台灣血液透析病友健康知能與健康生活品質之相關性研究
背景及目的：
目前發展的健康知能量表主要以英語和西班牙語為主，並無專為中文語系設計的量表，而且也沒有為 特定疾病病患設計之健康知能量表。近年來，台灣的慢性腎臟病盛行率極高，且透析治療的人數也逐 年增加。因此，知能的提升或能提高血液透析病患的身心健康程度。本研究透過自行研發的健康知能 量表，及簡易整體健康狀態衡量工具，測量血液透析病患健康知能的高低與健康生活品質。本研究之 目的不僅瞭解台灣血液透析病患的健康知能及生活品質，並探討健康知能與健康生活品質之間的關係
，是否受到遵從行為影響。
研究方法：
本研究依據 Nutbeam 提出的健康知能架構，以功能性或基礎知能、溝通或互動能力及批判型知能為基 本構面，發展出適用於血液透析病患之中文化健康知能量表。問卷也納入了 SF-12 健康生活品質狀況 問卷調查血液透析病患的健康生活品質，以及個人特質問卷。自民國 97 年 12 月起開始於七家樣本醫 院開始訪查，截至 98 年 4 月止，血液透析病患健康知能問卷共回收 591 份。本研究透過敘述性統計 分析將樣本做整理，並以因素分析、變異量分析、相關分析、複迴歸分析及路徑分析，對本研究之研 究假說加以驗證。
結論：(1) 分析本研究樣本發現，血液透析病患之健康知能、健康生活品質及遵從行為三方的路徑圖為：
「健康知能」 → 「遵從行為」 → 「健康生活品質」。
(2) 主要影響血液透析病患整體健康知能的個人特質，有年齡、有無過去病史、家中主要經濟來源及 主要經濟來源者之社經地位等四項前因變項。
(3) 台灣的血液透析病患整體健康知能為 0.77 分 ( 標準差＝ 0.17) ，生理健康生活品質為 37.16 分 ( 標 準差＝ 9.09) ，心理健康生活品質為 50.47 分 ( 標準差＝ 10.36) 。
(4) 健康知能方面，病患的身體照護相關知能分數最高，進階健康知能的表現最差。健康知能的好壞
，除了受病患平時所吸收的健康資訊多寡影響外，經驗也是影響健康知能的一項重要因素。
A Study on the Relationship among Health Literacy and Health Quality of Hemodialysis Patient in Taiwan
Objectives :
Most of health literacy instruments were designed for people who speak English and Hispanic. Neither spe cific instrument were devised for Chinese, nor for specific group of patients. Prevalence of chronic renal di sease in Taiwan is high, and number of dialysis patient increase year by year. Health literacy is a possible s olution to enhance the health status among hemodialysis patients. This research utilizes a self-devised instr ument to measure health literacy and Short Form (SF-12) to measure quality of life. Purposes of this study set out including to examine the relationship of health literacy and quality of life among hemodialysis patie nts, to test the mediating role of compliance behavior to the relationship of health literacy and quality of lif e.Methods :
This study employs self-administered questionnaires. Based on the theory raised by Nutbeam, health litera cy instrument Chinese health literacy is devised with questionnaire of this research bases on health literacy structure produced by Nutbeam. The structure includes tthree basic factorconstructs: functional health liter acy, interactive health literacy and critical health literacy. Questionnaire of this reaserch also includes SF-1 2 is used to measure-item short form health statusquestionnaire ,and demography questions. . This research was started to investigate Data was collected from hemodialysis patients data at seven hospitals, from Dece mber in 2008 till April in 2009. This research study collected 591 valid questionnaires. Data analysis inclu des utilizes descriptive analysis to display data, and utilizes, factor analysis, ANOVA, correlation analysis, multiple regressions and path analysis to test the model validity.
Results :
(1) Path among health literacy, quality of life and adherence is : health literacy → adherence → quality of l ife.(2) Main demography data which affect to health literacy is age, history of disease, main economic source and social economic status of main economic source.
(3) The mean(±SD) score of literacy was 0.77 (0.17). Mean(±SD) physical and mental score are 37.16(9.0 9) and 50.47(10.36).
(4) Literacy of physical care among hemodialysis patients is well, advanced health literacy is weak. This re sult investigates that not only quantity of health information affects health liracy, but also experience.
