跳到主要內容

臺灣博碩士論文加值系統

(18.97.14.82) 您好!臺灣時間:2025/02/19 01:11
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

我願授權國圖
: 
twitterline
研究生:游勝宏
研究生(外文):Yu Shenq-Horng
論文名稱:中風後憂鬱與損傷位置之相關性:整合分析
論文名稱(外文):Post-stroke depression and its relation to lesion location: a meta-analysis
指導教授:劉景寬劉景寬引用關係余麗樺余麗樺引用關係
指導教授(外文):Liu Jing-KuanYu Li-Hua
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:2002
畢業學年度:90
語文別:中文
論文頁數:81
中文關鍵詞:中風後憂鬱損傷位置整合分析
外文關鍵詞:post-stroke depressionlesion locationmeta-analysis
相關次數:
  • 被引用被引用:4
  • 點閱點閱:520
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:5
摘 要
大腦損傷的解剖學定位與中風後憂鬱的發生之間的關聯性仍是未解決的問題,對於這些衝突的現象值得作進一步探索與釐清;因此,本研究的目的是從中風後憂鬱與大腦損傷位置的關聯性之研究領域中,根據現有的研究結果,做一系統性的量化回顧,並探究造成研究差異的可能調節變項,以尋求一致性且更強而有力的結論。
研究中所回顧的文獻範圍係取自MEDLINE、PsyINFO資料庫,系統性地蒐集相關文獻,且檢視重要文獻中參考資料所列之文獻,從每篇研究報告中登錄重要特徵變項,計算中風後憂鬱與大腦損傷位置的關連效果量,採整合分析技術進行分析。
本整合分析中包含47篇研究文獻,參與研究之患者達3507位,研究結果顯示中風後憂鬱與右腦損傷有輕度的關連性存在,而研究結果之異質性來源主要包括語言功能障礙患者的排除控制、使用不同之憂鬱評量工具與方式等因素。
未來的研究應著重於訂定明確的研究報告規範,進一步地改善對於失語症患者的憂鬱評量工具和採用合宜的方法學,以清楚地探究中風後憂鬱與損傷位置之關連性。
Abstract
What is the relationship between the neuroanatomic loci of brain damage and the incidence of post-stroke depression (PSD)? It is still an unsolved issue. It is necessary to conduct a study to clarify and explore further. With the purpose of gaining a consistent, strong and credible conclusion on the relationships between PSD and the loci of brain damage , the study aimed to adopt meta-analysis (a) to systematically reanalyze the findings of related studies and (b) to investigate the moderator variables that resulted in the differences.
The MEDLINE and PsyINFO computerized databases were searched for the related reviewed literature. Besides, the literature listed in the important related literature were also examined. For each study, the important study characteristics were recorded, and the effect sizes of the relationships between PSD and lesion location were computed. Furthermore, the relationships between study characteristics and the effect sizes obtained were examined to search for the possible moderator variables.
A total of 3507 patients participated in 47 studies in the meta-analysis. Results revealed that there was a slight relation between post-stroke depression and right hemispheric lesion. The major sources of heterogeneity of study results included the systematic exclusion of patients with language dysfunction, and the use of different assessors and instruments for diagnosing depression.
Future efforts should aim at enhancing the standards for reporting of studies, assessment tools should be further improved for use in aphasia patients and appropriate methodology should be adopted to study post-stroke depression and its relation to lesion location.
