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研究生:林慧姿
研究生(外文):Hui-zi Lin
論文名稱:原住民及漢人腸躁症、慢性疾病及生活品質之相關性探討-以花蓮某兩村為例
論文名稱(外文):Association between quality of life and either irritable bowel syndrome or chronic diseases in Hans and indigenous Taiwanese in two Hualien communities.
指導教授:鴻義章鴻義章引用關係
指導教授(外文):Upay Kanasaw
學位類別:碩士
校院名稱:慈濟大學
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
畢業學年度:97
語文別:中文
論文頁數:109
中文關鍵詞:腸躁症慢性疾病生活品質
外文關鍵詞:irritable bowel syndromechronic diseasesquality of life
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背景:近年來,醫療照顧的目的被認為不單是延長病人生命而已,更重要的是提昇病患的生活品質。腸躁症為一種慢性且週期性腹痛、便秘、腹瀉症狀,原因不明又難以根治的疾病。腸躁症病患較不易入睡、較易曠課曠職、較常尋求醫生協助、較差的生活品質等,顯著地低於未罹病者,且當病患有共病症時,生活品質會顯著降低,也會浪費許多直接和間接的醫療社會成本。
目標:評估花蓮地區一般族群的生活品質,進行族群間生活品質比較,及評估腸躁症及其它共病症是否影響生活品質。
方法:本研究採橫斷性研究設計,調查時間為97年6月至8月,研究樣本為居住於花蓮縣北部兩個平地鄉村落,且年齡介於18歲到70歲的成年居民,以結構性問卷及面訪收集研究資料。問卷內容包含基本人口學變項、羅馬準則第三版、生活品質問卷(SF-36台灣版問卷)、健康行為、及個人病史等部分。
結果:SF-36生活品質八大構面平均分數範圍介於63.67分至91.29分,年輕人、男性、高學歷者、漢人、及未婚者,均有較高的生活品質得分。腸躁症患者在「身體疼痛」、「一般健康狀況」、「活力狀態」、「社會功能」和「心理健康」五個面向的生活品質平均分數,顯著地低於未罹患者約5.8分~10.7分;罹患慢性病者的各面向生活品質分數,均比未罹患慢性病者低。控制年齡、性別、種族等變項影響後,罹患共病症者的生活品質分數較未罹患慢性病者低約20.3分~56.9分。
結論:本社區調查研究顯示,罹患腸躁症或其它慢性病的患者,生活品質得分顯著較低。且控制多因子的影響後,罹患共病症者的生活品質仍舊顯著較低。
Background: In recent year, the purpose of medical care not only to extend the life of patients and, more importantly, to improve the quality of life of patients. Irritable bowel syndrome (IBS) is a chronic condition that manifests with cyclical abdominal pain, constipation, and diarrhea. Currently, IBS has no well established determinant and is incurable. IBS patients are more likely to have sleep problems and to absent from school and work, and more frequently to seek for medical assistance. As a result, IBS not only reduce the life quality of patients but also cause waste of direct and indirect medical expenditures.
Aim: The specific aims of the research are to assess the quality of life of Taiwan indigenous peoples (TIP) and Hans Chinese (HC) of Hualien area and to assess the determinants of the quality of life. We also assumed that residents affected with multiple chronic diseases have lower quality of life.
Methods: This cross-sectional study was carried out during June to August in 2008. The study areas of the present survey were randomly selected from villages that locate at the northern rural area of Hualien County and have a TIP-to-HC ratio of approximate 1-to-1. All adults (age: 18-70 years) of the selected villages were interviewed in-person. The present study used a structured questionnaire, which includes items associated with demographic characteristics, Rome III, SF-36, health behavior, and personal and family history of major diseases.
Results: The mean scores of the eight domains of the SF-36 range from 63.7 to 91.3. Younger age, male sex, unmarried status, and higher educational level are correlated with have higher scores of SF-36. Subjects affected with multiple chronic conditions have significantly lower SF-36 scores than subjects without any chronic conditions. The mean scores of ‘bodily pain’, ‘general health’, ‘vitality’, ‘social functioning’, and ‘mental health’ for IBS patients were significantly lower than those of subjects without IBS. As compared with subjects without any chronic conditions and adjusted for the influences of age, sex and ethnicity, the SF-36 scores for subjects affected with multiple chronic conditions were lower for 20.3~56.9.
Conclusions: This community survey shows that there are significant associations between quality of life and either demographic characteristics or the presence of multiple chronic conditions.
誌謝 I
摘要 II
Abstract III
表目錄 VII
圖目錄 VIII
第一章 研究背景及研究目的 1
第二章 文獻探討 2
2.1 腸躁症 2
2.1.1 定義與診斷 2
2.1.2 腸躁症之致病機轉 3
2.1.3 腸躁症盛行率 3
2.1.4 腸躁症相關因素 3
2.2 生活品質(QUALITY OF LIFE ,QOL) 5
2.2.1 生活品質的測量 6
2.2.2 SF-36 6
2.2.3 SF-36之比較研究 9
2.3 腸躁症(或FGIDS)與SF-36 12
第三章 研究架構及研究假說 14
3.1 研究架構 14
3.2 研究假說 15
依據本研究之架構及參考文獻探討的結果,研究主要假說包括: 15
第四章 研究材料與方法 16
4.1 研究地區及對象 16
4.2 資料蒐集及測量 16
4.3 樣本數及統計檢定力估計 18
4.4 資料處理與統計分析 18
第五章 結果 20
5.1 研究對象的基本資料 20
5.2 慢性病之基本資料分析 20
5.3 生活品質量表之分析 22
5.4 健康行為與生活品質得分之比較 24
5.5 慢性病種類生活品質得分比較 24
5.6 多因子迴歸分析 28
第六章 討論與結論 33
6.1 研究結果摘要 33
6.2 一般族群生活品質分數之討論 34
6.3 罹患慢性病及共病症時對生活品質之影響 34
6.4 結論 37
6.5 建議 37
6.6 研究限制 38
參考文獻 39
附件一 問卷 88
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網頁資料:
1.http://sf36.cgu.edu.tw/guideline.htm
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