| Abstract: | 在臨床上約有6.6-62%之血液透析患者遭受麻刺、蟲爬、酸癢、酸脹、或搔癢等下肢深部不適感之不寧腿症候群症狀困擾，進而影響其睡眠品質及生活品質。因此，協助不寧腿症候群患者改善因症狀所帶來的困擾是刻不容緩的。本研究旨在探討RLS之HD患者，其人口學變項，憂鬱症狀、不寧腿症候群嚴重程度、睡眠品質、及生活品質之分佈情形。此外，本研究亦探討RLS之HD患者，藉由遠紅外線照射小腿與床上踩腳踏車之腿部伸展運動，對於改善憂鬱、不寧腿症候群嚴重程度、睡眠品質、及生活品質的關係。本研究為類實驗型研究，將於中部某部醫學中心血液透析室進行個案的招募及資料收集。對本研究有興趣之研究對象將隨機分派至實驗A組、實驗B組、以及對照組等三組，每組各6人。分配於實驗A組之受測者於血液透析期間進行每週 3 次，為期12週的床上腳踏車運動30分鐘介入措施外加照射遠紅外線30分鐘。分配於實驗B組之受測者於血液透析期間進行每週 3 次，為期12週施以每週 3次的床上腳踏車運動30分鐘。分配於對照組之受測者於血液透析期間進行每週 3 次，為期12週，接受一般常規透析照護。資料於收案執行介入措施前進行第一次之基準資料收集，並於執行介入措施後之第三個月進行後續追蹤資料之收集。本研究結果顯示，在實驗A組執行遠紅外線照射小腿加床上踩腳踏車之腿部伸展運動介入措施後，研究個案之睡眠品質(t=3.43，P=.019)和生活品質(t=-3.43，P=.019)呈現明顯差異。在實驗B組執行床上踩腳踏車之腿部伸展運動介入措施後，研究個案之不寧腿嚴重程度(t=3.76，P=.013)和憂鬱症狀(t=2.88，P=.035)呈現明顯差異。而對照組之研究受測者在不寧腿症候群嚴重程度、憂鬱症狀、睡眠品質、及生活品質等各方面皆沒有呈現差異。進一步比較三組間之差異發現僅在生活品質方面呈現顯著不同(H=7.45，P=.024)。期望本研究結果可協助RLS之HD患者，藉由遠紅外線照射小腿與腿部規律伸展運動降低憂鬱與不寧腿症候群之嚴重程度，並進而提升其睡眠品質及生活品質。臨床護理人員亦可藉由遠紅外線照射與腿部規律伸展運動來解決透析患者護理問題，發揮護理獨立功能。
In clinical settings, about 6.6-62% of hemodialysis patients suffer from the restless leg syndrome such as itching, soreness, tingling, and feelings of insect crawling, and consequently, it will affect patients’ quality of sleep as well as quality of life. Therefore, it is imperative to assist patients with restless leg syndrome to improve the discomforts caused by symptoms. The aim of this study is to examine the distribution of demographic variables, depressive symptoms, severity of restless legs, sleep quality, and quality of life in hemodialysis patients with restless leg syndrome.This study was an experimental study and the research participants recruited and collected in the hemodialysis room of a medical center in central Taiwan. Participants interested in this study randomly assigned to the experimental group A, the experimental group B, and the control group, each group of 6 people. Participants who were in the experimental group A received both a 30-minute in-bed cycling exercise and a 30-minute far-infrared radiation, 3 times per week for 12 weeks. Participants who were in the experimental group B received a 30-minute in-bed cycling exercise, 3 times per week for 12 weeks. Participants who were in the control group received general routine dialysis care. Baseline data were collected before the intervention were implemented, and the follow-up data were collected at third month after the intervention. The results of this study showed that after the intervention of far-infrared radiation plus in-bed cycling exercise in the experimental group A, the participants presented significant differences in the quality of sleep (t=3.43, P=.019) and quality of life (t=-3.43, P=.019). After the intervention of the in-bed cycling exercise in the experimental group B, the participants presented significantly differences in the severity of restless legs (t=3.76, P=.013) and depressive symptoms (t=2.88, P=.035). The study participants in the control group showed no differences in the severity of restless legs syndrome, depressive symptoms, sleep quality, and quality of life. Further comparison of the differences among the three groups found that only the quality of life presented significantly different (H=7.45, P=.024).It is expected that the results of this study can assist hemodialysis patients with restless leg syndrome to reduce the severity of hospital anxiety, depression, and restless leg syndrome through far-infrared radiation and in-bed cycling exercise, and further improve their sleep quality and quality of life. It can also assist clinical nursing staffs to solve the nursing problems of dialysis patients as well as to elaborate the independent nursing function. |