目 錄
中文摘要 ……………………………………………………………………… I
英文摘要 ……………………………………………………………………… II
目 錄 ……………………………………………………………………… III
圖表目次 ……………………………………………………………………… IV
公式目次 ……………………………………………………………………… V
第一章 緒論 ……………………………………….…………………… 1
第一節 研究背景 …………………………….…………………… 1
第二節 研究動機與目的 …………………….…………………… 2
第二章 文獻探討 ………………………………….…………………… 5
第一節 中風與憂鬱 ………………………….…………………… 5
第二節 中風後憂鬱與損傷位置的假設 ..…….…………………… 7
第三節 整合分析 …………………………….…………………… 8
第四節 文獻回顧在中風後憂鬱與損傷位置之研究發現 ……….….. 13
第五節 中風後憂鬱與大腦損傷部位的影響因素 ….…………… 14
第三章 研究設計與方法 ……………………………………………… 20
第一節 整合分析研究樣本的收集 ……………………………… 20
第二節 研究重要特徵變項的登錄 ……………………………… 21
第三節 登錄員間信度的計算 …………………………………… 23
第四節 效果量的計算方法 …………………………………… 25
第五節 單一研究多重效果量的求算 …………………………… 27
第六節 效果量之分析 …………………………………………… 28
第七節 研究流程 …………………………………………………….. 31
第四章 研究結果 ………………………………………………………….. 32
第一節 研究樣本及效果量來源 ………………………………….. 32
第二節 整體的效果量分析 ………………………………………. 34
第三節 調節變項的分析 .………………………………………... 37
第五章 討論 .…………………………………………………………. 52
第一節 效果量的分析 ……………………………………….. 52
第二節 綜合討論 ……………………………………………….... 57
第三節 研究限制 .………………………………………………. 62
第六章 結論與建議 .…………………………………………………. 64
第一節 結論 ….…………………………………………………. 64
第二節 建議 .……………………………………………………. 65
參考文獻(含整合分析使用) ………………………………………….. 67
附錄一 研究特徵登錄表 ……………………………………………….. 77
附錄二 研究品質統計表 ……………………………………………….. 80
參 考 文 獻
1. 王秀紅(民88):統合分析的概念及其在護理的應用。護理研究。7(2),83-91
2. 林 憲(民86):老年癡呆症。身心醫學雜誌。第八捲,第二期,65-73
3. 林邦傑(民76):整合分析的理論及其在國內的應用。教育與心理研究。政治大學。10,1-38
4. 許美慧(1996):腦中風患者復健治療預後之探討。中華復健醫誌。24,41-49
5. 許俊傑 陳慧霞 藍守仁(民84):統合分析的概念與方法。公共衛生。22,41-49
6. 應立志(民78):整合分析方法之介紹與應用。台北:書恆出版社。
7. 蘇王麟 楊百嘉(1991):中風後憂鬱症之初步研究。中華復健醫誌。19,103-109
8. 衛生署:衛生統計資訊網(2002/07/22) http://www.doh.gov.tw/ statistic/data/死因摘要/90年/表01.xls
9. *Agarwal, A., Nag, D., Kar, A. M., Agarwal, A. K., & Chowdhury, S. R. (1987). Dexamethasone suppression test & post-stroke depression. Indian Journal of Medicine and Research, 85, 297-301.
10. Alexopoulos,G.S.,Meyers,B.S.,Young,R.C.,Campball,S.,Silbersweig,D. & Charlson ,M.(1997). Vascular depression hypothesis. Archives of General Psychiatry,54,915-922.
11. *Agrell, B., & Dehlin, O. (1994) . Depression in stroke patients with left and right hemisphere lesions. A study in geriatric rehabilitation in-patients. Aging (Milano), 6(1), 49-56.
12. *Andersen, G., Vestergaard, K., & Ingeman-Nielsen, M. (1995). Post-stroke pathological crying: Frequency and correlation to depression. European Journal of Neurology, 2(1), 45-50.
13. Andersen, G., Vestergaard, K. Ingeman-Nielsen, M., .& Lauritzen, L.(1995). Risk factors for post-stroke depression. Acta Psychiatrica Scandinavica, 92,193-198.
14. *Angeleri, F., Angeleri, V. A., Foschi, N., Giaquinto, S., Nolfe, G., Saginario, A., & Signorino, M. (1997). Depression after stroke: an investigation through catamnesis. Journal of Clinical Psychiatry, 58(6), 261-265.
15. *Astrom, M. (1996). Generalized anxiety disorder in stroke patients. A 3-year longitudinal study. Stroke, 27(2), 270-275.
16. Astrom, M., Adolfson, R.& Asplund, K. (1993). Major depression in stroke patients: a 3-year longitudinal study. Stroke, 24,976-982.
17. *Bacher, Y., Korner-Bitensky, N., Mayo, N., Becker, R., & Coopersmith, H. (1990). A longitudinal study of depression among stroke patients participating in a rehabilitation program. Canadian Journal of Rehabilitation, 4, 27-37.
