慢性腎臟病患者經常感到疲憊，體適能隨著病程進展而減少，規律的運動可改善體適能狀況，促進心理層面的健康及提升生活品質，然而規律運動不易維持，跨理論模式的行為改變策略可有效增進規律運動的動機，做為養成規律運動習慣的措施基礎。本研究目的旨探討以跨理論模式為基礎的運動行為介入方案對慢性腎臟病患者體適能、每週運動量及生活品質之成效，以次級資料分析法，選取運動狀況處於動機期及準備期階段的慢性腎臟病患者，隨機分派為兩組，實驗組（n ＝ 29）介入運動行為介入方案，與個案進行 30至40分鐘面談，討論無法達成規律運動之原因，運用衛教手冊教導運動注意事項及原則；控制組（n ＝ 38）僅給予衛教手冊及個案管理師提供之一般照護而無諮詢及討論，兩組分別於介入後第三、六個月強化維持規律運動的動機，並檢測運動改變階段、體適能、每週運動量及生活品質前後測之變化。本研究選取前測、第三個月、第六個月之資料，以Mixed model分析兩組患者前測、第三個月、第六個月體適能、每週運動量及生活品質前後測之變化。研究結果顯示接受運動行為介入方案三個月及六個月後，實驗組個案運動改變階段增加高於控制組(p < .05)，第三個月的BMI及腰臀比低於控制組(p < .05)，兩組個案肌力、柔軟度、心肺耐力、每週運動量無顯著差異。接受運動行為介入方案三個月後，兩組個案整體生活品質顯著增加(p < .05)，第三個月及第六個月後兩組一般健康狀態、生理層面、心理層面、社會關係層面及環境層面無顯著差異(p > .05)。建議臨床人員以跨理論模式為基礎的衛教方式，增進慢性腎臟病患者規律運動的動機及刺激行為改變。

Patients with chronic kidney disease often suffer from fatigue and their physical fitness is reduced when the disease progresses. Patients who exercise regularly may improve their physical fitness, thus their quality of life may be improved. However the regular exercise is not easy to maintain. The processes of change in the Trans-theoretical model may promote the motivation for keeping regular exercises. The purpose of this study was to explore the use of Trans-theoretical model in exercise behaviors for patients with chronic kidney disease. The intervention programs included strategies of cognitive and behavioral change processes for enhance patient's motivation. Outcome indicators were physical fitness, total metabolic equivalents per week and quality of life.
A secondary analysis of data that collected from a randomized control trial was implemented. Sixty-seven patients with chronic kidney disease were randomly assigned to the experimental (n = 29) or control group (n = 38). Experimental patients received exercise behavior intervention which involved 30 to 40 minutes face to face discussion about why regular exercising could not be achieved and importance in change in the exercise behavior. Different strategies were used to change the conditions so that regular exercise motivation can be maintained. The control group received standardized care. Both groups had a booklet about principles and rules of exercise. The two group status on exercise behavior, physical fitness, total metabolic equivalents per week and quality of life were evaluated on the third and sixth month.
Mixed model analysis was used to test physical fitness, total metabolic equivalents per week and quality of life. The stage of change in experimental group increased significantly than control group at the third and sixth month (p < .05). The body mass index and waist-hip-ratio in experimental group decreased significantly in compare with control group in the third month (p < .05). There was no statistic significance on the muscular strength , flexilibity, cardiorespiratory endurance and total metabolic equivalents per week between groups. Two groups have increased significantly overall quality of life at the third month (p < .05). No significant findings on overall quality of life, general health, physical domain, psychological domain, social relation domain and environment between groups. These results support the applicability of the Trans-theoretical model for an exercise intervention that may promote regular exercise motivation in patients with chronic kidney disease.

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