跳到主要內容

臺灣博碩士論文加值系統

(3.236.124.56) 您好!臺灣時間:2021/07/31 05:07
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:鄭榮耀
研究生(外文):Rong-Yaw Cheng
論文名稱:慢性病患生活品質影響因素之研究--以南投縣埔里地區為例
論文名稱(外文):Factors Affecting Quality of Life of Chronic Disease Patients-- A Study on PuLi Township of Nantou County
指導教授:錢慶文錢慶文引用關係
指導教授(外文):Ching-Wen Chien
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:醫務管理研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
中文關鍵詞:慢性病健康相關生活品質台灣簡明版世界衛生組織生活品質問卷
外文關鍵詞:chronic diseasehealth-related quality of lifeHRQOLthe questionnaire named as WHOQOL-BREF Taiwan version
相關次數:
  • 被引用被引用:7
  • 點閱點閱:301
  • 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:0
隨著我國經濟發展以及醫療科技的進步,國人在生活型態上的改變所造成的身體問題,直接影響到國民的健康,最明顯的莫過於慢性病逐漸形成國人健康的主要威脅。慢性病不僅對患者的健康和生活品質造成影響,在經濟層面上也對個人、家庭及社會造成沉重的負擔。因此期望透過客觀的健康生活品質評量,探討影響慢性病患生活品質的因素,以做為醫院對慢性病患臨床服務的參考和衛生教育宣導上的重點依據。
本研究自南投縣埔里鎮抽樣訪問753位民眾,並以受訪者姓名與埔里某地區教學醫院健保住院申報檔合併,其中女性受訪者443位(58.83%),男性受訪者310位(41.17%)。受訪者患有慢性病共369人(49%);193位女性受訪者患有慢性病(43.57%),176位男性受訪者患有慢性病(56.77%)。
本研究測量生活品質的工具採用姚開屏等人發展的「台灣簡明版世界衛生組織生活品質問卷(WHOQOL-BREF)」,共分為生理、心理、台灣版社會及台灣版環境等四個範疇。
在研究結果方面,本研究問卷的信度(Cronbach’s α值)除了台灣版社會範疇稍低於0.70之外,其餘範疇皆高於0.70,顯示問卷資料的內部一致性很高。比較慢性病患與非慢性病患健康生活品質的四個範疇,結果發現,慢性病的有無對健康生活品質,在生理範疇上有明顯的影響,顯示有無罹患慢性病確實對生活品質有影響。此外,本研究歸納發現,自覺健康、自覺快樂、社經地位等為主要影響慢性病患生活品質的因素,從這些因子中可以發現健康教育的重要性。本研究的研究結果顯示不同的慢性病患其生活品質上確有不同,因此,在醫務管理上,建議醫療院所應當在其社區居民中以優先順序做好對慢性病患照護,擬定社區醫療的服務方針。如此,除了能降低醫療資源的使用之外,病患也能得到更好的健康及更高的生活品質。
Owing to the economic advancement and the achievement of medical technical, the physical problems of our citizen due from the change of daily life style directly influence their health, the most of all to threaten the health of our people is nothing but chronic disease. Chronic disease affects both health and life quality of patients, and furthermore is due in an economical heavy burden for persons, families and society. Hence it is expected to be on a prime authority of both the references to the hospitals clinical services treating to chronic disease patients and the demonstration of health education that is by the way of the impersonally assessing on the health-related quality of life to study the influencing factors
about the life quality of chronic disease patients,
This research is developed by the way of adopting purposive sampling 753 citizen in Pu-Li township, and colligate their names to the hospitalization application files of national health insurance at a local teaching hospital in Pu-Li township, the valid samples consisted of 443 females (58.83%) and 310 males (41.17%). This valid samples consisted of 369 CHRONIC DISEASE patients (49%), 193 chronic disease female patients (43.57%) and 176 non- chronic disease male patients (56.77%) are included.
The questionnaire named as WHOQOL-BREF Taiwan version, developed by Yao Kai-Ping et al., is used in this study as the measurement of HRQOL, which is divided into four domains: physical domain, psychological domain, social domain-Taiwan version and environmental domain-Taiwan version.
