憂鬱症患者可能因為內分泌異常，引起骨骼組織形成降低及增加骨質再吸收，造成骨密度低，因此骨質疏鬆症對憂鬱症婦女而言是一個重要但容易忽略的疾病。然而現今國內並沒有針對憂鬱症婦女骨密度及相關影響因素加以探討之研究。本研究探討憂鬱症婦女骨密度及相關因素。以橫斷式研究，採立意取樣，100位診斷憂鬱症婦女，透過結構式自擬問卷、貝氏憂鬱量表收集影響骨密度之相關因子，以Hologic Delphi QDR-2000之雙能量X光吸收測量儀來檢查髖骨骨密度。
研究結果發現：（1）個人因素：年齡大小和是否有罹患骨質疏鬆症家族史於骨密度呈現顯著差異；體重及身體質量指數與骨密度有顯著正相關。（2）生活飲食習慣：有無喝咖啡或喝茶於骨密度有顯著差異。（3）憂鬱程度：憂鬱程度與骨密度呈現有意義負相關，顯示憂鬱程度高者其骨密度較低。憂鬱程度、喝茶、骨質疏鬆症家族史、年齡4個變項能聯合預測骨密度28﹪的變異數。
根據本研究結果提出以下建議：一、護理人員應該積極對於高齡、罹患骨質疏鬆症家族史、憂鬱程度高的憂鬱症婦女加強骨質疏鬆症防治工作並鼓勵進行定期骨密度檢查。二、將來研究能對個案進行影響骨密度內分泌檢驗，來進一步了解對骨密度的影響。三、憂鬱症患者有年輕化趨勢，未來應設計一個長期定期追蹤的研究，來追蹤骨密度變化，持續找出影響骨密度相關因子。
關鍵字：憂鬱症、骨密度

Endocrine abnormality secretion is potentially responsible for low bone density in subjects with depression due to decreased bone formation and increased bone resorption. Osteoporosis in depression women is an important but ignored issue. No study focused on associated factors of bone density among major depression women in Taiwan. This study explored the associated factors of bone density among depression women. A purposive cross- sectional design was used one hundred depression women who were diagnosed by a psychiatrist were recruited to participate. The instruments used include a self-constructed questionnaire and Beck Depression Inventory(BDI-II). Bone density was measured at the hip using a Hologic Delphi QDR-2000 Dual Energy X-ray Absorptiometry.
The findings of the study were as followed: (1)Personal factors: age and family history of osteoporosis were statistically significant related to bone density. Weight and body mass index were significantly associated with bone density. (2)Lifestyle habits: consumption of coffee or tea were statistically significant related to bone density. (3)depression degree: depression degree was significantly associated with bone density.
Depression degree, consumption of tea, family history of osteoporosis and age accounted for 28﹪variance of bone density.
Based on the study results, it was suggested: 1.Nurses take care of elderly, individuals osteoporosis family history, and high depression degree depression women with should offer osteoporosis related health education and encourage regular bone density examination. 2.Future study for depression women could include endocrine to further identify the associated factors related to bone density. 3.The onset age of major depression is getting younger, a longitudinal study should be conducted to exam the bone density changes with age.
Key word: depression, bone density

目錄
　　　　　　　　　　　　　　　　　　　　　　　 頁 數
致 謝…………………………………………………………Ⅰ
中文摘要…………………………………………………………Ⅲ
英文摘要…………………………………………………………Ⅴ
目 錄……………………………………………………… Ⅶ
圖表目次…………………………………………………………X
第一章 緒論
第一節 研究背景和動機…………………………………………1
第二節 研究目的…………………………………………………5
第二章 文獻查證
第一節 骨質疏鬆症之定義及分類………………………………6
第二節 骨質疏鬆症的危險因子…………………………………7
第三節 憂鬱症與骨密度之相關研究………………………… 14
第四節 骨質疏鬆症的檢查方法與診斷標準………………… 15
第五節 研究概念架構………………………………………… 20
第六節 研究假設……………………………………………… 22
第七節 名詞界定……………………………………………… 23
第三章 研究方法
　　　　　　　　　　　　　　　　　　　　　　　 頁 數
第一節 研究設計……………………………………………… 24
第二節 研究對象……………………………………………… 25
第三節 研究工具……………………………………………… 26
第四節 研究步驟……………………………………………… 30
第五節 資料處理與分析……………………………………… 32
第四章 分析與結果
第一節 憂鬱症婦女個人因素資料分佈……………………… 35
第二節 憂鬱症婦女生活飲食習慣資料分佈………………… 41
第三節 憂鬱症婦女憂鬱程度資料分佈……………………… 44
第四節 憂鬱症婦女骨密度分佈……………………………… 46
第五節 個人因素不同憂鬱症婦女T-score骨密度（g/cm2）分佈差異…………………………………………………48
第六節 生活飲食習慣不同憂鬱症婦女T-score骨密度（g/cm2）分佈差異………………………………………………55
第七節 憂鬱症婦女不同憂鬱程度與骨密度之關係………… 57
第八節 各預測變項與骨密度之逐步迴歸分析結果………… 60
第五章 討論………………………………………………………… 61
第六章 結論與建議
　　　　　　　　　　　　　　　　　　　　　　　 頁 數
第一節 結論…………………………………………………… 64
第二節 建議…………………………………………………… 65
第三節 研究限制……………………………………………… 67
參考資料
中文部分…………………………………………………………69
英文部分 ……………………………………………………… 72
附錄
附錄一 憂鬱症婦女骨密度及相關因素問卷調查表………… 80
附錄二 貝氏憂鬱量表………………………………………… 84
附錄三 專家名單 …………………………………………… 86
附錄四 專家檢測效度結果…………………………………… 87
附錄五 購買中文版貝氏憂鬱量表第二版收據………………101
附錄六 參與研究同意書………………………………………102


圖表目次 頁 數
圖一 憂鬱症婦女骨密度及相關因素初探之概念架構………21
圖二 憂鬱症婦女骨密度及相關因素初探收案流程…………31
表一 各種骨密度測量儀優缺點………………………………16
表二 對應研究假設之描述統計法……………………………33
表三 對應研究假設之推論統計法……………………………34
表四 憂鬱症婦女個人因素資料分佈…………………………36
表五 憂鬱症婦女生活飲食習慣分佈…………………………42
表六 憂鬱症婦女憂鬱程度資料分佈…………………………45
表七 憂鬱症婦女骨密度分佈…………………………………47
表八 個人因素不同憂鬱症婦女T-score骨密度（g/cm2）分佈差異……………………………………………………… 51
表九 生活飲食習慣不同憂鬱症婦女T-score骨密度（g/cm2）分佈差異………………………………………………… 56
表十 憂鬱程度不同之憂鬱症婦女T-score骨密度（g/cm2）之單因子變異數分析結果……………………………… 58
表十一憂鬱程度不同憂鬱症婦女骨質疏鬆分佈之差異分析………………………………………………………… 59

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