本研究的目的在瞭解長期照護機構住民便秘現況以及探討黑棗汁介入改善長期照護機構住民慢性便秘的程度。採類實驗性研究設計，研究對象來自新竹縣市四家長期照護機構（三家養護機構及一家安養機構），收案條件符合慢性便秘診斷住民、能清楚表達感受、能以國語、台語或客語溝通者；排除意識不清，無表達能力者、有飲水或低渣飲食限制者、服用黑棗汁後24小時內，出現解水便超過3次者、研究期間，排便藥物有調整劑量或有執行灌腸之住民。收案時間為2011年1月3日至2011年4月9日，共68位參與本研究，研究樣本隨機分派至實驗組及對照組，各有34位，完成本研究過程者實驗組31位及對照組30位。實驗組每天早上給予服用黑棗汁180c.c.，為期6天。對照組則維持常規性照護，未安排任何介入性措施。
評量工具包括基本資料表、排便相關日常生活記錄表、Bristol 糞便性質量表與病人自評便秘症狀量表；於黑棗汁介入措施實施前及介入後第3小時、第6小時、第9小時及第24小時進行兩組便秘指標1.腸蠕動次數2.排便次數3.排便性狀4.便秘不適症狀評量。以SPSS 17.0版之軟體進行資料分析，研究結果顯示：長期照護機構住民便秘發生率為64.2%。黑棗汁介入後，實驗組的後測便秘指標優於前測，達統計顯著差異（p＜.001）；對照組的前、後測便秘指標沒有顯著差異；實驗組前後測便秘指標的差異優於對照組前後測便秘指標的差異（p＜.001）。

The purpose of this study was to understand the status of constipation of long-term care facility residents and the effects of Prune Juices on their chronic constipation. A quasi-experimental research design was used. The subjects were recruited from residents of four long-term care facilities (three infirmary care centers and one domiciliary care center) in Hsinchu City. Those subjects who were diagnosed with chronic constipation, who could clearly expressed their feelings, could communicate with Mainland Chinese or Taiwanese languages were included. However, those subjects with consciousness, without ability to express, having drinking water or low-residue diet restrictions, having more than three times the solution by water during 24 hours after prune juices, having defecation drug dose adjustment or implementation of residents enema were excluded. The study ran from January 3rd to April 9th, 2011. A total of 68 residents participated. They were randomly assigned to either experimental or control groups. There were 31 subjects in the experimental group and 30 in the control group completed the study. Experimental group has taken the 180c.c. prune juices every morning per day during six days. Control group has remained routine care without intervention.

Assessment tools included basic information table, stool-related daily record sheet, the Bristol stool form scale and the patient assessment of constipation symptoms (PAC-SYM) questionnaires. The time of measurement was before and after the intervention, the first 3 hours, 6 hours, 9 hours and 24 hours after the administration of the prune juices. Both groups were assessed with their constipation indicators, including 1. peristalsis number, 2. defecation, 3. defecation traits, and 4. assessment of constipation symptoms. With SPSS 18.0 version of the software for data analysis, the results showed 64.2% of long-term care facility residents had problems with constipation. Post-test of constipation indicators were statistically significant better than pre-test in the experimental group (p < .001); the control group were not. Analyzing the differences of constipation indicators between pre- and post-tests, the experimental group were statistically significant better than the control group (p < .001).

目 錄
誌 謝…………………………………………………………………………Ⅰ
中文摘要…………………………………………………………………………Ⅱ
英文摘要…………………………………………………………………………Ⅲ-Ⅳ
目 錄…………………………………………………………………………Ⅴ-Ⅵ
圖表索引…………………………………………………………………………Ⅶ
第一章 緒論……………………………………………………………………1
第一節 研究動機………………………………………………………………1-2
第二節 研究重要性及目的……………………………………………………2-4
第二章 文獻查證………………………………………………………………5
第一節 便秘定義、診斷與盛行率……………………………………………5-6
第二節 便秘原因及症狀………………………………………………………7-10
第三節 便秘治療與處置………………………………………………………10-12
第四節 黑棗汁對便秘治療機轉及相關性研究………………………………13-15
第三章 研究方法………………………………………………………………16
第一節 研究設計………………………………………………………………16
第二節 研究架構………………………………………………………………17
第三節 研究假設………………………………………………………………18
第四節 研究對象與樣本………………………………………………………18-19
第五節 研究工具與變項………………………………………………………20-22
第六節 研究過程………………………………………………………………23-25
第七節 資料處理與分析………………………………………………………26-29
第八節 減少內外在效度威脅之研究控制……………………………………29-30
第四章 研究結果………………………………………………………………31-32
第一節 研究對象基本屬性……………………………………………………33-37
第二節 長期照護機構住民便秘的現況………………………………………38
第三節 黑棗汁介入對便秘改善程度之成效分析……………………………38-57
第五章 討論……………………………………………………………………58-63
第六章 結論與建議……………………………………………………………64
第一節 結論……………………………………………………………………64
第二節 研究限制與建議………………………………………………………64
參考文獻
中文部分…………………………………………………………………………65-66
英文部分…………………………………………………………………………67-75
附錄
附錄一 個人基本資料表………………………………………………………76-77
附錄二 排便相關日常生活記錄表……………………………………………78
附錄三 「Bristol糞便性質量表」原始及中文翻譯量表…………………79-80
附錄四 「Bristol糞便性質量表」中文翻譯量表的作者使用授權同意書81
附錄五 「病人自評便秘症狀量表」…………………………………………82
附錄六 「病人自評便秘症狀量表」原著作者使用授權同意………………83-84
附錄七 研究倫理審議證明書…………………………………………………85
附錄八 機構同意書……………………………………………………………86-89


圖 表 索 引
圖ㄧ 研究概念架構……………………………………………………………17
圖二 研究過程…………………………………………………………………24
圖三 研究步驟…………………………………………………………………25
圖四 研究流程…………………………………………………………………32
圖五 實驗組與對照組每一觀測時間，其腸蠕動次數平均值比較…………47
圖六 實驗組與對照組每天排便總次數比較…………………………………50
圖七 實驗組與對照組每天排便性狀平均值比較……………………………53
圖八 實驗組與對照組每一觀測時間，其便秘不適症狀平均得分比較……57
表ㄧ 研究變項與操作定義……………………………………………………21-22
表二 描述性統計………………………………………………………………27-28
表三 推論性統計………………………………………………………………29
表四 兩組研究對象基本資料屬性比較………………………………………35-37
表五 實驗組與對照組在黑棗汁介入後便秘指標（腸蠕動次數、排便次數
、排便性狀、便秘不適症狀）組內比較………………………………………43
表六 以GEE檢定實驗介入前後不同時間，腸蠕動次數之成效分析………45-46
表七 以GEE檢定實驗介入前後不同時間，排便次數之成效分析…………49
表八 以GEE檢定實驗介入前後不同時間，排便性狀之成效分析…………52
表九 以GEE檢定黑棗汁介入前後不同時間，便秘不適症狀之成效分析…55-56

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