| 摘要: | 血液透析患者在漫長的疾病與治療過程中，常面對許多生理、心理、社會、經濟方面的壓力。與患者生活最密切的家屬，不但與患者共同經歷疾病的治療與控制，而且還需擔負照顧的責任。家屬長期的精神壓力與體力的勞累，造成家屬極大負擔。因此瞭解血液透析患者及家屬的壓力與需求，實有其必要性。 本研究主要目的是探討血液透析患者及家屬之壓力與需求程度，以及影響之相關因素。採結構式問卷調查法，共訪談患者及其家屬194人，資料經由統計分析後，得到以下的研究結果： 血液透析患者平均年齡為54.5歲，以女性居多，原發病原因以腎臟病為最多，糖尿病名列第二，年齡分佈以60歲以上老人較多，學歷偏低，大部分患者已婚且無工作。 患者有中高程度的壓力感受，其中最大壓力事件的前三項依序為：1.我容易貧血，覺得疲倦、全身無力。2.我因為洗腎而活動受影響，不能遠行。3.我因為洗腎而產生併發症。影響患者壓力程度的因素，包括患者的人口統計特徵及疾病特性。此外患者有中高程度的需求感受，其中前三項最重要的需求事件，依序為：1.希望知道如何利用社會資源（醫療補助、生活補助、免稅優惠等）。2.能夠知道避免疾病惡化的方法。3.能夠減輕身體的疲倦、無力與不舒服。影響患者需求程度的因素，除了性別、年齡、教育程度、就業狀況外，還包括經濟來源、經濟狀況、身體狀況與併發症等因素。 在照顧血液透析患者的家屬方面，以女性為主，家屬有中低程度的壓力感受，其中最大照顧壓力事件的前三項依序為：1.擔心患者病情惡化。2.擔心患者情緒不穩定。3.擔心患者沒有得到好的照顧。影響家屬壓力程度的因素，除了家屬的人口統計特徵外，還包括是否與患者同住、照顧時間長短、經濟狀況、健康狀況及與患者相處關係。此外家屬有中高程度的需求感受，其中前三項最重要的需求事件，依序為：1.醫護人員能盡全力照顧患者。2.希望知道如何利用社會資源。3.想知道避免患者疾病惡化的方法。影響家屬需求程度的因素，包括就業狀況、教育程度、家庭結構、是否與患者同住、經濟狀況、健康狀況等因素。 此外，患者的壓力越高，其需求也越高；家屬壓力愈大，需求也愈大。
Hemodialysis patients, during the long-drawn ailing and treating process, frequently suffer many stresses of physical, mental, social and economic aspects. The patient’s closest family members not only share the same experience of treating and controlling the ailment as the patient, but also take the full responsibility of taking care. To such family members, long-drawn mental stress and physical fatigue have caused an enormous burden. Thus, it is apparently imperative to manifest the stresses and demands for hemodialysis patients and the family members. The study is to probe into the stresses and demands for hemodialysis patients and families and related influential factors. The questionnaire survey is adopted in interviewing the patients and their families numbering 194 persons. These data, statistically analyzed, can extract the following results: Hemodialysis patients, whose average age is 54.5 with more females, originally suffer chronic glomer ulonephritis as No.1 cause and diabetes as No. 2 cause, with the age range of over 60-year-olds in educational underclass, most of whom are married and jobless. Hemodialysis patients suffer medium to high level stresses, among which the first three things are as follows in sequential: 1. I feel anaemia, fatigue, and weakness. 2. I can't do such activities as traveling far because of hemodialysis. 3. Complications arise in the wake of hemodialysis. The factors in affecting the patients’stress cover the population property and disease speciality. Besides, the hemodialysis patients display medium to high level demands, among which the first three demands are as follows in sequential: 1. Hope to know how to utilize social resources (medical subsidy, living subsidy, preferential tax-exemption, etc.) 2. Be able to know the methods to avoid disease deterioration. 3. Be able to alleviate the body’s fatigue, weakness, and discomfort. The factors in affecting the variation of the hemodialysis patients’ demands include gender, age, educational level, and employment status, together with economic sources/ status, physical condition and complications, etc. In the category of the hemodialysis patients’ families, the focus here is the female, who suffers medium to low level stress, but regarding the pressure of taking care, the first three events are as follows in sequential: 1. Worry about the patient’s disease deterioration. 2. Worry about the instability of the patient’s emotion. 3. Worry about the occurrence of incomplete medical care. The factors in affecting the pressure of the hemodialysis patients’ families cover: whether or not to live with the patient, how long to spend taking care, economic status, health condition and getting along with the patient. Besides, As to the medium to high demands from the patient’s family, the first three important demands are as follows in sequential: 1. Medical staff can do their level best to take care of the patients. 2. Hope to know how to utilize social resources. 3. Want to know the methods to avoid the patient’s disease Deterioration. The factors in affecting the demand variation of the patient’s family cover: employment status, educational level, family structure, whether or not to live the patient, economic status, and health condition. Besides, the higher the stress of the patient grows, the greater the demands become, and the same is with the stress and the demands for the patient’s family. |
