設計 14
第二節 研究參與者及招募 15
第三節 研究工具 16
第四節 資料收集過程及策略 19
第五節 資料整理與分析 19
第六節 研究之嚴謹度 21
第七節 倫理考量 23
第四章 研究結果 24
第一節 研究參與者基本資料 24
第二節 受訪者故事之敘說 26
~鴻哥持守飲食控制歷程故事~ 26
~星哥持守戒菸、戒酒之歷程故事~ 33
~小靜持守飲食控制歷程故事~ 40
~榮伯持守戒菸、戒酒與運動歷程故事~ 47
~文哥持守飲食控制歷程故事~ 54
~藍妹持守飲食及藥物歷程故事~ 65
~小婕持守飲食歷程故事~ 73
~維哥持守運動、戒除菸酒歷程故事~ 86
第三節 慢性腎臟病患者持守健康行為之總結 93
~蠶豆先生持守健康行為故事之敘說~ 94
第五章 討論 104
第一節 腎病與共病使身體受衝擊,意識健康受威脅而改變 104
第二節 生活中內外在因素,削弱或強化行動執行程度 105
第三節 不斷嘗試解決問題策略,面臨挑戰不氣餒 108
第四節 特殊嗜好難捨離,客觀數據為示警 110
第五節 重要他人伴行,突破難關增信心 111
第六節 展現生命之韌性,腎利有恆心 113
第六章 結論與建議 115
第一節 結論 115
第二節 研究建議 116
第三節 研究限制 117
參考文獻 119
附件一 初步訪談大綱 130
附件二 正式訪談大綱 131
附件三 人體試驗說明及同意書 132
附件四 受訪者訪談紀錄表 133
附件五 反思日誌 134
附件六 同儕檢核 135
附件七 受訪者檢核表 136
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