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研究生:林仕苾
研究生(外文):Shih-Pi Lin
論文名稱:探討慢性思覺失調症病人的藥物態度及賦權對藥物副作用與生活品質關係之影響
論文名稱(外文):The Influences of Drug Attitudes and Empowerment on the Relationships Between Side Effects and Quality of Life in Patients With Chronic Schizophrenia
指導教授:楊秋月楊秋月引用關係
指導教授(外文):Chiu-Yueh Yang
學位類別:博士
校院名稱:國立陽明大學
系所名稱:護理學系
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:2018
畢業學年度:106
語文別:中文
論文頁數:102
中文關鍵詞:藥物態度賦權生活品質思覺失調症藥物副作用
外文關鍵詞:drug attitudeempowermentquality of lifeschizophreniaside effect
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目 錄
誌 謝 ……………………………………………………………………… i

中文摘要 ……………………………………………………………………… iii

Abstract ……………………………………………………………………… v

目 錄 ……………………………………………………………………… vii

圖 目 錄 ……………………………………………………………………… x

表 目 錄 ……………………………………………………………………… xi

第一章 緒論…………………………………………………………………… 1
第一節 研究背景……………………………………………………… 1
第二節 研究目的……………………………………………………… 4
第二章 文獻查證……………………………………………………………… 5
第一節 思覺失調症…………………………………………………… 5
第二節 思覺失調症病人的藥物副作用……………………………… 7
第三節 思覺失調症病人的生活品質………………………………… 9
第四節 思覺失調症病人的藥物態度…………………………………12
第五節 思覺失調症病人的賦權………………………………………14
第六節 藥物副作用、賦權、藥物態度與生活品質的相關研究…… 16
第三章 研究方法……………………………………………………………… 19
第一節 研究設計……………………………………………………… 19
第二節 研究架構……………………………………………………… 20
第三節 研究對象……………………………………………………… 24
第四節 名詞界定……………………………………………………… 25
第五節 研究假設……………………………………………………… 26
第六節 研究工具……………………………………………………… 27
第七節 資料收集過程與倫理考量………………………………31
第八節 資料分析……………………………………………………… 32
第四章 結果 …………………………………………………………………… 34
第一節 思覺失調症病人人口學特性、賦權、藥物態度、藥物副作用、生活品質的分佈情形 …………………………………… 35
第二節 思覺失調症病人的賦權、藥物態度、藥物副作用、生活品質間隔六個月的變化 ……………………………………… 40
第三節 思覺失調症病人的人口學特性與兩個時間點生活品質的關係 44
第四節 思覺失調症病人的賦權、藥物態度與藥物副作用、生活品質相關性………………………………………………………… 54
第五節 思覺失調症病人的藥物態度於藥物副作用與生活品質關係的影響機制……………………………………………………… 60
第六節 思覺失調症病人的賦權於藥物副作用與生活品質關係的影響機制…………………………………………………………… 63
第五章 討論 ……………………………………………………………………… 65
第一節 思覺失調症病人人口學特性、賦權、藥物態度、藥物副作用、生活品質的分佈情形 …………………………………… 65
第二節 思覺失調症病人的賦權、藥物態度、藥物副作用、生活品質間隔六個月的變化 …………………………………………… 70
第三節 思覺失調症病人的人口學特性與兩個時間點生活品質的關係 72
第四節 思覺失調症病人的賦權、藥物態度與藥物副作用、生活品質相關性………………………………………………………… 74
第五節 思覺失調症病人的藥物態度於藥物副作用與生活品質關係的影響機制……………………………………………………… 76
第六節 思覺失調症病人的賦權於藥物副作用與生活品質關係的影響機制…………………………………………………………… 77
第六章 結論與建議 …………………………………………………………… 78
第一節 結論 …………………………………………………………… 78
第二節 護理應用 ……………………………………………………… 81
第三節 限制與建議 …………………………………………………… 83
參考文獻 ……………………………………………………………………… 85
附錄 …………………………………………………………………………… 94
附錄1 Hogan’s藥物態度量表中文版 (Drug Attitude Inventory )授權書 94
附錄2 利物浦大學抗精神病藥物副作用量表 (The Liverpool University Neuroleptic Side Effect Rating Scale )授權書………………………. 95
附錄3 世界衛生組織之生活品質簡明問卷台灣版 (The World Health Organization Quality of Life- BREF)授權書 ………………………. 96
附錄4 病人賦權覺察量表(Patient Perception of Empowerment Scale)授權書. 97
附錄5 精神疾病汙名內化量表(Internalized Stigma of Mental Illness Scale, ISMIS)授權書……………………………………………………… 98
附錄6 活性與負性症狀量表(Positive and Negative Syndrome Scale, PANSS)授權書…………………………………………………… 99
附錄7 健康性格習慣量表(Health, Personality, Habit Scale, HPH) (修訂版)購買證明…………………………………………………………… 100
附錄8 人體試驗計畫同意函……………………………………………… 101
附錄9 問卷內容…………………………………………………………… 102


圖目錄
圖3-1 研究架構圖 ………………………………………………………… 20
圖3-2A 直接效應 …………………………………………………………… 21
圖3-2B 中介效應 …………………………………………………………… 22
圖4-1 藥物態度 (T1)於藥物副作用(T1)對生活品質心理範疇(T1)的中介模型……………………………………………………………………… 62
圖4-2 藥物態度 (T1)於藥物副作用(T1)對生活品質環境範疇(T1)的中介模型……………………………………………………………………… 62



表目錄
表2-1 藥物副作用、賦權、藥物態度與生活品質的相關研究………18
表4-1-1 樣本流失與否於關鍵變項(T1)的差異分析…………………36
表4-1-2 研究對象的基本人口屬性與疾病特性…………………………………37
表4-1-3 兩次資料收集之自我烙印、健康、性格、習慣(HPH)、精神病症狀、心率變異度與藥物劑量的差異情形情形………………………………39
表4-2-1 賦權、藥物態度、藥物副作用、生活品質間隔六個月的變化……… 43
表4-3-1 人口學特性與生活品質生理健康範疇(T1) (T2)的關係……………… 45
表4-3-2 人口學特性與生活品質心理範疇(T1) (T2)的關係………………47
表4-3-3 人口學特性與生活品質社會關係範疇(T1) (T2)的關係……………… 49
表4-3-4 人口學特性與生活品質環境範疇(T1) (T2)的關係………………51
表4-3-5 症狀嚴重度、收案單位與生活品質(T1) (T2)的關係…………53
表4-4-1 不同時段藥物態度、藥物副作用與生活品質的相關性………56
表4-4-2 不同時段賦權、藥物副作用與生活品質的相關性……………59
表4-5 基準點藥物態度於藥物副作用對生活品質的中介效應…………61
表4-6 賦權(T2)於藥物副作用(T1) (T2)對生活品質之生理健康範疇(T2)的中介效應……………………………………………………………………… 64
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