18. *Berg, A., Palomaki, H., Lehtihalmes, M., Lonnqvist, J., & Kaste, M. (2001). Poststroke depression in acute phase after stroke. Cerebrovascular Diseases, 12(1), 14-20.
19. Bryan,R.N.,Manplio,T.A.,Schertz,L.D.,Jungereis,C.,Poirier,V.c.,Elster,A.D. & Kronmal,R.A.(1994). Amethod for using MR to evalute the effects of cardiovascular disease on the brain: the cardiovascular health study. American journal of Psychiatry,12,219-226.
20. *Burvill, P. W., Johnson, G. A., Chakera, T. M. H., Stewart-Wynne, E. G., Anderson, C. S., & Jamrozik, K. D. (1996). The place of site of lesion in the aetiology of post-stroke depression. Cerebrovascular Diseases, 6, 208-215.
21. Carson, A.J., MacHale, S., Allen, K., Lawrie, S,. Stephen, M., Dennis, M., House, A.& Sharp, M. (2000). Depression after stroke and lesion location : a systematic review. The Lancet, 356(9226),122-126.
22. *Collin, S. J., Tinson, D., Lincoln, N. B., & Nadina, B. (1987). Depression after stroke. Clinical Rehabilitation, 1(1), 27-32.
23. Conn V.S.& Armer J.M. (1996).Meta-analysis and public policy: Opportunity for nursing impact. Nursing Outlook,44,267-271.
24. Cook,D.J.,Guyatt,G.H.,Ryan,G.,Clifton,J.,Buckingham,L.,Willan,A,Mcooroy,W.,Oxman,A.D.,(1993). Should unpublished data be inclued in meta-analysis? Current covictions and controversies The Journal of the American Medical Association ,,269,2749-2753 .
25. Cooper, H.M. & Hadges, L.V. (1994). The Handbook of Research Synthesis, Russell Sage Foundation.
26. Cooper, H.M.& Rosenthal, R. (1994). Statistical versus traditional procedures for summarize research findings. Psychological Bulletin, 1616(3),509-511.
27. *Dam, H., Pederson, H.E., Ahlgren, P.(1989). Depression among patients with stroke. Acta Psychiatrica Scandinavica, 80,118-124.
28. *Eastwood, M.R., Rifat, S.L., Nobbs, H., Ruderman, J. (1989). Mood disorder following cerebrovascular accident. British Journal of Psychiatry, 154,195-200.
29. *Ebrahim, S., Barer, D., & Nouri, F. (1987). Affective illness after stroke. British Journal of Psychiatry,151, 52-56.
30. *Feibel, J. H., & Springer, C. J. (1982). Depression and failure to resume social activities after stroke. Archives of Physical Medicine Rehabilitation, 63, 276-278.
31. *Finkelstein, S., Benowitz, L.I.& Baldessarini, R.J., (1982). Mood, vegetative disturbance, and dexamethasone suppression test after stroke. Annals of Neurology,12,463-468.
32. *Folstein, M.F., Maiburger, R.& McHugh, P.R. (1977). Mood disorder as a specific complication of stroke. Journal of Neurology, Neurosurgery and Psychiatry,40,1018-1020.
33. Fujikawa,G., Yamawaki,S.,Touhouda,Y.(1994) Back ground factors and clinical symptoms of major depression with silent cerebral infarction. Stroke ,25,798-801.
34. *Gainotti, G., Azzoni, A., Gasparini, F., Marra, C., & Razzano, C. (1997). Relation of lesion location to verbal and nonverbal mood measures in stroke patients. Stroke, 28(11), 2145-2149.
35. *Gass, C. S., & Lawhorn, L. (1991). Psychological adjustment following stroke: an MMPI study. Psychological Assessment , 3(4), 628-633.
36. *Gesztelyi, R., Fekete, I., Kellermann, M., Csiba, L., & Bereczki, D. (1999). Screening for depressive symptoms among post-stroke outpatients in Eastern Hungary. Journal of Geriatric Psychiatry & Neurology, 12(4), 194-199.
