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研究生:洪偉倫
研究生(外文):Wei-Lun Hung
論文名稱:以模糊理論探討慢性骨盆腔疼痛婦女之憂鬱、日常活動功能及疼痛恐懼感情形
論文名稱(外文):Using Fuzzy Theory to Realize the Situation of Depression, Daily Activities and Pain Catastrophe of Women’s Chronic Pelvic Pain
指導教授:鄭博文鄭博文引用關係
指導教授(外文):Bor-Wen Cheng
學位類別:碩士
校院名稱:國立雲林科技大學
系所名稱:全球運籌管理研究所碩士班
學門:商業及管理學門
學類:行銷與流通學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:74
中文關鍵詞:模糊理論疼痛恐懼感憂鬱慢性骨盆腔疼痛日常活動功能
外文關鍵詞:the activities of daily lifeDepressionCatastrophized painFuzzy theoryChronic pelvic pain
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慢性骨盆腔疼痛(Chronic pelvic pain, CPP)為女性常見之慢性疼痛,約有三分之一的女性患有此疼痛。而在婦科門診當中,約有20%的門診病患是因為慢性骨盆腔疼痛而求診的,可見慢性骨盆腔疼痛盛行率相當高。當慢性骨盆腔疼痛發生時,婦女許多日常活動皆會因此而受到影響,甚至造成人際關係及家庭生活的困擾。台灣目前尚未針對婦女慢性骨盆腔疼痛因素進行完整探討,因此,實有必要針對此議題深入研究。
本研究利用Crombez等於2008所提之影響慢性疼痛之理論架構,並且參考國外慢性骨盆腔疼痛之影響情形,建構本研究之觀念性架構。本研究發現會影響慢性骨盆腔疼痛的情形有:(1)憂鬱程度;(2)日常活動功能;(3)疼痛恐懼感。
疼痛會因個人因素而模糊不清,本研究以Zadeh所提之模糊理論(fuzzy theory)設計本研究之問卷量表,以Matlab及Excel套裝軟體進行模糊數值轉換,並且以統計分析軟體SPSS12.0進行資料分析。
本研究以個案醫院婦產科門診之慢性骨盆腔疼痛婦女為研究對象,共60位婦女。研究結果發現,本研究所提之研究變項於不同之背景變項下,大部份具有顯著關係。本研究之成果可以合理解釋慢性骨盆腔疼痛之情形,以協助婦女減緩疼痛的困擾。
Chronic pelvic pain (CPP) is a common chronic pain among women. There are about one-third of women suffering from the pain in general population. Among the outpatient services of department of gynecology, around 20% outpatients consulted with the doctors due to CPP. Therefore, CPP is very common among women. When CPP occurred, it affects the patients’ daily activities or even interferes their personal relationship with other family members. There is no study that thoroughly studied the factors of CPP in Taiwan so far. Thus, it is necessary to investigate the possibly associated variables that affect CPP.
This study applied the study of Crombez et al(2008) and some other studies to investigate what affect CPP. The study found that CPP could possibly worsen the following three situations:(1) depression;(2) the activities of daily life;(3) pain catastrophe.
The definition of painful degree is quite ambiguous due to personal factors. The questionnaire of the study was designed by applying fuzzy theory which is brought by Zadeh. Matlab and Excel was adopted to generate the fuzzy scores. Finally, SPSS12.0 was used to analyze the data.
There were sixty women participated in this study from the obstetrics and gynecology department of the studied hospital located in Yunlin county. The results show that variables suggested by this study have significant influence on the setting variables. The outcome of the study reasonably explains the situations of CPP, and helps women ease up the persecution of CPP.
