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研究生:吳姿蓉
研究生(外文):Tzu-Jung Wu
論文名稱:「帶狀皰疹後神經疼痛」病患之憂鬱相關因子研究
論文名稱(外文):The Related factors of Depression in the Patients with Postherpetic Neuralgia
指導教授:王興耀王興耀引用關係
指導教授(外文):Shing-Yaw Wang
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:行為科學研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2000
畢業學年度:88
語文別:中文
論文頁數:98
中文關鍵詞:慢性疼痛帶狀皰疹帶狀皰疹後神經疼痛憂鬱
外文關鍵詞:Chronic painHerpes ZosterPostherpetic NeuralgiaDepression
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慢性疼痛病患中,憂鬱是一常見而嚴重的問題,本研究旨在探討「帶狀皰疹後神經疼痛」個案之憂鬱程度、疼痛程度與持續時間之關係,並預測影響「帶狀皰疹後神經疼痛」個案其憂鬱發生之相關因素。
以立意取樣方式,於南部某醫學中心皮膚科門診選取「帶狀皰疹後神經疼痛」有效樣本71名,並以性別、年齡±5歲配對,同時於眼科門診選取白內障術後71名「對照組」個案以玆比較。研究工具包括有(一)個案基本屬性資料表(二)視覺類比量表(三)柯氏中譯版之貝氏憂鬱量表。以卡方檢定、t檢定、配對t檢定、皮爾遜積差相關、單因子變異數分析及邏輯迴歸分析(Logistic Regression)為主要之資料處理與統計分析。
本研究結果發現:(一)「帶狀皰後神經疼痛」個案疼痛部位以胸神經節佔有35.2%居多、疼痛程度範圍在0至10分,平均為4.15±2.11、疼痛持續時間範圍在6至720天,平均為76.39±135.16。(二)「帶狀皰疹後神經疼痛」個案於貝氏憂鬱量表上之平均得分為13.34±7.90,以輕度憂鬱佔有46.5%居多,且憂鬱程度顯著高於「對照組」個案。(三)除年齡與疼痛程度程顯著正相關外,並未發現其他基本屬性與憂鬱程度、疼痛程度、持續時間有關係。(四)疼痛程度與憂鬱程度有顯著正相關;疼痛持續時間與憂鬱程度無顯著正相關,但疼痛時間30至90天、120天以上者,其憂鬱程度分別高於30天以下者。(五)影響憂鬱發生之顯著預測因子分別為,中度疼痛以上者(VAS>3分),其勝算危險比OR值為2.96;疼痛持續時間30天以上者,其勝算危險比OR值為4.38。
Depression is a major and common problem in chronic pain patients. The purpose of the research was to investigate the relationship between depression, pain intensity and duration among Postherpetic Neuralgia patients, and to explore the potential predictors related to the depression.
Purposive sampling was to used recruit subjects of two groups:(1)Postherpetic Neuralgia cases:seventy-one Postherpetic Neuralgia cases from the clinic of dermatology(2)Control group:seventy-one matched sex and age±5years cases from the eye clinic. Three measurement instruments were as follows:Personal demographic Data Form, Visual Analogue Scale(VAS)and Beck Depression Inventory(BDI). Descriptive statistics, Chi-Square test, two-sample t test, Pair-t test, Pearson’s product moment correlation, One- way ANOVA, Least- Significant Difference(LSD)and Logistic Regression were utilized to analyze data.
The results revealed that:(1)The most common affected dermatomes for all Postherpetic Neuralgia cases were thorax(35.2%).The mean score of the VAS was 4.15±2.11(range from 0 to10);the mean of pain duration was 76.39±135.16 days(range from 6 to 720 days).(2)The mean score of the BDI was 13.34±7.90. With Postherpetic Neuralgia patients(46.5%)reached the 10 cutoff point for the diagnosis of mild depression, Postherpeitc Neuralgia patients showed significantly higher score on BDI than control groups.(3)Depression, pain intensity and duration were not associated with demography variables(sex, age, marriage, education, job status and religion)(4)Pain intensity had height significant correlation with depression;Pain duration had not significant correlation with depression.(5)Muti-variate analysis with the logistic regression model revealed that only moderate pain(VAS>3)(OR=2.96)and pain duration more than 30 days(OR=4.38)were related to depression.
致 謝..................................................Ⅰ
中文摘要..................................................Ⅲ
英文摘要..................................................Ⅳ
目 錄..................................................Ⅵ
圖表目錄..................................................Ⅷ
第一章 緒論
第一節 研究動機與重要性...............................01
第二節 研究目的.......................................06
第三節 名詞解釋.......................................07
第二章 文獻探討
第一節 帶狀皰疹之病因學與流行病學.....................09
第二節 與「帶狀皰疹後神經疼痛」相關之研究.............13
第三節 慢性疼痛病患其憂鬱之盛行率.....................19
第四節 慢性疼痛與憂鬱之相關研究.......................24
第三章 研究設計與方法
第一節 研究架構.......................................31
第二節 操作性定義.....................................32
第三節 研究假設.......................................34
第四節 研究對象.......................................35
第五節 研究步驟.......................................44
第六節 研究工具.......................................45
第七節 資料分析.......................................49
第四章 研究結果
第一節 「帶狀皰疹後神經疼痛」與「對照組」個案之
憂鬱程度.........................................51
第二節 「帶狀皰疹後神經疼痛」個案基本屬性與憂鬱程度
、疼痛程度、持續時間之關係......................54
第三節 「帶狀皰疹後神經疼痛」個案疼痛程度、持續時
間與憂鬱程度之關係...............................62
第四節 影響「帶狀皰疹後神經疼痛」個案憂鬱發生之重要
預測因素.........................................65
第五章 討論
第一節「帶狀皰疹後神經疼痛」個案之憂鬱情形...............69
第二節「帶狀皰疹後神經疼痛」個案其疼痛程度、持續時
間與憂鬱程度之關係................................73
第三節 影響「帶狀皰疹後神經疼痛」個案憂鬱發生與否之相關
預測因子..........................................77
第六章 結論、建議與限制
第一節 結論..............................................79
第二節 建議..............................................81
第三節 研究限制..........................................84
參考文獻.................................................85
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