進階搜尋


  查詢北醫館藏
系統識別號 U0007-2801201114171500
論文名稱(中文) 規律運動訓練對二尖瓣脫垂女性患者運動自我效能、運動耐力及症狀困擾之探討
論文名稱(英文) The effects of regular exercise training on self-efficacy for exercise, exercise tolerance and symptom distress in female patients with mitral valve prolapse
校院名稱 臺北醫學大學
系所名稱(中) 護理學研究所
系所名稱(英) Graduate Institute of Nursing
學年度 99
學期 1
出版年 100
研究生(中文) 張雅茹
研究生(英文) Ya-Ju Chang
學號 M406096004
學位類別 碩士
語文別 中文
口試日期 2010-12-29
論文頁數 114頁
口試委員 指導教授-蔡仁貞
委員-陳保羅
委員-邱愛富
中文關鍵字 運動自我效能  運動耐力  症狀困擾  運動訓練 
英文關鍵字 self-efficacy for exercise  exercise tolerance  symptom distress  exercise training 
學科別分類
中文摘要 二尖瓣脫垂是心臟科中相當常見的疾病,國外盛行率為5-15%,好發於年輕女性,症狀的不適長期的困擾著病人,除了使用藥物治療來緩解其症狀外,許多研究皆提出規律運動有助於二尖瓣脫垂症狀困擾之改善,但有關運動自我效能及運動耐力分析的探討著墨較少,因此本研究目的在探討規律運動訓練對二尖瓣脫垂女性患者運動自我效能、運動耐力及症狀困擾之影響。本研究於北部某醫學中心收案,採前後測實驗法,以隨機抽籤方式分組,以 35位接受門診追蹤治療之二尖瓣脫垂女性病患爲對象,分為運動組17人,對照組18人。運動訓練為期12週、每週三次、每次三十分鐘,兩組於運動訓練計畫第一週及第十二週收集相關資料,包括運動跑步機測試運動耐力及填寫問卷,問卷包括運動自我效能量表、僧帽瓣脫垂症狀量表。並以Mann-Whitney U test、Spearman Correlation、Generalized estimating equation、Intention-To-Treat Analyses等檢定法分析資料。結果顯示:未實施運動訓練計畫前,所有個案之運動自我效能平均分數偏低,為34.6 ± 25.6分(總分120分);運動耐力偏低為8.7 ± 1.9分;症狀困擾平均得分為20.0 ± 8.3分(總分55分)。運動訓練計畫前,所有個案運動自我效能、運動耐力與症狀困擾皆未有顯著相關。運動組運動自我效能相對於對照組明顯增加27.5分(p = .01);運動組運動耐力於規律運動訓練後由9.4 ± 2.3 METs提升為12.8 ± 2.6 METs,經運動訓練計畫後運動組較對照組增加3.0 METs(p< .001);症狀困擾方面,雖然運動組與對照組的比較,在統計上未有顯著差異(p = .05),但就運動組於運動訓練後,其症狀困擾由19.4 ± 8.3分降為10.5 ± 8.3分,可發現二尖瓣脫垂女性患者經運動訓練後,症狀困擾有緩解的趨勢。因此建議醫護人員協助二尖瓣脫垂女性患者養成規律運動的習慣,以每週三次、每次三十分鐘,運動強度為60-80 %最大運動心率之運動模式為原則,來協助提升患者之運動自我效能、運動耐力及症狀困擾的緩解。
英文摘要 Mitral valve prolapse is very common in cardiac disease, several abroad studies report prevalence rate that range from 5 to15%. It is likely to occur in young women. The symptoms distress for the patients is a long-term problem. In addition to use of medication to relieve their symptoms, many studies indicate that regular exercise could improve the distress of mitral valve prolapse symptoms. However, the exercise self-efficacy and exercise tolerance was rarely discussed. The purpose of this study is to investigate the effect of exercise training in patients with mitral valve prolapse in female exercise self-efficacy, exercise tolerance and symptom distress . The study was designed with pre-test and post-test experimental, randomized assignment in northern part of a medical center. The study included 35 female patients with mitral valve prolapse. 17 subjects were in exercise group, and the other 18 in control group. The exercise training included 30-minute session for each time, three times per week, lasting for 12 weeks. The relative data were collected on the baseline and last week, that is the twelveth week, including treadmill exercise testing and questionnaires. The questionnaire included exercise self-efficacy scale and mitral valve prolapse symptoms scale. The statistics are analysized with the Mann-Whitney U test, Spearman Correlation, Generalized estimating equation and Intention-to-treat analysis . The results shows that before the exercise training program, the scores in different categories of all cases were somewhat low: self- efficacy scores for 34.6 ± 25.6 points (total scores 120 points); exercise capacity for 8.7 ± 1.9 METs; symptom distress and the average for 20.0 ± 8.3 points (total scores 55 points). No significant relationships among exercise self-efficacy, exercise tolerance and symptom distress was observed. Exercise self-efficacy in exercise group significantly increased 27.5 points (p = .01) compared with the control group. After exercise training, exercise tolerance in exercise group increased from 9.4 ± 2.3 METs to 12.8 ± 2.6 METs. Exercise group was significantly improved compared to the control group, the exercise tolerance increased 3.0 METs (p <.001). Although symptom distress in the exercise group compared with the control group revealed no significant overall improvement (p = .05), the score of exercise group symptom distress decreased from 19.4 ± 8.3 points to 10.5 ± 7.0 points. Result of this study suggests that health care workers may help patients develop the habit of regular exercise, which means three times a week, thirty minutes for each time, at intensity of 60-80% maximum heart rate . According to the principles mentioned above, it could enhanced exercise self-efficacy, exercise tolerance, and possibly symptom distress relieve in female patients with mitral valve prolapse.