Results of this study indicate that the reliability (Cronbach’s α) of the questionnaire is higher than 0.70 except for the social domain (slightly lower than 0.70), revealing good internal consistency. Comparing four domains in HRQOL of chronic disease patients with non- chronic disease ones, the result shows the scoring in physical domain of non- chronic disease patients is significantly higher than chronic disease patients. This demonstrates that having or not having chronic disease indeed affects the HRQOL. Moreover, after generalizing this research about factors affecting HRQOL of chronic disease patients with statistical analysis, consciously feeling healthy, happily and society position are the main affecting factors, and the importance of health education could be found by these affecting factors. Results of this study indeed reveal the different quality of life from individual chronic disease patients. Hence, in the light of hospital management, feasible suggestions about the community medical service policy for taking care of chronic disease patients according to the priorities should be made by whose hospitals. In this way medical resource consuming can be reduced, and patients would be able to acquire improved health and better quality of life.
參考文獻
一、中文部分
錢慶文(2003):健保總額支付制度下全面醫療品質管理與評估之研究。行政院衛生署九十二年度科技研究發展計畫。
陳啟禎(2003):埔里鎮社區老年人健康相關生活品質之探討。國立陽明大學醫務管理研究所碩士論文。
姚開屏(2002):健康相關生活品質概念與測量原理之簡介。台灣醫學會;6 卷;2期。
姚開屏(2002):台灣版世界衛生組織生活品質問卷之發展與應用。 臺灣醫學,6(2),193-200。
張彧、王顏和、姚開屏、王榮德(2002):脊髓損傷者生活品質問卷之發展。臺灣醫學,6(2),209-214。
黃三桂、王悅萍、錢慶文(2002):疾病管理對糖尿病患醫療資源耗用之影響。(國立陽明大學醫務館裡研究所碩士論文)
賴力行 (2002):南投縣信義鄉鄉民血中鉛與高尿酸血症相關性之研究。(中國醫藥學院環境醫學研究所碩士論文)
何維德(2001):糖尿病人醫療利用分析與疾病管理可行性之初探。台中市: 私立中國醫藥學院醫務管理研究所碩士論文;6-7頁。
高森永(2001):長期照護下老人的健康相關生活品質與健康價值評估。行政院衛生署研究計畫。
吳聰賢(2001) 信義鄉全民健保成人健檢資料分析探討---高血脂症,痛風,肥胖中國醫藥學院環境醫學研究所 碩士論文)
姚開屏(2001):台灣版世界衛生組織生活品質問卷發展小組,台灣版世界衛生組織生活品質問卷之發展及使用手冊(第一修訂版)。
姚開屏(2000):簡介與評論常用的一般性健康相關生活品質量表兼談對未來研究的建議。測驗年刊 2000; 47: 111-138。
姚開屏(2000):台灣版世界衛生組織生活品質問卷發展小組,台灣簡明版世界衛生組織生活品質問卷之發展及使用手冊(第一版)。
雷玉華、邱周萍(2000):生活品質概念分析。國防醫學;第31卷;第2期。
張慈惠、黃秀梨(2000)。生活品質評量之臨床應用。台灣醫學; 4:86-90。
姚開屏(1999):台灣版世界衛生組織生活品質問卷發展小組,台灣版世界衛生組織生活品質問卷之發展及使用手冊(第一版)。
周碧瑟、李家琳、蔡世澤(1999):台灣第二型糖尿病流行病學。糖尿病經濟影響與良性照護研究會刊10。
洪惠萍(1999) 原住民痛風患者之性別﹑族別及腎功能之差異 高雄醫學院公共衛生研究所 碩士論文。
陳柏熹、王文中(1999):生活品質量表的發展。中國測驗學會測驗年刊;46輯;1期;57-74頁。
姚開屏、陳坤虎 (1998):如何編製一份問卷—以「健康相關生活品質」問卷為例。職能治療學會雜誌; 16: 1-24[特稿]。
章順仁(1998) 台灣原住民痛風之流行病學研究 高雄醫學院醫學研究所 博士論文。
林瑞祥(1998):糖尿病診斷及治療新知。當代醫學;25(7):523-6。
吳佳珍、林秋菊(1997):「生活品質」的概念分析。榮總護理;第14卷;第1期。
范靜媛(1997):非胰島素依賴型糖尿病盛行率與危險因素。中華衛誌; 16(4):291-308。
姚開屏 (1996):從心理計量的觀點看測量工具的發展。職能治療學會雜誌; 14: v-xxi。
周碧瑟等人(1989):社區性高血壓、糖尿病流行病學的探討-七十八年度陽明十字軍社區預防醫學計畫成果報告。
施敏雄、蕭新煌(1981):我國社會指標之回顧與檢討。台北:明德基金會;生活素質層面之探討-生活素質第一次研討會論文集

二、英文部分