37. Glass, G.V.(1976). Primary, secondary ,and meta-analysis of research. Education Research,5,3-8.
38. Glass,G.V.,McGraw,B., & Smith,M.L.(1981). Meta-analysis in social research. Beverly Hills,CA:Sage.
39. *Gonzalez-Torrecillas, J. L., Mendlewicz, J., & Lobo, A. (1995). Effects of early treatment of poststroke depression on neuropsychological rehabilitation. International Psychogeriatrics, 7(4), 547-560.
40. Gardon, W. A..& Hibbard, M.R. (1997). Poststroke Depression : An Examination of the Literature. Archives of Physical Medicine Rehabilitation, 78,658 -663.
41. *Gordon, W. A., Hibbard, M. R., Egelko, S., Riley, E., Simon, D., Diller, L., Ross, E., & Lieberman, A. (1991). Issues in the diagnosis of post-stroke depression. Rehabilitation Psychology, 36(2), 71-87.
42. *Grasso, M. G., Pantano, P., Ricci, M., Intiso, D. F., Pace, A., Padovani, A., Orzi, F., Pozzilli, C., & Lenzi, G. L. (1994). Mesial temporal cortex hypoperfusion is associated with depression in subcortical stroke. Stroke, 25(5), 980-985.
43. *Haroon, E. A. (1986). Psychiatric disturbances following stroke. Indian Journal of Psychiatry, 28(4), 335-341.
44. Harrison, L.L.,(1996).Pulling it all together. The importance of integrative research reviews and meta-analysis in nursing. Journal of Advanced Nursing, 24, 224-225.
45. Han-Hwa Hu, Wen-Yung Sheng , Fu-Li Chu ,Chung-Fu Lan & Benjamin N Chiang (1992) . Incidence of Stroke in Taiwan . Stroke, 23,1237-1241
46. Hedges, L.V. & Olkim, I.(1985).Statistical method for meta-analysis. Orlando, FL: Academic Press.
47. *Herrmann, M., Bartels, C., Schumacher, M., & Wallesch, C. W. (1995). Poststroke depression. Is there a pathoanatomic correlate for depression in the postacute stage of stroke? Stroke, 26(5), 850-856.
48. *Hibbard, M. R., Gordon, W. A., Stein, P. N., Grober, S. & Sliwinski, M. (1992). Awareness of disability in patients following stroke. Rehabilitation Psychology, 37(2), 103-120.
49. Hosking, S.G., Marsh, N.V.& Friedan, P.J. (1996). Poststroke depression : prevalence ,course, and associated factors [Review]. Neuropsychology Review,6(3),107-133.
50. *House, A., Dennis, M., Warlow, C., Hawton, K., & Molyneux, A. (1990a). Mood disorders after stroke and their relation to lesion location. A CT scan study. Brain, 113(Pt 4), 1113-1129.
51. Hunter, J.E. & Schmidt, F.L. (1990). Method of Meta-Analysis: Correcting error and bias in research finding. Newbury Park. CA: Sage.
52. *Iacoboni, M., Padovani, A., Di Piero, V., & Lenzi, G. L. (1995). Post-stroke depression: relationships with morphological damage and cognition over time. Italian Journal of Neurological Sciences, 16(4), 209-216.
53. Johnson,B.T. (1989). DSTAT: Software for the meta-analysis review of research literatures. NJ: Lawrence Erlbaum Associates.
54. *Jonkman, E. J., de Weerd, A. W., & Vrijens, N. L. (1998). Quality of life after a first ischemic stroke. Long-term developments and correlations with changes in neurological deficit, mood and cognitive impairment. Acta Neurologica Scandinavica, 98(3), 169-175.
55. *Kase, C. S., Wolf, P. A., Kelly-Hayes, M., Kannel, W. B., Beiser, A., & D''Agostino, R. B. (1998). Intellectual decline after stroke: the Framingham Study. Stroke, 29(4), 805-812.
56. *Kim, J. S., & Choi-Kwon S. (2000). Poststroke depression and emotional incontinence: correlation with lesion location. Neurology, 54(9), 1805-1810.