論文目次 目錄
致 謝 …………………………………………………….. Ⅰ
中文摘要 …………………………………………………….. Ⅲ
英文摘要 …………………………………………………….. Ⅴ
目 錄 …………………………………………………….. Ⅶ
圖表目次 …………………………………………………….. XI

第一章 緒論
第一節 研究動機與重要性………………………………1
第二節 研究目的……….……………………………….6
第三節 名詞解釋……………………………………… 7
第二章 文獻查證
第一節 二尖瓣脫垂病患及其症狀困擾………………10
第二節 症狀困擾對於二尖瓣脫垂患者的影響………23
第三節 二尖瓣脫垂患者運動耐力之情形……………25
第四節 運動自我效能對於規律運動訓練的影響……26
第五節 規律運動訓練對二尖瓣脫垂患者症狀困擾之成
效………………………………………………33
第三章 研究方法
第一節 研究架構………………………………………37
第二節 研究設計………………………………………39
第三節 研究對象與收案場所…………………………40
第四節 研究工具………………………………………42
第五節 運動測試………………………………………46
第六節 運動訓練計畫…………………………………48
第七節 資料收集過程…………………………………51
第八節 資料統計分析…………………………………53
第四章 分析與結果
第一節 二尖瓣脫垂女性患者人口學特性……………55
第二節 年齡及教育程度與運動自我效能、運動耐力及
症狀困擾之關係……………………………62
第三節 運動自我效能、運動耐力及症狀困擾之情形64
第四節 運動自我效能、運動耐力及症狀困擾之相關性
……………………………71
第五節 規律運動訓練之介入對於運動自我效能、運動
耐力及症狀困擾之成效………………………73
第五章 討論
第一節 二尖瓣脫垂女性患者人口學特性……………83
第二節 運動自我效能、運動耐力及症狀困擾之情形85
第三節 運動自我效能、運動耐力及症狀困擾之相關性
………………………………………………88
第四節 運動自我效能、運動耐力及症狀困擾之成效…
………………………………………………89
第六章 結論與討論
第一節 結論……………………………………………92
第二節 研究限制………………………………………94
第三節 建議……………………………………………95
參考資料
中文部分 …………………………………………………97
英文部分 ……………………………………………… 100
附錄
附錄一 個案基本資料……………………………… 106
附錄二 僧帽瓣脫垂症狀測量表(MVP Syndrome Check
List, MVPSCL) …………………………………… 107
附錄三 僧帽瓣脫垂症狀測量表原著作者同意書… 108
附錄四 運動自我效能量表………………………… 109
附錄五 運動自我效能量表原著作者同意書……… 111
附錄六 運動自我效能量表專家效度名單………… 112
附錄七 Modified Bruce Protocol ……………… 113

附錄八 Borg’s自覺費力量表(Relaing of
Perceived Exertion,RPE)……………………………114
圖表目次
圖一 研究架構圖…………………………………………………38
圖二 資料收集過程………………………………………………52
圖三 二尖瓣脫垂女性患者收案流程圖…………………………58
表一 統計分析方法………………………………………………54
表二 完成計劃者與退出計劃者人口學特性之檢定……………57
表三 二尖瓣脫垂女性患者人口學特性及兩組人口學特性之檢
定……………………………………………………………61
表四 年齡及教育程度與運動自我效能、運動耐力及症狀困擾之
關係…………………………………………………………63
表五 運動訓練計畫前,二尖瓣脫垂女性患者運動自我效能之情
形,及兩組之運動自我效能得分之檢定…………………66
表六 運動訓練計畫前,二尖瓣脫垂女性患者症狀困擾之情形,
及兩組症狀困擾得分之檢定………………………………70
