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題名 慢性腎臟病患選擇透析治療之意圖探討－ 計畫行為理論之應用
Choice intention for dialysis modality among Chronic Kidney Disease patients: Application of theory of planned behavior作者 余馥羽 貢獻者 許文耀
余馥羽關鍵詞 計畫行為理論
慢性腎臟病
血液透析治療
腹膜透析治療
選擇意圖
Theory of planned behavior
Chronic Kidney disease
Hemodialysis
Peritoneal dialysis
choice intention日期 2013 上傳時間 3-Mar-2014 15:31:39 (UTC+8) 摘要 2011年台灣慢性腎臟病維持全球最高之流行率（2,584 每百萬人）；而發生率僅次於美國位居第二，慢性腎臟病在台灣帶來的醫療及經濟問題著實值得國人重視。腹膜透析治療為一有效之透析治療方式，相較於血液透析更能保護殘餘腎臟功能且花費較省，中央健保局自2007年起大力推廣腹膜透析，然台灣腹膜透析使用率僅10%。過去研究多以探索性、訪談等方式，僅能列舉出慢性腎臟病患者對不同透析治療方式的偏好因素，較缺乏統整性且無法全面瞭解慢性腎臟病患選擇意圖。本研究以計畫行為理論為主軸，並增加知識、負向情緒兩變項，探討影響末期腎臟病患者之治療決策因素，以問卷的方式施測收集共57份有效問卷，並進行相關分析、階層迴歸分析、複迴歸分析、t-test等統計考驗。本研究結果包含：1.研究結果支持以計畫行為理論之差異值預測慢性腎臟病患者對透析治療方式的選擇意圖，且以計畫行為理論變項間的差異值來預測選擇意圖能有更佳的預測力。2.影響選擇意圖之重要變項包含：差異態度、差異知覺行為控制、知識與負向情緒。3.選擇腹膜透析者與慢性腎臟疾病相關知識、負向情緒之得分皆較選擇血液透析者高。 參考文獻 中文參考文獻中央健保局（2012）。透析總額專業醫療服務品質指標。王國川（1997）。計劃行為理論各成份量表之信、效度評估－以青少年搭機車戴安全帽之研究為例。國立中正大學學報，8，73-100。台灣腎臟醫學會（2010）。慢性腎臟病防治手冊新版。台北:行政院衛生署國民健康局。伍碧琦、吳麗珍、陳彩鳳、蔡來蔭（2011）。南部某醫學中心住院病人對病人自主態度與其相關因素之探討。長庚護理，22（4），451-462。成令方（2002）。醫「用」關係的知識與權力。臺灣社會學，3，11-70。江慧珣（2003）。多媒體式護理指導對慢性腎功能不全患者知識、態度、行為意向與行為之成效（碩士），國防醫學院，台北市。吳哲熊、楊紹佑（2009）。腹膜透析方法與介紹。腎臟與透析，21（4），206-210。李佩珍（2012）。透析給付方式認知影響透析醫護人員處方行為之研究（碩士），淡江大學，台北縣。周麗華（1999）。透析患者的憂鬱現象及其護理處置。台灣腎臟護理學會雜誌，8（2）。林文源（2008）。腹膜透析推廣與病患選擇:一個動態歷程的觀點。腎臟與透析，20（1），61-64。紀育君（2007）。比較血液透析及腹膜透析病患醫療利用情形及推廣腹膜透析治療方法之可行性（碩士），亞洲大學，台中。涂珮瓊、許文耀、張正雄、陳盈如（2011）。門診癌症患者參與心理社會介入之意圖評估－計畫行為理論之運用。中華心理衛生學刊，24（3），403-428。常逸平（2009）。腹膜透析比血液透析便宜嗎？--以初次接受透析治療患者醫療資源耗用為例（碩士），國立陽明大學，台北。張芳綺、朱宗信（2009）。腹膜透析在不同疾病的使用建議。腎臟與透析，21（4），221-227。張碧玉、毛莉雯、黃尚志、黃素貞、簡麗珠、黃麗利、蔡秋月（2000）。透析患者之生活品質測量：比較血液透析及腹膜透析病患。ActaNephrologica，14（4），307。張靜芸、洪國欽、曾金鳳、謝湘俐（2009）。現行衛教與醫療給付制度對透析模式選擇之衝擊。臺灣腎臟護理學會雜誌，8（1）。梁嘉慧（2007）。慢性腎臟疾病患者選擇腹膜透析模式影響因素之探討（碩士），臺北醫學大學，台北市。許建民（2006）。職棒比賽現場觀賞行為意圖之研究—計畫行為理論之應用。國立體育學院論叢，17（4），11-24。陳佩英、史麗珠、王正旭、賴裕和、張獻崑、陳美伶（1999）。疼痛對癌症病患焦慮與憂鬱之影響。台灣醫學。陳鈺緯、潘吉豐（2008）。夜間居家血液透析。腎臟與透析，20（4），199-202。黃秀秦（2008）。末期腎病患者選擇透析方式之相關因素探討—以中部某醫學中心為例（碩士），亞洲大學，台中。黃其琨、朱惠玲（2012）。