Jordhoy MS. Fayers P. Loge JH. Saltnes T. Ahlner-Elmqvist M. Kaasa S.(2001)Quality of life in advanced cancer patient: the impact of sociodemographic and medical characteristics. British Journal of Cancer.85(10):1478-85
Nishimura, R.,LaPorte, R.E.,Dorman, J.S.,Tajima,N.Becker, D.Orchard, T.J.(2001) Mortality trend in type I diabetes:the allegheng county(pennsylvania)Relationship between blood pressure and urinary albumin excretion in development of microalbuminuria.Diabetes,39,245-249.
Riedinger MS. Dracup KA. Brecht ML. Padilla G. Sarna L. Ganz PA.(2001). Quality of life in patient with heart failure:do gender difference exit?Heart&Lung:Journal of Acute &Critical Care.30(2):105-16
Michelson H. Bolund C. Brandbreg Y.(2000).Multiple chronic health problems are negatively associated with health related quality of life (HRQoL)irrespective of age.Quality of Life Research.9(10):1093-1104
Mercier C. Peladeau N. Tempier R.(1998). Age, gender and quality of life.Community Mental Health Journal.34(5):487-500
The WHOQOL Group. The World Health Organization (1998) Quality of life assessment ( WHOQOL) : Development and general psychometric properties.Soc Sci Med;46: 1569-85.
The WHOQOL Group. Development of the world health
organization (1998)WHOQOGBREF quality of life assessment. Psychol Med; 28:551-8.
Padilla GV, Frank-Stormborg M. (1997)Single instruments for measuring
quality oflife. In: Frank-Stonnborg M, Olsen SJ, editors.
Instruments for clinical health-care research London: Jones and
Bartlett publisher;.p. Z 14-34.
Alexandria, VA.(1997)American Diabetes Association:Diabetes Facts and Figures. American Diabetes Association
Joint national committee on prevention,detecton,evaluation and treatment of high blood pressure:The sixth report of the joint national committee on prevention , detection,evaluation and treatment of High blood pressure(JNC VI).Archives of Internal Medicine,1997,157,2413-2446.
Warren E., David Nash.(1997)Disease management-A system approach to improving patient outcome. American Hospital Publishing, Inc.
Szabo S. (1996) The World Health Organization Quality of Life (WHOQOL) assessment instrument. In Spilker B (ed.), Quality of life and pharmacoeconomics in clinical trials, 2nd ed., Philadelphia: Lippincott-Raven,: 355-362.
World Health Organization. (1995) Resources for new WHOQOL centers. Geneva: WHO, (MNH/PSF/95.3)
Brooks, R. G. (1995). Health status measurement: A perspective on change. London:MacMillan Press.
Gift HC, Atchison KA. (1995) Oral health, Health, and Health-Related
Quality of life. Med Care ; 33:57-77
Bowling A. (1995) Measuring disease : A review of quality measurement
scale. Philadelphia: Open University Press ;.p.1-6.
Wingard, D.L.,Barrett-Connor,E.(1995)Heart disease and diabetes.In diabetes in America.Washington,DC,U.S.Govt.Printing Office,429-448.