表七 運動自我效能、運動耐力及症狀困擾之相關性…………72
表八 兩組運動自我效能得分前後測之差異……………………74
表九 兩組運動耐力前後測之差異………………………………76
表十 兩組症狀困擾之前後測差異………………………………78
表十一 ITT分析後,兩組運動自我效能之前後測差異………… 80
表十二 ITT分析後,兩組運動耐力之前後測差異……………… 81
表十三 ITT分析後,兩組症狀困擾之前後測差異……………… 82
參考文獻 參考資料
中文部分
王啟華、趙蘇敏、滿江紅、何尚寬(2002)實用人體解剖生理學 ?G 台北市:合記。
李碧霞(2000)中年人運動階段、身體活動及其影響因素之研究∼ 以臺北市中山區居民為例 未發表碩士論文,台北市:國立台灣師範大學衛生教育研究所。
邱艶芬、于博芮、陳幸眉(2002)高血壓病患進行中度運動之短期與長期效應 台灣醫學,6 (1),17-24。
林旭龍(2000)應用跨理論模式於大學女生身體活動之主客觀評價的
研究 未發表碩士論文,台北市:國立台灣師範大學衛生教育研究所。
林雅芳(2005)病患接受經皮冠狀動脈血管成形術後規律運動行為之探討 未發表碩士論文,台南市:國立成功大學醫學院護理學系研究所。
郭曉文(2000)學童母親規律運行為之相關因素探討 未發表碩士論
文,台北市:國立台灣師範大學衛生教育研究所。
高毓秀、黃奕清(2000)成年人運動行為影響因素之徑路分析 ?G 護理研究,8(4),435-446。
陳秀珠(1998)?G 老人運動行為及其相關因素研究--以台北市基督長老教會松年大學五十五歲以上學員為例 未發表碩士論文,台北市:國立台灣師範大學衛生教育研究所。
陳素惠、梁靜祝(1999)執行心臟復健運動對一位冠狀動脈疾病患者活動耐力之成效 長庚護理,10(2),50-55。
陳明豐(2005)二尖瓣脫垂是什麼東西 ?G 健康世界,230,8-10。
陳益祥(2001)以徑路分析探討自我效能、目標設定相關變相與直排輪表現的關係 國立台北師範學院學報,14,761-769。
范姜群信、梁子賢(1999)僧帽瓣脫垂 基層醫學。14,63。
黃婉茹(2003)應用跨理論模式於職場女性運動行為之研究 未發表
碩士論文,台北市:國立台灣師範大學衛生教育研究所。
許泰彰(2000)國小教師運動行為及其相關因素之研究 ?G 未發表碩士論文,桃園縣:國立體育學院體育研究所。
張天鈞(2000)運動、荷爾蒙與健康 當代醫學,27(12),955-958。
楊鎧鍵、曾春典(2004)僧帽瓣脫垂症候群 台灣醫界,47(2),6-7。
葉集孝(2005)二尖瓣脫垂 中華民國內膜異位症婦女協會會刊,12,14-14。
謝秀芬、紀俊吉(2008)自我效能與女性運動行為之探討 大專體育,95,76-81。
蔡佳宏(2002)應用跨理論模式於老人運動行為之研究:以台北市中
山區長青學苑學員為例 未發表碩士論文,台北市:國立台灣師範大
學衛生教育研究所。

英文部分
Al-Ali, N., & Haddad, L. G. ( 2004). The effect of the health belief model in explaining exercise participation among Jordanian myocardial infarction patients. Journal of Transcultural Nursing,15(2), 114-121.
Allison, M. J., & Keller, C. ( 2002). Physical activity maintenance in elders with cardiac problem. Geriatric Nursing, 21(4), 200-203.
Alpert, M. A., Mukerji, V., Sabeti, M., Russell, J. L., & Beitman, B. D. (1991). Mitral valve prolapse, panic disorder and chest pain. Medical Clinics of North America,75(5), 1119-1133.
