本文選題：腹膜透析 + 患者�。� 參考：《吉林大學》2017年碩士論文

【摘要】：研究目的:描述腹膜透析患者授權能力、自我效能和自我管理的現(xiàn)狀;分析影響腹膜透析患者授權能力、自我效能和自我管理的因素;明確自我效能在腹膜透析患者授權能力和自我管理間的中介作用。研究方法:通過方便抽樣法選取在長春市兩所三級甲等醫(yī)院進行規(guī)律腹膜透析治療的患者作為研究對象,于2015年7~12月對符合納入標準的253名腹膜透析患者進行調查,調查工具采用:一般資料調查表、腹膜透析授權簡化量表、慢性病自我效能量表、腹膜透析患者自我管理量表。利用均數(shù)、標準差、頻數(shù)、構成比等描述腹膜透析患者的一般資料、授權能力、自我效能和自我管理現(xiàn)狀;運用t檢驗、單因素方差分析、秩和檢驗、多元回歸分析探討患者授權能力、自我效能及自我管理的影響因素;運用Pearson分析或Spearman分析探討患者的授權能力、自我效能和自我管理之間的相關性;采用Bootstrap中介效應檢驗程序分析自我效能在授權能力和自我管理中的中介效應。結果:1.研究對象授權能力平均得分為(3.91?0.59)分。是否發(fā)生過并發(fā)癥及不同性別、年齡、文化程度、婚姻狀況、職業(yè)、就業(yè)狀態(tài)、家庭月收入、醫(yī)療費用支付方式、病程、透析齡、接受健康教育次數(shù)、用藥情況的腹膜透析患者授權能力得分差異具有統(tǒng)計學意義(P0.05)。2.研究對象自我效能得分為(6.82?1.12)分,自我管理得分為(63.87?10.87)分。3.研究對象授權能力與其自我效能總分及各維度呈顯著正相關(P0.05)。4.研究對象授權能力與其自我管理總分及各維度呈顯著正相關(P0.05)。5.研究對象自我效能總分及各維度與其自我管理總分及各維度均呈顯著正相關(P0.05)。6.自我效能是授權能力與自我管理間的中介變量,中介效應大小為6.2146。結論:1.腹膜透析患者的授權能力處于中等水平,部分患者仍存在授權能力較低的情況;性別、年齡、文化程度、婚姻狀況、職業(yè)、就業(yè)狀態(tài)、家庭月收入、醫(yī)療費用支付方式、病程、透析齡、接受健康教育次數(shù)、服藥依從性、并發(fā)癥是影響患者授權能力的主要因素。2.腹膜透析患者的自我效能和自我管理處于中等水平,并受患者社會人口學因素和臨床相關因素影響。3.腹膜透析患者的授權能力、自我效能和自我管理密切相關,授權能力可直接正向預測其自我管理并且可通過自我效能間接預測自我管理,自我效能是腹膜透析患者授權能力與自我管理間的中介變量。
[Abstract]:Objective: to describe the status quo of empowerment, self-efficacy and self-management in peritoneal dialysis patients, and to analyze the factors that affect the ability, self-efficacy and self-management of peritoneal dialysis patients. To clarify the role of self-efficacy between empowerment and self-management in peritoneal dialysis patients. Methods: according to the convenience sampling method, 253 peritoneal dialysis patients who were treated with regular peritoneal dialysis in two Grade 3A hospitals in Changchun were investigated from July to December 2015. The survey tools were as follows: general information questionnaire, simplified peritoneal dialysis authorization scale, chronic self-efficacy scale and self-management scale for peritoneal dialysis patients. Using the mean, standard deviation, frequency and composition ratio to describe the general data, empowerment ability, self-efficacy and self-management status of peritoneal dialysis patients, t test, single factor analysis of variance, rank sum test, etc. Multiple regression analysis was used to explore the influencing factors of patients' empowerment, self-efficacy and self-management, and Pearson analysis or Spearman analysis was used to explore the correlation between patients' empowerment ability, self-efficacy and self-management. The bootstrap mediating effect test program is used to analyze the intermediary effect of self-efficacy in empowerment and self-management. The result is 1: 1. The average score of authorization ability was 3.91 鹵0.59). Whether there have been complications or not, sex, age, education, marital status, occupation, employment status, monthly family income, payment of medical expenses, course of disease, age of dialysis, number of times of health education, The score of authorization ability of peritoneal dialysis patients with drug use was significantly different (P 0.05). 2. The self-efficacy score of the subjects was 6.82 鹵1.12), and the self-management score was 63.87 / 10.87). There was a significant positive correlation between the empowerment ability and the total score of self-efficacy and the dimensions of self-efficacy (P 0. 05. 4). There was a significant positive correlation between the ability of authorization and the total score of self-management and the dimensions of self-management (P 0. 05. 5). The total scores and dimensions of self-efficacy were positively correlated with the total score of self-management and each dimension (P0.05. 6). Self-efficacy is an intermediary variable between empowerment and self-management with a mediation effect of 6. 2146. Conclusion 1. The authorization ability of peritoneal dialysis patients was at the medium level, and some patients still had low authorization ability; gender, age, education, marital status, occupation, employment status, monthly income of family, payment method of medical expenses, course of disease, Age of dialysis, times of health education, drug compliance and complications were the main factors affecting patients' empowerment ability. The self-efficacy and self-management of peritoneal dialysis patients were at the medium level, and were affected by social demographic factors and clinical related factors. 3. The empowerment ability, self-efficacy and self-management of peritoneal dialysis patients are closely related. Empowerment ability can directly positively predict self-management and indirectly predict self-management through self-efficacy. Self-efficacy is an intermediate variable between empowerment and self-management in peritoneal dialysis patients.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.5

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