中文摘要 i
英文摘要 ii
誌謝.... iv
目錄.... v
表目錄 vii
圖目錄 ix
一、緖論1
1.1 研究動機與背景 1
1.2 研究目的與問題 3
1.3 研究流程 3
1.4 名詞界定 4
二、文獻探討 8
2.1 慢性疼痛 8
2.2 慢性骨盆腔疼痛 9
2.3 慢性骨盆腔之相關因素 10
2.4 慢性疼痛之測量工具 13
2.5 模糊統計於問卷上的應用T 16
三、研究方法 21
3.1 研究架構 21
3.2 研究假設 21
3.3 研究工具 22
3.4 研究對象 24
3.5 問卷設計 24
3.6 信效度分析 25
3.7 資料處理與分析 28
四、研究結果 30
4.1 研究量表之信效度 30
4.2 慢性骨盆腔疼痛婦女之社會人口學特性T 30
4.3 口語評估之歸屬度函數T 32
4.4 常態檢定 34
4.5 婦女慢性骨盆腔疼痛之狀況 35
4.6 社會人口學特性與慢性骨盆腔疼痛強度之獨立關係 37
4.7 慢性骨盆腔疼痛婦女其社會人口學特性與研究變項之模糊關係T 39
五、結論與建議 48
5.1 研究結果發現 48
5.2 本研究與過去研究比較 50
5.3 專家訪談結果 51
5.4 提供婦女改善疼痛情形方案 53
5.5 模糊語意量表的運用 53
5.6 未來研究方向 54
參考文獻 55
中文文獻 55
英文文獻 56
附錄一、正式施測問卷 59
中文文獻
1.林芷伊(2007)•機構關節炎老人之慢性疼痛及相關因素探討,輔英科技大學護理研究所
2.郭東明(1998)•慢性骨盆腔疼痛•中華民國內膜異位症婦女協會會刊•5(2),5
3.李宜貞(2006)•女性慢性骨盆腔疼痛•中醫婦科醫學雜誌•7,14-17
4.威廉•派克(2003)•婦科診療室•(張嘉倩、李千毅編譯)•台北市:天下遠見
5.張慰萱(1989)•慢性疼痛之社會心理層面觀•中華物療誌•14,73-76
6.吳瑞屏(2006)•頸部多裂肌收縮型態之動態超音波研究-探討慢性頸痛的影響,國立台灣大學物理治療學研究所
7.吳柏林(1996)•模糊統計在問卷調查上之分析與應用•行政院國家科學委員會補助專題研究報告
8.王潤清(2004)•慢性疼痛對情緒狀態及睡眠品質之影響:慢性癌痛與慢性每日頭痛之比較•台北醫學大學護理研究所
9.李瓊瑛(2006)•機構老人慢性疼痛及因應之生活經驗•輔英科技大學護理研究所
10.王朝正(2002)•模糊語意問卷及信效度之相關研究,國立台中師範學院教育測驗統計研究所
11.甘強森(2004)•模糊語意問卷運用於服務品質量測之研究-以行動電話業者之服務品質探討為例,中華大學科技管理研究所
12.楊婉君•模糊迴歸與傳統迴歸應用於估計潛在特質之模擬比較分析研究,國立台中師範學院教育測驗統計研究所
13.林信惠、蕭文峰•模糊口語評估尺度之歸屬度函數建構及特性探討•資訊管理學報•8(1),1-19
14.賴雅琦•國中生對校園犯罪之被害恐懼感研究,國立成功大學教育研究所
英文文獻
1.A.A.W. Peters, S.A.H.M. Van den Tillaart(2007). The difficult patient in gastroenterology: chronic pelvic pain, adhesions, and sub occlusive episodes. Best Practice & Research Clinical Gastroenterology, 21(3), 445-463.
2.Cynthia Farquhar, Pallavi Latthe(2006). Chronic pelvic pain:Aetiology and therapy. Reviews in Gynaecological and Perinatal, 6, 177-184
3.Georgine Lamvu, Rachel Williams, Denniz Zolnoun, Mary E. Wechter, Anne Shortliffe, Grace Fulton, John F. Steege(2006). Long-term outcomes after surgical and nonsurgical management of chronic pelvic pain: One year after evaluation in a pelvic pain specialty clinic. American Journal of Obstetrics and Gynecology, 195, 591–600.
4.Geert Crombez, Christopher Eccleston, Guido Van Hamme, Petra De Vlieger(2008). Attempting to solve the problem of pain: A questionnaire study in acute and chronic pain patients. Pain, 137, 556-563.