American College of Sports Medicine (ACSM).( 2006). ACSM ’s guidelines for exercise testing and prescription( 7th ed. ). Philadelphia:Lippincott Williams & Wilkins.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215.
Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist , 37, 122-147 .
Bandura, A. (1986). Social foundations of thought and action. Englewood Cliffs, NJ:Prentice Hall.
Beton, D. C., Brear, J. D., Edwards, J. C., & Leonard, J. C. (1983). Mitral valve prolapse: An assessment of clinical feature, associated condition and prognosis. Quarterly Journal of Medicine, 206, 150-164.
Borg’s G. (1970). Perceived exertion as an indicator of somatic stress.Scandinavian journal of rehabilitation medicine, 2, 92-98.
Boudoulas, H., &Wooley, C. F. (1988). Mitral valve prolapse and mitral valve prolapse syndrome. New York: Mount Kisco.
Bouknight & 2’rourke (2000). Current management of mitral valveprolapse. American Family Physician, 61(11), 3343-3350.
Burns, K. J., Camaione, D. N., Froman, R. D., & Clark, B. A., (1998).Predictors of referral to cardiac rehabilitation and cardiac exercise self-efficacy. Clinical Nursing Research,7(2), 147-163.
Carlson, J. J., Norman, G. J., Feltz, D. L., Franklin, B. A., Johnson, J. A.,& Lock, S. K. (2001). Self-efficacy, psychosocial factors, and exercise behavior in traditional versus modified cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation, 21, 363-373.
Drory, Y., Fisman, E. Z., Pines, A., & Kellermann, J. J.(1989). Exercise response in young women with mitral valve prolapse. Chest, 96(5), 1076-1080.
De Barros, C.T., & Cabrita , J. (1999). Self-report of symptom frequency and symptom distress in kidney transplant recipients. PharmacoepidemiolDrug Safety, 8, 395-403.
Freed, L. A., Levy , D., Levine, R. A., Laeson, M. G., Evans, J. C., & Fuller,D. L. (1999). Prevalence and clinical outcome of mitral valve prolapse.The New England Journal of Medicine, 341, 1-7.
Freimark, D., Shechter, M., Schwamenthal, E., Tanne, D., Elmaleh, E.,Shemesh, Y., et al. (2007). Improve exercise tolerance and cardiac function in severe chronic heart failure patients undergoing a supervised exercise program. International Journal of Cardiology, 116,
309-314.
Fu , M. R., Le Mone , P., & Mc Daniel , R.W. ( 2004). An integrated approach to an analysis of symptom mamagement in patients with cancer. Oncology Nursing Forum, 31,65-70.
Grau, J. B., Pirelli, L., Yu, P.-J., Galloway, A. C., & Ostrer, H. (2007). The genetics of mitral valve prolapse. Clinical Genetics , 72 (4), 288-295 .
Hepner, A. D., Ahmadi-Kashani, M., Movahed, M.-R. (2007). The prevalence of mitral valve prolapse in patients undergoing echocardiography for clinical reason. International Journal of Cardiology ,123 (1), 55-57
Hung, H. F., Kao, P. F., Lin, Y. S., Chen, F. C., Chen, F. C., Tsai, J. C., et al.(2007). Changes of serum β-Endorphin by programmed exercise training are correlated with improvement of clinical symptoms and quality of life in female mitral valve prolapse syndrome. Cardiology, 108,252-257.
Jacquet-Davis, P. (1995). Mitral valve prolapse . Cardiovascular update, 2(1), 1-5.
Kao, Y. H., Lu, C. M., & Huang, Y. C. (2002). Impact of a transtheoretical model on the psychosocial factors affecting exercise among workers. The Journal of Nursing Research, 10(4), 303-310.
Karvonen, M. , Kentala, E., & Mustala, O. (1957). The effects of training on heart rate: A longitudinal study. Annales medicinae experimentalis et biologiae Fenniae, 35, 307-315.
King, J. E. (2007). Mitral valve prolapse :Understanding its presence and treatment. The Journal for Nurse Practitioners, 10,480-481.
Litt, M. D., Kleppinger, A., & Judge, J. O. (2002). Initiation and maintenance of exercise behavior in older women: Predictors frome the social learning. Journal of Behavior Medicine , 23(1), 83-97.
Maron, B.J., Ackerman, M.J., Nishimura, R.A., Pyeritz, R.E., Towbin, J.A., & Udelson, J.E.( 2005). Task force 4:HCM and other cardiomyopathies, mitral valve prolapse, myocarditis, and Marfan syndrome. Journal of the American College of Cardiology 2005, 45,1340-1345.