以計畫行為理論探討外籍人士品嚐臺灣小吃之行為態度與行為意圖。臺灣飲食文化暨餐飲管理國際學術研討會論文集，533-554。黃智英、楊郁（2004）。慢性腎臟病衛教簡介。臺灣腎臟護理學會雜誌，3（2）。黃圓婷（2005）。花蓮地區長期接受血液透析患者對於疾病與治療的知識、態度及自我照顧行為相關性之研究（碩士），慈濟大學，花蓮。劉苑菁（2008）。糖尿病健康促進機構醫師對血糖控制不佳之第2型糖尿病人選擇抗糖尿病藥物之行為意向及其相關因素之探討（碩士），國立台灣大學，台北。劉照金、劉一慧（2011）。臺灣體育專業人員知識分享成效之研究。臺灣體育運動管理學報，11（1），1-23。蕭仕敏、王淑麗、吳鈴珠（2008）。協助一位慢性腎臟疾病患者接受腹膜透析預先植管的護理經驗。臺灣腎臟護理學會雜誌，7（2），22-33。 鍾昀臻（2006）。運用互動式影音衛教光碟改善末期腎病患者決策、不確定感及生活品質之成效（碩士），輔英科技大學高雄市。顏乃欣（2010）。情緒對決策歷程的影響。心理學門熱門前瞻研究，11（4），113-120。顏如娟、許明暉（2007）。從資訊揭露與醫病雙方共同決策談醫病關係的演化。北市醫學雜誌，4（8），643-649。藺汝平（2007）。台灣腎臟專科醫師對ESRD病人選擇透析模式的看法（碩士），國立陽明大學，台北。 英文參考文獻Ajzen, I. 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國立政治大學
心理學研究所
98752021
102資料來源 http://thesis.lib.nccu.edu.tw/record/#G0987520212 資料類型 thesis dc.contributor.advisor 許文耀 zh_TW dc.contributor.author (Authors) 余馥羽 zh_TW dc.creator (作者) 余馥羽 zh_TW dc.date (日期) 2013 en_US dc.date.accessioned 3-Mar-2014 15:31:39 (UTC+8) - dc.date.available 3-Mar-2014 15:31:39 (UTC+8) - dc.date.issued (上傳時間) 3-Mar-2014 15:31:39 (UTC+8) - dc.identifier (Other Identifiers) G0987520212 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/64327 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 心理學研究所 zh_TW dc.description (描述) 98752021 zh_TW dc.description (描述) 102 zh_TW dc.description.abstract (摘要) 2011年台灣慢性腎臟病維持全球最高之流行率（2,584 每百萬人）；而發生率僅次於美國位居第二，慢性腎臟病在台灣帶來的醫療及經濟問題著實值得國人重視。腹膜透析治療為一有效之透析治療方式，相較於血液透析更能保護殘餘腎臟功能且花費較省，中央健保局自2007年起大力推廣腹膜透析，然台灣腹膜透析使用率僅10%。過去研究多以探索性、訪談等方式，僅能列舉出慢性腎臟病患者對不同透析治療方式的偏好因素，較缺乏統整性且無法全面瞭解慢性腎臟病患選擇意圖。本研究以計畫行為理論為主軸，並增加知識、負向情緒兩變項，探討影響末期腎臟病患者之治療決策因素，以問卷的方式施測收集共57份有效問卷，並進行相關分析、階層迴歸分析、複迴歸分析、t-test等統計考驗。本研究結果包含：1.研究結果支持以計畫行為理論之差異值預測慢性腎臟病患者對透析治療方式的選擇意圖，且以計畫行為理論變項間的差異值來預測選擇意圖能有更佳的預測力。2.影響選擇意圖之重要變項包含：差異態度、差異知覺行為控制、知識與負向情緒。3.選擇腹膜透析者與慢性腎臟疾病相關知識、負向情緒之得分皆較選擇血液透析者高。 