57. Lezak, M.D.(1995). Neuropsychological Assessment . Third Edition. Oxford : Oxford University Press.
58. Lipsey,M.W. & Wilson,D.B (2001).Practical meta-anasis, Sage Publication.
59. *MacHale,S.M., O''Rourke,S.J., Wardlaw J.M.& Dennis M.S. (1998). Depression and its relation to lesion location after stroke. Journal of Neurology, Neurosurgery & Psychiatry,64,371-374
60. *Malec, J. F., Richardson, J. W., Sinaki, M., & O''Brien, M. W. (1990). Types of affective response to stroke. Archives of Physical Medicine Rehabilitation, 71, 279-284.
61. *Marin, R. S., Biedrzycki, R. C., & Firinciogullari, S. (1991). Reliability and validity of the Apathy Evaluation Scale. Psychiatry Research, 38(2), 143-162.
62. Moody, L.E. (1990) .Meta-analysis :Qualitative and quantitative method. Advancing nursing science through research. Newburry Park. CA: Sage.
63. Morris, P.L., Robinson, R.G.& Raphael, B.(1990). Prevalence and course of depressive disorders in hospitalized stroke patients. The International Journal Psychiatry in Medicine,20,349-364.
64. *Morris, P. L., Robinson, R. G., & Raphael, B. (1992). Lesion location and depression in hospitalized stroke patients: Evidence supporting a specific relationship in the left hemisphere. Neuropsychiatry Neuropsychology & Behavioral Neurology, 5(2), 75-82.
65. *Nagaraja, D., Verma, A., & Chatterjee, S. (1997). Post-stroke mood disorders. Journal of the Association of the Physicians in India, 45, 179-181.
66. *Nelson, L. D., Cicchetti, D., Satz, P., Stern, S., Sowa, M., Cohen, S., Mitrushina, M., & van Grop, W. (1993). Emotional sequelae of stroke. Neuropsychology, 7(4), 553-560.
67. *Ng, K. C., Chan, K. L., & Straughan, P. T. (1995). A study of post-stroke depression in a rehabilitative center. Acta Psychiatrica Scandinavica, 92(1), 75-79.
68. *Paradiso, S., & Robinson, R. G. (1998). Gender differences in poststroke depression. Journal of Neuropsychiatry & Clinical Neurosciences, 10(1), 41-47.
69. *Paolucci, S., Antonucci, G., Pratesi, L., Traballesi, M., Grasso, M. G., & Lubich, S. (1999). Poststroke depression and its role in rehabilitation of inpatients. Archives of Physical Medicine & Rehabilitation, 80(9), 985-990.
70. Petitti, D.B.(2000). Meta-analysis ,Decision Analysis ,and Cost- Effectiveness Analysis. Oxford University Press.
71. *Pohjasvaara, T., Leppavuori, A., Siira, I., Vataja, R., Kaste, M., & Erkinjuntti, T. (1998). Frequency and clinical determinants of poststroke depression. Stroke, 29(11), 2311-2317.
72. Rabkin,J.G., Charles,E. & Kass,F.(1983) Hypotension and DSM-III depression in psychitatric outpatients. American journal of Psychiatry, 140:1072-1074.
73. Robinson,R.G.(1998). The Clinical Neuropsychiatry of Stroke. Cambridge University Press.
74. *Robinson, R.G., Kubos, K.L., Starr, L.B., Rao K.& Price T.R.(1983). Mood changes in stroke patients: relationship to lesion location. Comprehensive Psychiatry, 24,556-566.
75. Robinson, R.G. ,Wilson, H.B. ,Kaplan E., Lisey J. & Price T.R. (1986). Depression Influences Intellectual Impairment in Stroke Patients. British Journal of Psychiatry, 148,541-547.
76. Robinson, R.G., Kubos, K.L., Starr, L.B., Rao, K. & Price, T.R. (1984). Mood disorders in stroke patients: importance of location of lesion. Brain, 107,81-93.
77. Rosenthal,R.(1978).Combining results of independent studies. Psychological Bulletin,85,185-193.
78. Rosenthal,R.(1991). Meta-Analytic Procedures for Social Research. Sage Publication.
79. *Rosse, R. B., & Ciolino, C. P. (1986). Effects of cortical lesion location on psychiatric consultation referral for depressed stroke inpatients. International Journal of Psychiatry in Medicine, 15(4), 311-320.
