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研究生:劉佩青
研究生(外文):Pei-Ching Liu
論文名稱:兒童氣喘與肥胖之關連性研究
論文名稱(外文):The Association between Obesity and Asthma in Children
指導教授:高碧霞高碧霞引用關係
指導教授(外文):Bih-Shya Gau
口試委員:陳月枝江伯倫胡賦強張碧真
口試委員(外文):Yueh-Chih ChenBor-Luen ChiangFu-Chang HuPi-Chen Chang
口試日期:2014-07-04
學位類別:博士
校院名稱:國立臺灣大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:196
中文關鍵詞:兒童氣喘兒童肥胖體重過重身體質量指數氣喘控制
外文關鍵詞:asthmaasthma controlBMIchildrenobesityoverweight
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背景:近年來兒童氣喘與兒童肥胖的盛行率節節高升,因此有越來越多的研究者開始試圖找出兩者之關連。雖然已經有相當數量的研究證實兩者之關連性,但是對於兩者關係之間的潛在機制仍未有充分的解答。國內相關的研究尚在起步的階段,但本國兒童氣喘與肥胖的盛行率仍未有減緩的趨勢,因此,需要更多本土的研究來定位出此高風險族群,以及辨識出可能危害兒童氣喘控制程度與肥胖程度的危險因子。
目的:本研究旨在驗證氣喘兒童的氣喘控制程度與肥胖程度之間的關連性,並探討可能同時影響兩者的重要共通因素。
研究方法:本研究採取橫斷式研究法,於台大醫院小兒過敏免疫科門診選取氣喘兒童,作為研究個案。主要使用的研究工具為自擬基本資料問卷、飲食頻率問卷、身體活動程度問卷,身高體重計以及肺活量功能計,來蒐集重要的研究變項,包括兒童個人及家庭的基本資料,兒童目前的氣喘控制程度、肺功能指數、身高與體重及所計算的BMI數值,以及其身體活動程度與飲食型態。再將藉由描述性統計、Kruskal-Wallis test、Linear regression、Logistic regression等統計方法,來探討兒童氣喘控制程度與肥胖程度之間的關係,以及辨識出對它們個別或共同產生影響的重要共通因素。
研究結果: 本研究共招募97位氣喘的兒童,其中男童共67位(69.1%)、女童共30位 (30.9%),收案期間為2009年12月至2011年9月。本研究中,氣喘兒童的氣喘控制程度與以兒童身體質量指數(BMI)所定義的兒童肥胖程度具有相關性(OR:1.19, 95% CI: 1.02~1.41)。兒童的人口學特性、飲食型態與身體活動程度相關的變項,均會同時影響氣喘兒童的氣喘控制程度與肥胖程度。家庭的低社經地位、攝取較高頻率的高油高糖飲食,與較差的氣喘控制及兒童肥胖相關;醫師鼓勵氣喘兒童多運動則顯著地可以同時降低氣喘控制不佳、及兒童肥胖的風險。另外,平日充足的睡眠也可能與較佳的氣喘控制及肥胖風險的降低相關。
結論: 本研究的研究結果不僅驗證了兒童氣喘與肥胖之關連性,並定位出具備某些特徵(人口學、飲食型態與身體活動程度相關)的氣喘兒童,同時也可能成為兒童肥胖的高風險族群。


Backgrounds: The concurrence of children obesity and asthma has been noticed during the past two decades. Thus, there is an increasing number of studies focusing on the relationship between these two health issues and the scientists continue on exploring the underlying mechanism connecting children asthma to obesity. Though the number of children suffering from obesity and/or asthma is also elevating in Taiwan, related studies focusing on Taiwanese children are lacking. There is a need to construct more localized studies to explore the relationship between childhood asthma and obesity in Taiwan’s pediatric population, also those important factors contributing to both health burden.
Purpose: The main purpose of this study is to clarify the relationship between childhood asthma and obesity and to identy the important and risk factor that may have impact on the both health issues.
Methods: This was a cross-sectional research. The research sample recruited from Pediatric Immunology clinic in National Taiwan University Hospital in Taipei. Questionnaires were adopted to collect children’s demographic variables and physical activities levels; and also Food Frequency Questionnare to explore the dietary pattern of recruited children. A weight/height scale was utilized to calculate children’s BMI and the the pulmonary function test was performed by using the spirometry. All those data were analyzed through statistics method such as descriptive analysis, Kruskal-Wallis test, linear or/and logistic regression to verify the relationships between research variables.
Results: 97 children with asthma were recruited. 67 (69.1%) of them were boys while 30 (30.9%) of them were girls. The data collecting period was between Dec. in 2009 till Sep. in 2011. There is a positive association between children’s asthma control level and their obesity status (OR: 1.19, 95% CI: 1.02~1.41). Several factors may both contribute to a worsen asthma control level and obesity including low SES status and a dietary pattern of a frequent intake of oily and hight-sugar food. Doctor’s education was significantly related to decrease the risk of a worsen asthma control and obesity. Finally, the sleep hours during the weekdays were somehow inversely associated with the risk of worse asthma control and obesity.
Conclusions: This study not only found some evidence of the positive relationship between childhood asthma and obesity, but also able to identify high-risk gourps by locating the risk demographic and behavioral factors contributing to both health burdens.


口試委員審定書 i
誌 謝 ii
中文摘要 v
英文摘要 vii
目錄 ix
圖目錄 xi
表目錄 xii
第一章 緒論 1
第一節 研究背景與重要性 1
第二節 研究目的 6
第三節 研究問題 7
第二章 文獻查證 9
第一節 兒童氣喘的定義與測量 9
第二節 兒童肥胖的定義與指標 16
第三節 兒童氣喘與肥胖之機轉及共同影響因素 20
第三章 研究方法 27
第一節 研究概念架構 27
第二節 名詞界定 30
第三節 主要研究假設 34
第四節 研究設計 35
第五節 研究對象與取樣方法 36
第六節 研究情境 38
第七節 研究工具 39
第八節 信度與效度 45
第九節 研究步驟 48
第十節 資料分析 49
第十一節 倫理考量 53
第四章 研究結果 55
第一節 研究對象基本屬性 55
第二節 氣喘兒童之肥胖程度 64
第三節 氣喘兒童之氣喘控制程度 78
第四節 兒童氣喘控制程度與肥胖程度之相關性及其共同影響因素 84
第五章 討論 125
第一節 氣喘兒童的肥胖程度及其隨性別與年齡之分布 125
第二節 兒童氣喘控制程度與肥胖程度的關連性 128
第三節 兒童氣喘控制程度與肥胖程度的影響因素 138
第六章 結論及建議 151
第一節 研究結論 151
第二節 研究限制 153
第三節 未來研究建議及護理的應用 156
參考文獻 161
中文部分 161
英文部分 163
附錄一 兒童氣喘控制程度問卷 181
附錄二 12歲(含)以上成人氣喘控制測驗ACT 182
附錄三 兒童身體活動問卷 183
附錄四 兒童飲食頻率問卷 185
附錄五 氣喘基本資料問卷 189
附錄六 家庭社會經濟地位區分法 191
附錄七 台大醫院倫理委員會審查同意書 193
附錄八 知情同意書 196


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