[[alternative]]運動計畫介入對於慢性腎病患者血液生化值及運動階段改善之成效

[[abstract]]背景 慢性腎病患者的心臟血管疾病有著更高的發生率及死亡率。而健康的生活型態，特別是參與規律的運動，可以降低高血壓、高血脂和糖尿病的高發生率。因此運動計畫的介入應儘早進行。 目的 本研究主要目的在瞭解運動計畫對於慢性腎病患血液生化值及運動階段的影響。 方法 本研究採類實驗性設計，於台灣北部某一家醫學中心腎臟科門診篩選診斷為慢性腎病患者為研究對象共94人，並隨機分派至實驗組(n=45)與對照組(n=49)。實驗組於收案後一個月進行團體運動計畫介入，並於收案後第二、三月進行電話個別輔導。兩組於實驗前、後均以「運動行為階段量表」及「血液生化值紀錄表」檢測。資料以獨立樣本單因子共變量變異數分析(ANCOVA)。 結果 實驗組在運動計畫介入後的膽固醇(198.03±43.52mg/dL to 160.97±37.39mg/dL)及規律運動人數(57.8% to 75.6%)有顯著差異，但紅血球、血色素、血比容及血糖等四項在運動計畫介入前後無顯著差異；而對照組的血液生化值及規律運動人數前後測均無顯著差異。經以兩組前測為共變項之共變數分析之後，顯示調節後的膽固醇平均值實驗組後測為158.75mg/dL，對照組後測為177.29mg/dL，實驗組顯著低於對照組。 結論 運動計畫介入能有效降低慢性腎病患者的膽固醇值，並增加規律運動者的百分比，可提供臨床護理人員對慢性腎病患者進行運動衛教之參考。[[abstract]]Background: Chronic kidney disease (CKD) patients face a relatively high risk of cardiovascular disease morbidity and mortality. A healthy lifestyle facilitated by participation in a regular exercise regimen may prevent or retard conditions commonly associated with CKD, including hypertension, hyper-lipidemia, and diabetes. Purpose: This study examined the effect of a tailored exercise program on blood biochemical values and other exercise related variables in CKD patients. Methods: A total of 94 subjects diagnosed with CKD by a nephrology outpatient clinic at a medical center in northern Taiwan participated in this quasi-experimental study. Subjects were randomly divided into an experimental group (n=45) or a control group (n=49). Experimental group subjects agreed to join a 3-month exercise program. Individual guidance was given remotely to the experimental group over the telephone during the second and the third months following initiation of the exercise intervention. Both groups completed the pretest and posttest forms of the Stages of Exercise Questionnaire, and blood biochemical data were obtained from patient medical files. Data were analyzed using analysis of covariance. Results: The preexercise cholesterol values (from 198.03±43.52 to 160.97±37.39 mg/dl) of the experimental group differed significantly from their postexercise values. Also, the number of subjects in the experimental group who reported exercising regularly rose from 57.8% pretest to 75.6% posttest. However, changes in red blood cell count, hemoglobin, hematocrit, and blood sugar were all insignificant in the experimental group. No significant change in any of these items was detected in the control group. The cholesterol value of the experimental group (158.75mg/dl) was significantly lower than that of the control group (177.29mg/dl) after applying analysis of covariance, using the pretest results of both groups as the covariate. Conclusions and Implications for Practice: The developed exercise program was found to reduce cholesterol levels in CKD patients effectively, to encourage more patients to do exercise regularly, and to offer clinical nursing staff an approach to encourage and teach CKD patients to exercise