Mellwig, K. P., Buuren, F. V., Gohlke-Baerwolf, C., & BjØrnstad, H. H. ( 2008). Recommendations for the management of individuals with acquired valvular heart diseases who are involved in leisure-time physical activities or competitive sports. The European Society of Cardiology, 15(1), 95-103.
Moore, S. M., Dolansky, M. A., Ruland, C. M., Pashkow, F. J., & Blackburn, G. G.(2003). Predictor of women’s exercise maintenance after cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation, 23(1), 40-49.
Mourot, L., Boussuges, A., Campo, P., Maunier, S., Debussche, X., & Blanc, P. (2009). Cardiovascular rehabilitation increase arterial compliance in type 2 diabetic patients with coronary artery disease. Diabetes Research and Clinical Practice, 84, 138-144.
Oka, R. K., DeMarco, T., Haskell, W.L. (2005). Effect of treadmill testing and exercise training on self-efficacy in patients with heart failure. European Journal of Cardiovascular Nursing , 4, 215 – 219.
Perkins, S., & Jenkins, S. (1998). Self-efficacy expectation, behavior performance, and mood status in early recovery from percutaneous transluminal coronary angioplasty. Heart & Lung, 27(1), 37-46.
Sallis, J. F., Hovell, M. F., & Hofstetter, C. R. (1992). Predictors of adoption and maintenance of vigorous physical activity in men and women. Preventive Medicine, 21, 237-251.
Scordo, K. A. (1991). Effects of aerobic exercise training on symptomatic women with mitral valve prolapse. The American Journal of Cardiology, 67, 863-868.
Scordo, K. A. (1994). Mitral valve prolapsed syndrome: Women as second class citizens. Capsules & Comments in Critical Care Nursing,2, 1-5.
Scordo, K. A. (1996). Taking control: Living with the mitral valve prolapse syndrome (2nd ed.).Cincinnati,OH: Kardinal.
Scordo, K. A. (1997). Mitral valve prolapsed syndrome. Nonpharmacologic management. Critical Care Nursing Clinics of North America ,9(4), 555-564.
Scordo, K. A. (2000). The treatment of mitral valve prolapse syndrome in a nurse-managed outpatient mitral valve prolapse clinic. Nursing Clinics of North America,35(4),1005-1017.
Scordo, K. A. (2005). Mitral valve prolapse syndrome health concerns, symptoms, and treatments. Western Journal of Nursing Research, 27(4), 390-405.
Sekuri, C., Utuk, O., Bayturan, O., Bilge, A., Kurban, Z., & Tavli, T. (2008). Effect of losartan on exercise tolerance and echocardiographic parameters in patients with mitral regurgitation. Journal of the Rennin-Angiotensin-Aldosterone System,9(2), 107-111.
Senuzun, F., Fadiloglu, C., Burke, L. E., & Payzin, S. (2006). Effects of home-based cardiac exercise program on the exercise tolerance, serum lipid values and self-efficacy of coronary patients. European Journal of Cardiovascular Prevention and Rehabilitation , 13 , 640–645.
Sims, J. M., & Miracle, V. A. (2007). An overview of mitral valve prolapse. Dimensions of Critical Care Nursing, 26(4), 145-149.
Stouffer, G. A., Sheahan, R. G., & Lenihan, D. J., (2001). Mitral valve prolapse: A review of the literature. The American Journal of the Medical Sciences, 320(6), 401-410.
Toren, P., Eldar, S., Cendorf , D., Wolmer, L., Weizman, R., Zubadi, R., et al. (1999). The prevalence of mitral valve prolapse in children with anxiety disorders. Journal of Psychiatric Research, 33, 357-361.
Turi, Z.G. (2004). Mitral valve prolapse.Circulation,19, 38-41.
Wilmore, J. H, & Costil l, D. L. (2005). Physiology of Sport and Exercise (3th ed.) . Champaign , IL: Human Kinetics
Wu, T., Ronis, D. L., Pender, N., & Jwo, J. (2002). Development of questionnaires to measure physical activity cognitions among Taiwanese adolescents. Preventive Medicine, 35(1), 54-64.

論文全文使用權限
  • 同意授權瀏覽/列印電子全文服務,於2013-02-10起公開。


  • 若您有任何疑問,請與我們聯絡!
    臺北醫學大學 圖書館 簡莉婷
    E-mail:etds@tmu.edu.tw
    Tel:(02) 2736-1661 ext.2519
    Fax:(02) 2737-5446