肝硬化病人疲憊與身體活動量相關因素之探討

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 中文摘要

 肝硬化（ Liver cirrhosis ）疾病是美國人民除了心臟病與癌症以外的第三大死因（ Mayo, 2003 ）。

在肝硬化症狀中，疲憊（ fatigue ）是極為常見且顯著的早期症狀之一，造成病人活動量降低，影響日常生活，甚至必須減少工作時數及減少社交活動，因此，本研究主要目的為探討肝硬化病人的疲憊程度和身體活動量情形及其相關因素。

 本研究採相關性描述性的研究設計，以立意取樣選取某教學醫學中心之消化內科門診或住院治療之

肝硬化病人為對象，利用結構式問卷，以直接訪談填寫的方式完成疲憊症狀量表及身體活動七日回憶量表的問卷，探討肝硬化病人身體活動量和疲憊之情形。分析研究結果以採用 SPSS13.0 統計軟體進行資料處理及統計分析，採百分比、平均值、標準差進行描述性統計分析，推論性統計則採單因子變異數分析（ one- way ANOVA ）、獨立 t 檢定（ independent t-test ），及皮爾森積差相關分析（ Pearson's correlation coefficient ）。

 研究結果發現：（ 1 ）病人最疲憊程度平均為 8.00 ± 1.26 。疲憊對活動的影響平均分數為： 5.20 ± 2.10 分。（ 2 ）肝硬化病人平均一日從事輕度身體活動時數為 16.53 ± 3.45 ，中度身體活動為 0.51

± 1.21 ，重度身體活動為 0.08 ± 0.21 ，極重度身體活動為 0.10 ± 0.39 小時。其平均一日中度及重度身體活動時數明顯低於其他文獻中提到的社區中老年人及中年婦女。（ 3 ）肝硬化病人平均從事一週中度和極重度身體活動時數及身體活動量與疲憊對病人最近 7 天活動影響程度，均有顯著的負相關（ p < .05 ）。（ 4 ）肝硬化病人平均從事一週中度身體活動時數與疲憊對病人最近 7 天影響心情的程度，有顯著的負相關（ r =-.35, p = .03 ）。（ 5 ）而病人平均從事一週極重度身體活動時數及極重度身體活動量與病人最近 7 天最疲憊程度，與有顯著負相關（ p < .05 ）。

 本研究發現病人具有中度程度的疲憊感受，中度及重度身體活動量有較偏低情形，並且疲憊與身體

活動量之間有著密切相關性，建議於門診或社區應加強即早開始評估肝硬化病人的疲憊程度及身體活動量，建立符合病人的身體活動訓練教導。

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Fatigue and Physical Activity in Liver Cirrhosis Patient

 英文摘要

 Liver cirrhosis is the third leading cause of death in the United States of America (Mayo, 2003). Fatigue is an extremely common and one of the initial presenting symptoms in cirrhotic patients. Causing decreases i n labor productivity and daily activities, these patients may and eventually have their labor hours and socia l activities limited. This study aims at investigating the relationship between severity of fatigue and daily a ctivities in patients with liver cirrhosis.

This research is a descriptive and cross-sectional study. Subjects were selected from patients with liver cirr hosis in internal medicine department outpatient service at Taipei Medical University. The interview used a structural formula questionnaire dealing with the past seven days of cirrhosis patients’ physical activity. In addition patients completed the fatigue symptom questionnaire. The date were analyzed with the SPSS13.0 statistics software for data processing and statistical analysis. Descriptive statistical analysis included perce ntage, mean values, and standard deviation to carry on inferential statistics and to compute the single factor variance analysis (one- way ANOVA), the independent t-test, and Pierson accumulated rate correlation ana lysis (Pearson's correlation coefficient).

Results of the study showed patients with the highest fatigue scores ranged from 8.00 ± 1.26. The average activity influence score is 5.20± 2.10. (2) Cirrhotic patients spent approximately 16.53 ± 3.45 hours in light daily activities, 0.51 ± 1.21 hours per day in moderate activities, 0.08 ± 0.21 and 0.10 ± 0.39 hours per day in heavy and extremely heavy activities respectively. (3) In cirrhotic patients, a negative correlation is note d with the time devoted for moderate and extremely heavy activities (p < .05). (4) A negative correction is also found in time devoted to moderate physical activities and the influence of fatigue on mood (r < -.35, p

= .03). (5) The time dedicated to extremely heavy activities and degree of fatigue in recent 7 days appears t o show significant negative correction (p < .05).

This research showed that the patient has the moderate fatigue, moderate and heavy physical activity has th e somewhat low situation. A close relation was observed between fatigue and physical activities, Result of this study may help nurses establishing for liver cirrhosis patients physical activities training guidance.