80. *Schramke, C. J., Stowe, R. M., Ratcliff, G., Goldstein, G., & Condray, R. (1998). Poststroke depression and anxiety: different assessment methods result in variations in incidence and severity estimates. Journal of Clinical & Experimental Neuropsychology, 20(5), 723-737.
81. *Schwartz, J.A., Speed, N.M., Brunberg, J.A., Brewer T.L., Brown, M.& Greden J.F.(1993). Depression in stroke rehabilitation. Biological Psychiatry,33, 694-699.
82. *Schwartz, J. A., Speed, N. M., Mountz, J. M., Gross, M. D., Modell, J. G., & Kuhl, D. E. (1990). 99mTc-hexamethylpropyleneamine oxime single photon emission CT in poststroke depression. American Journal of Psychiatry, 147(2), 242-244.
83. Sharpe, M., Hawton, K.E.& House, A.O. (1990). Mood disorders in long-term survivors of stroke: associations with brain lesion location and volume. Psychological Medicine,20,815-828.
84. *Shadish,W.R., Robinson, L. & Lu, C. (1999). ES: A Computer Program for Effect Size Calculation. St. Paul, MN: Assessment Systems Corporation.
85. Singh, A., Black, S. E., Herrmann, N., Leibovitch, F. S., Ebert, P. L., Lawrence, J., & Szalai, J. P. (2000). Functional and neuroanatomic correlations in poststroke :the Sunnybrook Stroke Study. Stroke. 31(3),637-644.
86. *Singh, A , Herrmann N., Black S.E. (1998). The importance of lesion location in post stroke depression: a critical review. Canadian of Journal Psychiatry, 43,92-927.
87. *Sinyor, D., Jacques, P., Kaloupek, D.G., Becker, R., Goldenberg, M.& Coopersmith H. (1986) Poststroke depression and lesion location: an attempted replication. Brain,109,537-546.
88. Smith,M.L., & Glass,G.V.,(1977) Meta-analysis of psychotherapy outcome studies. American psychologist,32,752-760.
89. Spencer,K. A., Tompkins, C. A., Schulz, R.(1997). Assessment of depression in patient with brain pathology: the case of stroke [Review]. Psychological Bulletin, 122(2),132-152.
90. Starkstein S.E., Robinson R.G, & Price T.R. (1987) Comparison of cortical and subcortical lesions in the production of poststroke mood disorders. Brain,110, 1045-1059.
91. Sterling,K.K.,Thacker,S.B.,Smith,S.J.,Stroup,D.F.,Zack,W.D.,& Berkelman ,R.L.(1991). A meta-analysis of the effect of estrogen replacement therapy on the risk of breast cancer. The Journal of the American Medical Association ,265,1985-1990
92. Sutton, A.J., Abrams, K.R., Jones, D.R., Sheldon, T.A.& Song, F. (2000). Method for Meta-analysis in Medical Research. John Wiley & Sons, LTD.
93. Thompson,S.G.(1994).Why sources of heterogeneity in meta-analysis should be investigated.British Medicine Journal,309,1351-1355.
94. Toedter, L. J., Schall, R. R., Reese, C. A., Hyland, D. T., Berk, S. N., & Dunn, D. S. (1995). Psychological measures: reliability in the assessment of stroke patients. Archives of Physical Medicine and Rehabilitation, 76, 719-725.
95. Weisz,J.R.,Weiss,B.,Han,S.S.,Grranger,D.A.& Morton,T.(1995). Effects of psychotherapy with children and adolescents revised:A meta-analysis of treament outcome sttudies.Psychological Bulletin. 117,450-468.
96. White, R.F. (1992). Clinical Syndromes in Adult Neuropsychology: The Practitioner''s Handbook. Elsevier science Publishers.
97. *Williams, J. M., Little, M. M., & Klein, K. (1986). Depression and hemispheric site of cerebral vascular accident. Archives of Clinical Neuropsychology, 1(4), 393-398.
98. Wolf,F.M.(1986).Meta-analysis:Quantitaive methods for research synthesis. SAGE publication.
(註:打 ” * ” 者為本研究納入分析之使用文獻)
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top