第五章 綜合討論
第五節 未來研究方向
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第五節 未來研究方向
國內慢性腎臟病患者，大多選擇以血液透析作為腎臟替代療法(中華民國腎 臟基金會，2009)，而目前世界各國選擇腹膜透析之比例存在不小的差異，例如 2006 年香港選用腹膜透析的患者比例高達 81%、墨西哥為 70%、紐西蘭有 39%，
但同年美國僅有 7%、台灣為 8%、日本僅 3%(USRDS, 2009)，影響末期腎病患者 選擇透析模式的可能因素包含：(1)禁忌症之限制、(2)對原先生活型態的改變 程度、(3)患者的自主性、(4)可否維持自我照顧、(5)治療的安全性、(6)身體 心像的威脅、(7)自我價值感的威脅、(8)先前的透析經驗、(9)他人的透析經驗、
(10)治療的可近性、(11)醫護人員的治療決策安排、(12)家庭成員的支持等(王 麗玲、楊麗芬，2004)，若能對不同透析模式患者的生活品質有更多了解，將能 作為末期腎衰竭患者選擇醫療照護決策之參考。在國內，鈕淑芬(2004)曾調查 血液、腹膜透析患者的一般性健康相關生活品質與相關影響因素，結果發現兩 者的生活品質得分並無顯著差異；在國外，Abdel-Kader 等人(2009)以美國賓 州共 151 位接受腹膜、血液透析、腎功能由第四期逐漸惡化至第五期等各組慢 性腎衰竭(CKD)患者為受詴，評估三組受詴在 HRQoL(SF-36)、心理社會因素與 IQoL(SEIQoL-DW)之差異與關連，結果發現三組的 SEIQoL-DW Index、HRQo、因 應風格、憂鬱程度皆無顯著差異。
由於在 Abdel-Kader et al.(2009)的研究中，腹膜透析患者受詴人數為 16 人，僅占所有受詴的 14%，且並未分析不同組別在不同生活品質向度的現況與 重要性是否存在組間差異，為了解國內選擇不同透析模式之慢性腎臟病患者在 個人化生活品質所著重的內涵、現況、以及現況-期望落差是否有所不同，研究 者原擬同時納入腹膜透析患者為研究對象，惟因研究時間的限制，未能及時進 行腹膜透析患者的評估，目前研究者已通過桃園某財團法人醫院人體詴驗倫理 委員會的核准，預定募集 60 位腹膜透析患者進行調查訪問，預定在收案完成 後，進行更進一步的比較分析。
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第三部份 個人基本資料
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