Wilson IB, Cleary PD. (1995) Linking clinical variables with health-related quality of life. JAMA;273:59-65
The WHOQOL Group. (1994) Development of the WHOQOL: Rationale and current status. International. Journal of. Mental Health; 23: 24-56.
Hypertension in Diabetic study(HDS):prevalence of hypertension in newly presenting type 2 diabetic patients and the association with risk factors for cardiovascular and diabetic complications.Jounal of Hypertension ,1993,11,309-317.
World Health Organization. (1993) WHOQOL study protocol. Geneva: WHO, (MNH/PSF/93.9).
Patrick, D. L., & Erickson, P.(1993).Assessing health-related quality of life for clinical decision-making In S. R. Walker & R. M. Rosser 9eds.Quality of life assessment :key issues in the 1999s.(pp.11-64)Netherlands:Kluwer Academic.
Meeberg GM. (1993) Quality of life: A concept analysis. J Adv Nurs; 18:32-8.
Chou, P.,Chen, H.H.,Hsiao, K.J.(1992)Community-based epidemiological study on diabetes in Pu-Li,Taiwan.Diabetes Care,15,81-89.
Zhan L. (1992) Quality of life : Conceptual and measurement issues. J Adv Nurs; 17:795-800
Tai,T.Y.,Chuang, L.M.,Chen,C.J.,Lin, B.J.(1991)Link between hypertension and diabetes mellitus epidemiological study of Chinese adults in Taiwan.Diabetes Care,14,1013-1020.
Ferrans CE. (1990) Quality of life conceptual issues. Semin Oncol Nurs
; 6:248-54.
Oleson M. (1990) Subjectively perceived quality of life. Image J Nws Sch ; 22:187-90.
Lohr KN. (1988) Outcome measurement: Concepts and questions. Inquiry; 25: 37-50.
Tai, T.Y.,Yang, C.L.,Chang, C.J.,Chang, S.M.,Chen, Y.H., Lin,B.J., Ko,L.S., Chen,M.S., Chen,C.J.(1987) Epidemiology of diabetes mellitus among adults in Taiwan,ROC.Jounal medical association of Thalandi ,70(suppl 2),42-48.
Allen MJ, Yen WM. (1986) Introduction to measurement theory. CA: Brooks/Cole Publishing Co,.
Abbey, A., & Andrew, F. M.(1985).Modeling the psychological determinants of life quality. Social Indicator Research,16,1-34.
Ferrans CE, Powers MJ (1985). Quality of life index : development and
psychometric properties. ANS;8:15-24.
Tai, T.Y.,Chen, C.Z.,Tsai, S.H.(1985)Epidemiology of diabetes mellitus among adult in Taipei,Taiwan.In Khalid BAK,Ng ML eds.Proceedings of the Third Congress of Endocrinology.Kuala Lumpur:Asian Federation of Endocrine Societies,39-43.
Campbell, A., Converse, P. E. & Rodgers, W. L.(1976). The Quality of Life. New York:Russell Sage Foundation.
Tsai, S.H.(1970).Epidemiology of diabetes mellitus in Taiwan.In:Tsjuii T,Wada M eds.Diabetes mellitus in Asia,1970.Amsterdam:Excerpta Medica,64-67.
Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The Barthel index. Maryland State Medical Journal, 14, 61-65.
Katz, S., Ford, A. B., Moskowitz, R. W. et al (1963). Studies of illness in the aged; the index of ADL: A standardized measure of biological and psychological function. JAMA, 185, 914-917.
Edwards, A. L. (1957). Techniques of attitude scale construction. New York: Prentice Hall.
三、網頁資料
1、行政院衛生署:衛生統計資訊網。http://www.doh.gov.tw/ statistic/index.htm(2004/6/2)。
2、內政統計資訊服務網。http://www.moi.gov.tw/W3/stat/ (2004/6/2) 。
3、中央健康保險局。http://www.nhi.gov.tw/01intro/intro_3.htm(2004/6/1) 。
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top