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研究生:鍾明勳
研究生(外文):Ming-Shun Chung
論文名稱:高雄縣湖內鄉青少年自殺風險的盛行率及相關危險因子
論文名稱(外文):The Prevalence and Related Factors of Adolescent Suicide in HuNei, Taiwan
指導教授:周碧瑟周碧瑟引用關係蘇東平蘇東平引用關係邱 �R 章
指導教授(外文):Pesus ChouTon-Ping SuHsien-Jane Chiu
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:公共衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2008
畢業學年度:96
語文別:中文
論文頁數:114
中文關鍵詞:青少年自殺盛行率篩檢問卷相關因子
外文關鍵詞:adolescent suicideprevalencescreeing questionnaireassociated factors
相關次數:
  • 被引用被引用:4
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  • 收藏至我的研究室書目清單書目收藏:6
目標:
推估本土10至15歲在學學生自殺風險盛行率,探討此學生族群自殺風險的危險因子,同時藉此發展本土青少年自殺風險之篩檢工具。
方法:
本研究是以學校為基礎的橫斷性研究,以某鄉鎮之國小高年級及國中學生為對象,採二階段診斷,第一階段針對全部之樣本,施予自填式問卷調查,第二階段針對半數之樣本,由精神專科醫師會談確定疾病診斷及自殺風險。再依據醫師診斷之自殺風險及問卷資料,發展出簡易篩檢問卷並推估問卷之效度。再由問卷之效度推算出自殺風險盛行率,最後再分析醫師診斷之自殺風險與基本資料和疾病相關資料之關聯性。
結果:
第一階段共有1106位學生接受問卷調查,其中有607位學生接受第二階段的會談評估。推估有18.0%之青少年有自殺風險。女性、愈高年級和睡眠困擾為青少年自殺風險的相關危險因子,但在加入憂鬱症及適應障礙之診斷後,睡眠困擾即不具統計上的顯著意義。本研究發展出簡易青少年自殺風險篩檢問卷5題,其中包括最近一星期內以來,是否常常覺得很想哭、是否心情不好、是否睡不好、是否覺得很煩及是否覺得想不開、甚至想死,5題中具有任3題,歸為篩檢陽性;此篩檢工具敏感度70.4%、精確度66.8%、陽性預測值31.5%及陰性預測率91.3%。
結論
本研究發現10至15歲在學學生自殺風險盛行率高,值得重視。因診斷憂鬱症與適應障礙需大量專業人力,不易執行。透過本研究發展出簡易篩檢工具可以篩檢出危險族群以便及早介入。
Objectives:
The aim of this study is to estimate the prevalence of suicidal risk among school children aged 10-15. We also find the associated factors for adolescent suicidal risk. At the same time, a screening tool for adolescent suicidal risk is developed.
Methods:
This is a school-based, cross-sectional study with two stages of diagnosis. All of the students in the 5th to 9th grade filled the questionnaires in the first stage and half of the students were interviewed by psychiatrists for psychiatric diagnosis and assessing suicidal risk in the second stage .According to the diagnosis in the second stage and the self-reported data, simple screening questionnaires was developed and the validity was estimated. The prevalence of adolescent suicidal risk was estimated with the validity of the questionnaires. The associated factors were found by analying the data collected in the second stage.
Results:
There were 1106 students jointing in the first screening stage and 607 students interviewed in the second stage. The prevalence of the student with suicidal risk was 18.0% .The associated factors were female, higher grade and sleeping disturbance. However, sleeping disturbance became non-significant after adjusted for depressive disorder and adjustment disorder. The simple screening questionnaire including in recent one week “I want to cry frequently”,” I have bad mood”, “I have poor sleep”, “I feel irritable”and “I can not think positively, even have some idea of death” was developed in this study. Any three of the five was positive with a sensitivity of 70.4% , a specificity of 66.8%, a positive predictive value of 31.5% and a negative predictive value of 91.3%.
Conclusions:
We found the prevalence of the students aged 10-15 was quite high and it needed more attention. It needed large professional efforts to make a diagnosis for derpessive disorders and adjustment disorder. In this study, we developed a simple screening questionnaire to find the risky group for early intervention.
目 錄 頁 碼
中文摘要…………………………………………………… 04
Abstract…………………………………………………… 06
致謝………………………………………………………… 08
第一章 緒論……………………………………………… 10
第一節 研究問題背景與研究動機…………………… 10
第二節 研究目的……………………………………… 13
第二章 文獻探討………………………………………… 14
第一節 高雄縣湖內鄉簡介…………………………… 16
第二節 自殺的原因…………………………………… 17
第三節 青少年自殺的盛行率………………………… 18
第四節 青少年自殺的危險因子……………………… 25
第五節 青少年自殺的治療與預防…………………… 35
第六節 青少年自殺篩檢的工具……………………… 38
第三章 研究方法………………………………………… 40
第一節 研究架構……………………………………… 40
第二節 研究問題……………………………………… 41
第三節 名詞界定……………………………………… 42
第四節 研究設計……………………………………… 47
第五節 研究對象……………………………………… 47
第六節 研究工具……………………………………… 47
第七節 研究資料收集過程…………………………… 49
第八節 統計分析……………………………………… 50
第四章 研究結果………………………………………… 53
第一節 青少年自殺風險評估工具的發展及效度…… 53
第二節 青少年自殺風險的盛行率…………………… 56
第三節 青少年自殺風險的相關危險因子…………… 65
第五章 討論……………………………………………… 74
第一節 青少年自殺風險的盛行率……………………
第二節 青少年自殺風險的相關危險因子……………
第三節 青少年自殺風險的評估工具………………… 74
77
84
第六章 結論與建議……………………………………… 88
第一節 結論…………………………………………… 88
第二節 建議…………………………………………… 90
第三節 研究限制……………………………………… 91
參考文獻…………………………………………………… 92
附錄………………………………………………………… 110

表次
頁 碼
表1-1………………………………………………………… 22
表1-2………………………………………………………… 34
表2-1………………………………………………………… 54
表2-2………………………………………………………… 54
表2-3………………………………………………………… 55
表3-1………………………………………………………… 58
表3-2………………………………………………………… 59
表3-3………………………………………………………… 61
表3-4………………………………………………………… 64
表4-1………………………………………………………… 65
表4-2………………………………………………………… 66
表4-3………………………………………………………… 66
表4-4………………………………………………………… 67
表4-5………………………………………………………… 69
表4-6………………………………………………………… 69
表4-7………………………………………………………… 70
表4-8………………………………………………………… 70
表4-9………………………………………………………… 71
表4-10……………………………………………………… 73
圖1…………………………………………………………… 68
圖2…………………………………………………………… 72
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