5.Geert Crombez, Patricia Bijttebier, Chris Eccleston, Tamara Mascagni,
Gustaaf Mertens, Liesbet Goubert, Katrien Verstraeten(2003). The child version of the pain catastrophizing scale (PCS-C): a preliminary validation. Pain, 104,639-646
6.Harald Breivik, Beverly Collett, Vittorio Ventafridda, Rob Cohen,Derek Gallacher(2006). Survey of chronic pain in Europe: Prevalence, impact on
daily life, and treatment. European Journal of Pain, 10, 287-333.
7.Jane Leserman, Denniz Zolnoun, Samantha Meltzer-Brody, Georgine Lamvu, John F. Steege(2006). Identification of diagnostic subtypes of chronic pelvic pain and how subtypes differ in health status and trauma history. American Journal of Obstetrics and Gynecology, 195, 554-61.
8.Krina T. Zondervan, Stephen H. Kennedy(2005). Epidemiology of chronic pelvic pain. International Congress Series,1279, 77- 84
9.Krina T. Zondervan, Patricia L. Yudkin, Martin P. Vessey, Crispin P. Jenkinson, Martin G. Dawes, David H. Barlow, and Stephen H. Kennedy(2001). Chronic pelvic pain in the community-Symptoms, investigations, and diagnoses. American Journal of Obstetrics and Gynecology, 184(6), 1149-1155
10.Krina T. Zondervan, Patricia L. Yudkin, Martin P. Vessey, Martin G. Dawes Lecturer, David H. Barlow Professor, Stephen H. Kennedy(1999). Patterns of diagnosis and referral in women consultning for chronic pelvic pain in UK primary care. British Journal of Obstetrics and Gynaecology, 106, 1156-1161.
11.Michael J.L. Sullivan, Pascal Thibault, Juste Andrikonyte, Heather Butler, Richard Catchlove,Christian Lariviere(2008). Psychological influences on repetition-induced summation of activity-related pain in patients with chronic low back pain. Pain.
12.Moore Jane, Kennedy Stephen(2005). Causes of chronic pelvic pain. Women''s Health Medicine, 2(1), 1-4
13.Philomeen T.M. Weijenborg, Anja Greeven, Friedo W. Dekker,
Alexander A.W. Peters, Moniek M. ter Kuile(2007). Clinical course of chronic pelvic pain in women. Pain, 132, S117-S123.
14.Pauline Slade, Christine Cordle(2005). Psychological aspects of the management
of chronic pelvic pain. Current Obstetrics & Gynaecology, 15, 298-305
15.Purana van Os-Bossagh, Trudy Pols, Wim C.J. Hop, Ton Nelemans, Wilhelm Erdmann, Aat C. Drogendijk, Arthur M. Bohnen(2002). Questionnaire as diagnostic tool in chronic pelvic pain (CPP): a pilot study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 103, 173-178
16.R. William Stones, Susan A. Selfe (2000), Psychosocial and economic impact of chronic pelvic pain. BaillieÁ re''s Clinical Obstetrics and Gynaecology, 14(3), 415-431
17.Randy S. Roth, Margaret R. Punch, Jan E. Bachman(2001).Educational achievement and pain disability among women with chronic pelvic pain. Journal of Psychosomatic Research, 51, 563-569
18.R.P.W.Fry, R.W.Beard, A.H.Crisp and S McGugan(1997). Sociopsychological factors in women with chronic pelvic pain with and without pelvic venous congestion. Journal of Psychosomatic Research, 42(1),1997
19.Susan D. Mathias, Miriam Kuppermann, Rebecca F. Liberman, Ruth C. Lipschutz, and John F. Steege(1996). Chronic Pelvic Pain: Prevalence, Health-Related Quality of Life, and Economic Correlates. Obstetrics& Gynecology, 87, 321-327
20.Ying Cheong, William Stones(2005). Investigations for chronic pelvic pain. Reviews in Gynaecological Practice, 5, 227-236.
21.Xin Shelly Wang, Tito R. Mendoza, Shuo-Zeng Gao and Charles S. Cleeland(1996). The Chinese version of the Brief Pain Inventory(BPI-C):it’s development and use in a study of cancer pain. Pain, 67, 407-416
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