zh_TW dc.description.tableofcontents 致謝..................................................I摘要.................................................II目次.................................................IV表次.................................................VI圖次................................................VII第一章 、緒論.........................................1第二章 、文獻回顧.....................................3第一節 、慢性腎臟病之定義與分期.......................3第二節 、慢性腎臟病治療方式...........................6第三節 、透析治療相關議題............................10第三章 、計畫行為理論................................29第一節 、理論背景....................................29第二節 、計畫行為理論各變項測量方式..................34第三節 、計畫行為理論應用於選擇情境..................41第四節 、計畫行為理論與慢性腎臟病....................46第四章 、研究目的與研究架構..........................49第一節 、研究目的....................................49第二節 、研究架構....................................51第五章 、研究方法....................................53第一節 、研究對象....................................53第二節 、研究程序....................................57第三節 、研究工具....................................57第四節 、資料處理....................................63第六章 、研究結果....................................67第一節 、計畫行為理論適用性..........................67第二節 、計畫行為理論變項與知識、負向情緒之影響......73第三節 、其他發現....................................75第七章 、討論........................................79第一節 、計畫行為理論架構之適用性....................79第二節 、選擇意圖影響因素............................82第三節 、選擇不同透析方式者之差異....................87第四節 、臨床應用....................................89第五節 、研究限制建議................................91參考文獻.............................................93附錄................................................107附錄一、人體試驗委員會臨床試驗同意書................107附錄二、計畫行為問卷................................108附錄三、慢性腎臟病與其治療方式知識問卷..............114附錄四、醫院焦慮憂鬱量表............................118 zh_TW dc.format.extent 11170158 bytes - dc.format.mimetype application/pdf - dc.language.iso en_US - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0987520212 en_US dc.subject (關鍵詞) 計畫行為理論 zh_TW dc.subject (關鍵詞) 慢性腎臟病 zh_TW dc.subject (關鍵詞) 血液透析治療 zh_TW dc.subject (關鍵詞) 腹膜透析治療 zh_TW dc.subject (關鍵詞) 選擇意圖 zh_TW dc.subject (關鍵詞) Theory of planned behavior en_US dc.subject (關鍵詞) Chronic Kidney disease en_US dc.subject (關鍵詞) Hemodialysis en_US dc.subject (關鍵詞) Peritoneal dialysis en_US dc.subject (關鍵詞) choice intention en_US dc.title (題名) 慢性腎臟病患選擇透析治療之意圖探討－ 計畫行為理論之應用 zh_TW dc.title (題名) Choice intention for dialysis modality among Chronic Kidney Disease patients: Application of theory of planned behavior en_US dc.type (資料類型) thesis en dc.relation.reference (參考文獻) 中文參考文獻中央健保局（2012）。