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研究生:陳冠戎
研究生(外文):Chen, kuan-jung
論文名稱:探討急診疼痛病人及家屬之負向情緒相關因素
論文名稱(外文):The association of negative emotion in patient with pain and their families at emergency visting
指導教授:蔣立琦蔣立琦引用關係
指導教授(外文):Chiang, li-chi
口試委員:林寬佳葉春長蔣立琦
口試委員(外文):Lin, Kuan-ChiaYeh, Chun-ChangChiang, li-chi
口試日期:2017-05-11
學位類別:碩士
校院名稱:國防醫學院
系所名稱:護理研究所
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:2017
畢業學年度:105
語文別:中文
論文頁數:177
中文關鍵詞:急診疼痛病人家屬負向情緒醫院焦慮憂鬱量表壓力知覺量表
外文關鍵詞:patients with pain in EDfamiliesnegative emotionhospital anxiety depression scale (HADS)perception stress scale(PSS)
相關次數:
  • 被引用被引用:0
  • 點閱點閱:362
  • 評分評分:
  • 下載下載:21
  • 收藏至我的研究室書目清單書目收藏:0
背景:在急診的高壓環境下,有23%-73%的急診病人伴隨有焦慮、憂鬱或壓力的負向情緒反應;而在急診就診族群中,主訴為疼痛者占了約7成,但過去鮮少針對急診疼痛病人及其家屬的負向情緒盛行率及相關因素作探討。
目的:本研究主要是在探討急診疼痛就診病人及家屬之人口學因素、疾病因素、疼痛需求因素等,是否與其產生焦慮、憂鬱、壓力等負向情緒有相關性。
方法:本研究採描述相關性研究設計,用橫斷式調查研究方法(cross-sectional survey research),以結構式問卷調查急診疼痛病人與家屬的負向情緒相關因素。
結果:共有三百份問卷,其中151份為病人及149份為家屬問卷。在單變量分析、潛在類別分析中,急診環境、檢傷時的疼痛程度及職業類別的確影響急診疼痛病人之負向情緒得分;而在家屬方面,其負向情緒相關因素仍不明確。而決策樹模型則顯示,病人若是符合相關條件下,負向情緒發生機率最高達92.3%;而家屬族群方面,其產生負向情緒之機率最高達72.7%。
結論:從整體的研究結果看來,在急診室的這種高壓的環境中,家屬或病人皆有高度負向情緒發生機率,醫療人員應該更敏感、積極地去觀察並處理此問題;另外,研究過程也發現,雖然最終疼痛處置的滿意程度並無明顯差異,但仍有約7成的病人伴隨輕度以上的疼痛程度離院,值得我們更深入去探討急診疼痛處置的有效性問題。

Background:The emergency department is a high-pressure environment in the hospital, Previous studies have been shown the 23%-73% patients in emergency department with negative emotion such as anxiety, depression and stress. In addition, there were no studies to investigate the negative emotion characteristics of their patient with pain and their family in the emergency department.
Purpose: The aim of present study was to investigate the factors of demographic, disease, and pain needs in patient with pain and their family in the emergency department related to negative emotions characteristics such as anxiety, depression, and stress.
Method: The structured questionnaire via cross-sectional survey was collected by the patient with pain and their family to compared the nagetive emotions characteristics between the two group.
Result:A total of 151 patients and 149 family members.The result of univariate analysis and lactent class analysis(LCA), showed significant effect of negative emotion score in the environment of emergency department, the pain level at triage, and occupation. However, the factors of negative emotion are unclear in family groups.The decision tree model showed that the negative emotion of patient was up to 92.3% under the relevant conditions, The family was up to 72.7%.
Conclusion: The patient and their family with high probability of negative emotion in the emergency department, the medical staff should be more sensitive and active to observe the problem;In addition, around 70% of the patient with mild to moderate pain while hospital discharging, we deserve further study to investigate the effectiveness of emergency department patient pain management.
Keywords: patients with pain in ED, families, negative emotion, hospital anxiety depression scale (HADS), perception stress scale(PSS)

第一章 緒論 2
第一節 研究背景 2
第二節 研究動機 5
第三節 研究目的 6
第二章 文獻查證 7
第一節 急診疼痛病人就醫現況 7
第二節 急診病人及家屬之負向情緒盛行率 12
第三節 急診就診相關理論 16
第四節 影響病人與家屬負向情緒之相關因素 20
第三章 概念架構 22
第一節 研究假設 23
第二節 名詞定義 24
第四章 研究方法 29
第一節 研究設計 29
第二節 研究對象與場所 30
第三節 資料收集步驟 40
第四節 研究倫理考量 48
第五章 研究結果 50
第一節 急診就診病人及家屬基本資料、疾病需求因素、疼痛需求因素之分佈 53
第二節 急診就診病人及家屬醫院焦慮憂鬱量表、壓力知覺量表結果之分佈 75
第三節 整體疼痛處置滿意度得分情形 84
第四節 基本資料、疾病需求因素、疼痛需求因素與負向情緒(焦慮、憂鬱、壓力)之分析 86
第五節 負向情緒(焦慮、憂鬱、壓力)與整體疼痛處置滿意度影響之逐步迴歸分析 101
第六節 以潛在類別分析(Latent Class Analysis; LCA)來探討基本資料、疾病需求因素、疼痛
需求因素導致負向情緒(焦慮、憂鬱、壓力)的產生進而影響疼痛處置滿意度的變化程度
103
第七節 以決策樹模型(Decision tree model)來預測高負向情緒得分相關因素之機率 125
第七章 結論及建議 143
第八章 研究限制 144
第九章 對護理的意義 145

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中文文獻
王蔚芸、王桂芸、湯玉英(2007)‧焦慮之概念分析‧長庚護理,18(1),59-67。
余民寧、黃馨瑩、劉育如(2011) ‧[台灣憂鬱症量表] 心理計量特質分析報告‧測驗學刊,58(3),
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張郁敏、蔣立琦(2014)‧以家庭為中心的急診室過渡期護理‧護理雜誌,61(4),91-96。
張齡芝 (2006) ‧北台灣醫院急診於白天, 傍晚及夜間醫療利用之分析‧元智大學資訊管理學系學
位論文,1-175。

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