背景：隨著人口老化越趨嚴重，慢性病盛行率越來越高，慢性傷口盛行率也高。針對慢性傷口病人，目前文獻多著重在探討慢性傷口病人出院的生活品質，而慢性傷口病人住院的舒適感受較少被關注，因此其相關影響因素也不明。
研究目的：探討慢性傷口病人的疼痛、感染、及住院舒適和其相關之影響因子。
研究方法：本研究採橫斷式相關性研究法(cross-sectional, correlational study design)，於南部某區域教學醫院綜合病房進行收案，採方便取樣，以經醫師診斷確定傷口超過六週未癒合之病人為對象，研究工具包括人口學資料、疾病特性、細菌採檢培養拭子、慢性傷口疼痛量表及慢性傷口舒適量表。研究步驟第一階段檢測各項評估量表信、效度;第二階段進行正式資料收集，包括以細菌採檢培養拭子於病灶處進行細菌培養採檢。以結構性訪談方式完成量表資料收集。以SPSS 24版進行統計分析，包括：平均值、標準差、百分比、次數分配，了解慢性傷口病人的人口學特性、疾病特性、疼痛、感染、及住院舒適的現況為何；以單因子變異數分析及獨立樣本t檢定和皮爾森積差相關分析慢性傷口病人的人口學特性、疾病特性、疼痛、感染、及舒適之間的差異與相關；以多元回歸分析影響慢性傷口病人住院舒適之相關因子。
研究結果：100位慢性傷口病人參與本研究，平均年齡為62.35 ± 16.29歲，慢性傷口住院病人的舒適不受傷口數量、類別、與感染影響。研究資料顯示所有個案均有疼痛情形。住院天數和傷口疼痛程度呈現顯著正相關(r= .22, p= .04)，表示傷口疼痛程度越高住院天數越長；住院天數(r=- .31, p= .00)和傷口疼痛程度(r=- .36, p< .001)與住院舒適呈現負相關，表示住院天數越長、傷口越疼痛則慢性傷口病人住院舒適越低。最後，住院舒適的預測因子為活動情形 (B= -2.98，t = -4.01，p< .001)及傷口疼痛(B= - .29，t= -4.25，p< .001)，可解釋變異量28%。
研究結論：活動情形、疼痛為慢性傷口住院病人舒適之重要預測因子，建議針對預測因子制定治療計畫、介入措施，以提升慢性傷口病人之住院舒適。因二個變項只解釋28%的舒適變異量，顯示還有其他的相關因素會影響慢性傷口病人的住院舒適度，未來可做進一步的探討。

Background: With the greying of population, the prevalence of chronic wounds is becoming higher. Most recent studies in chronic wounds have focused on exploring older patients’ quality of life after discharge from an acute care setting. However, their comfort level during hospitalization has received less attention and its related factors remain unclear.
Purposes: To explore predictors of comfort during hospitalization among older patients with chronic wounds.
Method: A cross-sectional, correlation design with structural interview questionnaires was used to collect data. A convenient sample of 100 patients with poor wound healing for at least 6 months participated in this study from medical-surgical units in a 396-bed regional teaching hospital locating in southern Taiwan. They had an age of 62.35±6.29. There were two stages in this study: (1) psychometric testing of two instruments used to measure chronic wound pain and comfort, and (2) formal data collection and analysis. Descriptive and inferential statistics, including analysis of variance, t-test, Pearson’s correlation, and multiple regression, were applied to analyze the data.
Result:. All participants experienced pain, and their comfort was not affected by the number and type of wounds and infection. However, there was a significantly positive correlation between the length of hospital stay and the degree of wound pain (r= .22, p= .04); a negative correlation between the length of hospital stay and comfort (r= -.31, p< .01); and a negative correlation between the degree of wound pain and comfort (r= -.36, p< .001). In addition, multiple regression showed that the predictors of comfort were activity status (B= -2.98, t= -4.01, p< .001) and wound pain (B= -0.29, t= -4.25, p< .001), which accounted for 28% of variance.
Conclusion: The longer hospital stay implies patients with higher wound pain and less comfort perceived with a negative correlation between the two variables. Activity status and pain are two important predictors of comfort among patients with chronic wounds during hospitalization. Thus, nursing interventions should aim at pain management and proper design in daily activities to improve comfort for patients with chronic wounds.

目次
誌謝 I
中文摘要 II
ABSTRACT III
目次 V
表目次 VII
圖目次 VIII
第一章 緒論 1
第一節 研究動機及重要性 1
第二節 研究目的 2
第三節 研究問題 2
第四節 研究假設 2
第二章 文獻查證 3
第一節 慢性傷口概況 3
第二節 慢性傷口對住院病人的影響 6
第三節 影響住院病人舒適的因素 15
第三章 研究方法 16
第一節 研究設計與研究架構 16
第二節 名詞定義 17
第三節 研究對象及場所 18
第四節 研究工具 18
第五節 研究步驟 21
第六節 研究倫理 22
第七節 資料處理及分析 23
第四章 研究結果 24
第一節 慢性傷口舒適量表 24
第二節 慢性傷口疼痛量表 27
第三節 慢性傷口病人人口學特性、疾病特性、疼痛、感染、及住院舒適的現況 28
第四節 慢性傷口病人的人口學特性、疾病特性、疼痛、感染、和住院 32
舒適的相關 32
第五節 影響慢性傷口病人住院舒適之預測因子 34
第五章 討論與結論 36
第一節 慢性傷口病人舒適量表 36
第二節 慢性傷口病人的人口學特性與疾病特性和住院舒適之相關 37
第三節 慢性傷口病人的傷口感染與疼痛和住院舒適之相關 38
第四節 慢性傷口病人住院舒適之預測因子 39
第五節 研究限制 39
第六節 研究應用 39
第七節 結論 40
參考文獻 42
中文部分 42
西文部分 44
附錄 58
附錄一 基本資料 58
附錄二 疾病特性相關資料 59
附錄三 慢性傷口疼痛量表 61
附錄四 慢性傷口舒適量表 63
附錄五 臨床試驗人體研究通過證明書 65



表目次
表2-1-1 慢性傷口種類、部位、病生理機轉 5
表4-1-1 慢性傷口舒適量表專家效度結果 25
表4-1-2 探索性因素分析 26
表4-2-1 慢性傷口疼痛量表專家效度結果 27
表4-3-1 慢性傷口病人人口學統計資料結果 29
表4-3-2 疾病特性相關統計資料結果 30
表4-3-3 慢性傷口舒適量表描述性統計資料結果 31
表4-3-4 疼痛量表相關統計資料 32
表4-4-1 慢性傷口病人的人口學特性、疾病特性與疼痛、感染、及舒適之間的差異…33
表4-4-2 慢性傷口病人的人口學特性、疾病特性、疼痛和住院舒適之間的相關 35
表4-5-1 慢性傷口病人住院舒適的預測因子 35

 
圖目次
圖3-1-1 研究架構 16

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