透析總額專業醫療服務品質指標。王國川（1997）。計劃行為理論各成份量表之信、效度評估－以青少年搭機車戴安全帽之研究為例。國立中正大學學報，8，73-100。台灣腎臟醫學會（2010）。慢性腎臟病防治手冊新版。台北:行政院衛生署國民健康局。伍碧琦、吳麗珍、陳彩鳳、蔡來蔭（2011）。南部某醫學中心住院病人對病人自主態度與其相關因素之探討。長庚護理，22（4），451-462。成令方（2002）。醫「用」關係的知識與權力。臺灣社會學，3，11-70。江慧珣（2003）。多媒體式護理指導對慢性腎功能不全患者知識、態度、行為意向與行為之成效（碩士），國防醫學院，台北市。吳哲熊、楊紹佑（2009）。腹膜透析方法與介紹。腎臟與透析，21（4），206-210。李佩珍（2012）。透析給付方式認知影響透析醫護人員處方行為之研究（碩士），淡江大學，台北縣。周麗華（1999）。透析患者的憂鬱現象及其護理處置。台灣腎臟護理學會雜誌，8（2）。林文源（2008）。腹膜透析推廣與病患選擇:一個動態歷程的觀點。腎臟與透析，20（1），61-64。紀育君（2007）。比較血液透析及腹膜透析病患醫療利用情形及推廣腹膜透析治療方法之可行性（碩士），亞洲大學，台中。涂珮瓊、許文耀、張正雄、陳盈如（2011）。門診癌症患者參與心理社會介入之意圖評估－計畫行為理論之運用。中華心理衛生學刊，24（3），403-428。常逸平（2009）。腹膜透析比血液透析便宜嗎？--以初次接受透析治療患者醫療資源耗用為例（碩士），國立陽明大學，台北。張芳綺、朱宗信（2009）。腹膜透析在不同疾病的使用建議。腎臟與透析，21（4），221-227。張碧玉、毛莉雯、黃尚志、黃素貞、簡麗珠、黃麗利、蔡秋月（2000）。透析患者之生活品質測量：比較血液透析及腹膜透析病患。ActaNephrologica，14（4），307。張靜芸、洪國欽、曾金鳳、謝湘俐（2009）。現行衛教與醫療給付制度對透析模式選擇之衝擊。臺灣腎臟護理學會雜誌，8（1）。梁嘉慧（2007）。慢性腎臟疾病患者選擇腹膜透析模式影響因素之探討（碩士），臺北醫學大學，台北市。許建民（2006）。職棒比賽現場觀賞行為意圖之研究—計畫行為理論之應用。國立體育學院論叢，17（4），11-24。陳佩英、史麗珠、王正旭、賴裕和、張獻崑、陳美伶（1999）。疼痛對癌症病患焦慮與憂鬱之影響。台灣醫學。陳鈺緯、潘吉豐（2008）。夜間居家血液透析。腎臟與透析，20（4），199-202。黃秀秦（2008）。末期腎病患者選擇透析方式之相關因素探討—以中部某醫學中心為例（碩士），亞洲大學，台中。黃其琨、朱惠玲（2012）。以計畫行為理論探討外籍人士品嚐臺灣小吃之行為態度與行為意圖。臺灣飲食文化暨餐飲管理國際學術研討會論文集，533-554。黃智英、楊郁（2004）。慢性腎臟病衛教簡介。臺灣腎臟護理學會雜誌，3（2）。黃圓婷（2005）。花蓮地區長期接受血液透析患者對於疾病與治療的知識、態度及自我照顧行為相關性之研究（碩士），慈濟大學，花蓮。劉苑菁（2008）。糖尿病健康促進機構醫師對血糖控制不佳之第2型糖尿病人選擇抗糖尿病藥物之行為意向及其相關因素之探討（碩士），國立台灣大學，台北。劉照金、劉一慧（2011）。臺灣體育專業人員知識分享成效之研究。臺灣體育運動管理學報，11（1），1-23。蕭仕敏、王淑麗、吳鈴珠（2008）。協助一位慢性腎臟疾病患者接受腹膜透析預先植管的護理經驗。臺灣腎臟護理學會雜誌，7（2），22-33。 鍾昀臻（2006）。運用互動式影音衛教光碟改善末期腎病患者決策、不確定感及生活品質之成效（碩士），輔英科技大學高雄市。顏乃欣（2010）。情緒對決策歷程的影響。心理學門熱門前瞻研究，11（4），113-120。顏如娟、許明暉（2007）。從資訊揭露與醫病雙方共同決策談醫病關係的演化。北市醫學雜誌，4（8），643-649。藺汝平（2007）。台灣腎臟專科醫師對ESRD病人選擇透析模式的看法（碩士），國立陽明大學，台北。 英文參考文獻Ajzen, I. 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