臺灣博碩士論文加值系統

心理社會狀態例如：自尊、憂鬰、家庭關係、精神疾病或憂鬱症會影響到糖尿病青少年之血糖控制。本研究以某醫學中心兒童青少年糖尿病患為研究對象，利用自填式量表(羅森保自尊量表、流行病學研究中心憂鬱量表、家庭關懷度量表)、結構式診斷性會談(簡短國際神經精神會談問卷－兒童青少年版)、及近半年和近一年之糖化血色素，探討糖尿病兒童及青少年其自尊、憂鬰情形、家庭關懷程度、以及是否罹患憂鬱症、焦慮症、干擾行為疾患等精神疾病與糖尿病控制的相關性。本研究為國內第一篇經兒童青少年精神科專科醫師會談診斷篩選糖尿病青少年是否罹患精神疾病之研究，同時亦合併自填式量表，評估個案主觀感受，兼顧主、客觀面向。
本研究共有57 名11 至20 歲之糖尿病患參與，研究發現年輕糖尿病患者其自尊與糖化血色素負相關、憂鬱程度與糖化血色素正相關、家庭關懷與糖化血色素負相關，而憂鬱症或任何一種精神疾病的發生也對血糖控制有負向影響，其糖化血色素較高。是故，在糖尿病臨床照顧上應注意個案身心狀態，並進行相關心理處遇，以提升血糖控制的成效，並減少照護成本。

The aim of this study was to evaluate the association of psychosocial factors and diabetic control in diabetic children and adolescents. Fifty-seven diabetic youths aged from 11 to 20 were recruited from a pediatric endocrine clinic in one medical center. Using self-reported scales (Rosenberg Self-Esteem Scale, Center for
Epidemiological Studies Depression Scale, family APGAR) and a structuralized interview questionnaire (Mini International neuropsychiatric Interview for child and Adolescents), we collected their psychosocial status such as the level of self-esteem, depressive severity, family function, and the presence of any sychiatric disorder such as depression, anxiety and disruptive disorder. The average HbA1c within the recent one year/ six months were collected for the status of their diabetic control.
Our results showed that: Self-esteem and family function were negatively correlated to HbA1c, while depressive score was positively correlated to HbA1c. The presence of any psychiatric disorder, especially depression, also correlated positively with HbA1c. Our study supports that certain psychosocial factors do have
association with diabetic control. Clinicians should screen for the presence of those disadvantage factors such as low self-esteem, depressive symptoms, poor family function and depressive disorder of all youth with diabetes especially those who have poor metabolic control. Further psychosocial intervention should be considered to
improve the effectiveness of diabetic control.

第壹章序論：研究動機與重要性… … … … … … … … … … … … … … … … … … … 1
第貳章文獻查證
第一節簡述兒童青少年糖尿病… … … … … … … … … … … … … .… … ..… … … … .3
第二節個人自尊、家庭特質與糖尿病控制… … … … … … … … … … … … … … … 5
第三節糖尿病與精神疾病… … … … … … … … … … … … … … … … … … … … … … 9
第叁章研究方法
第一節研究設計… … … … … … … … … … … … .… .… … … … … … .… … … … … … 13
第二節研究工具… … … … … … … … … … … … … … … … … … … … … … … … … .15
第肆章研究結果
第一節樣本特性… … … … … … … … … … … … … … … … … … … … … … … … … ...19
第二節糖尿病控制好壞與各心理社會因子之關連… … … … … .… .… … … ........22
第三節個人及家庭特質與糖尿病控制… … … … … … … … … … .… .… … … … … 23
第四節精神疾病共病與糖尿病控制… … … … … … … … … … … … .… … ...… … ..26
第伍章討論… … … … … … … … … … … … … … … … … … … … … .… … … … … … ..28
第陸章結論與建議… … … … … … … … … … … … … … … … … … … … … … … .......39
參考文獻… … … … … … … … … … … … … … … … … … … … … … … … … … … … … .40

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