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研究生:張智傑
研究生(外文):Chih-ChiehChang
論文名稱:影響全球腦中風疾病負擔之因子分析(2008-2017):重複測量資料方法應用
論文名稱(外文):Analyses of Factors Affecting the Global Burden of Stroke (2008-2017) :Applications of Repeated Measurement
指導教授:翁慧卿翁慧卿引用關係徐之昇徐之昇引用關係
指導教授(外文):Hui-Ching WengJason C. Hsu
學位類別:碩士
校院名稱:國立成功大學
系所名稱:公共衛生研究所碩士在職專班
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2020
畢業學年度:108
語文別:中文
論文頁數:119
中文關鍵詞:腦中風疾病負擔因子分析重複測量
外文關鍵詞:strokeburden of diseaseanalyses of factorsrepeated measurement
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研究背景與目的
腦中風(cerebrovascular accident,CVA)是導致死亡及失能的主要因素,尤其在低收入和中等收入國家。與腦中風相關的風險因子包括高血壓、糖尿病、肥胖等;然目前研究腦中風疾病負擔與因子間相關性的文獻多著墨於個體健康、行為或國家經濟等單一層面,少有多面向且長期間探討的文章。因此,本篇以國家為研究對象,將與腦中風疾病負擔相關的重要因子納入分析,進行長期追蹤資料研究,探討全球腦中風疾病負擔(發生率、盛行率、失能調整人年及死亡率)與重要關聯因子之相關性為何,及瞭解其彼此間有無異同之處。
研究方法
依2017年全球疾病負擔研究對象為標的,資料來源包括世界衛生組織、世界銀行、教科文組織、華盛頓大學健康測量與評估研究中心之統計數據,進而以國家為單位,運用重複測量方法分析2008年至2017年各國資料,探討重要關聯因子對不同構面的腦中風疾病負擔之影響。
結果與結論
共計120國符合納入條件,其中多數位於歐洲區域(含中亞),與因子間之相關性因疾病負擔構面不同而有所差異,其中總膽固醇及平均餘命與各類疾病負擔面向皆呈現負向關聯,若以中風分型進行探究,除溫度變項較無影響外,餘呈現相關方向不一或顯著性不等之結果。
腦中風疾病負擔之預防及改善不僅需應用跨層面模式方法,並亟待政府、非政府、社區、及個人等單位共同參與方能有效執行,對於國家政策而言,除需向民眾推廣個體層次的健康與生活行為自控外,亦可藉由法規訂定進行菸酒品項管理,期以降低該等因素之影響。
Cerebrovascular accident (CVA) is a major cause of death and disability, especially in low- and middle-income countries. However, the current literature on the correlation between the burden of stroke disease and the factors is mostly focused on a single level such as individual health, behavior, or national economy. To explore the correlation between the global stroke burden (incidence, prevalence, disability-adjusted person-year and mortality) and important related factors, and to understand whether there are similarities and differences between them. This article takes the country as the research object and incorporates important factors related to the burden of stroke into the analysis. Based on the 2017 global burden of disease research target, data sources include statistical data from the World Health Organization, the World Bank, UNESCO, and the Institute of Health Indicators and Evaluation of the University of Washington. Data from 2008 to 2017 will be applied using a repeated measurement statistical method to analyze the correlation. A total of 120 countries are eligible for inclusion, most of which are located in Europe (included Central Asia). Results indicated the correlation with factors varies according to the facets of disease burden. Among them, total cholesterol and average life expectancy are negatively related to the burden of various diseases. If the investigation is based on the stroke classification, in addition to the temperature variation term, the results of the correlations are different or the significance is not the same. The prevention and improvement of the stroke burden not only requires the application of cross-level models and methods, but also requires the joint participation of government, non-government, community, and individuals to effectively implement it.
中文摘要 i
Abstract ii
誌 謝 iv
目 錄 v
表目錄 vii
圖目錄 ix
第一章 緒論 1
第一節 研究背景 1
第二節 研究目的 2
第三節 名詞解釋 3
第二章 文獻回顧 6
第一節 腦中風疾病負擔 6
第二節 腦中風疾病負擔相關因子 8
第三節 腦中風疾病負擔與因子間相關性 14
第三章 材料與方法 15
第一節 研究問題與假說 15
第二節 研究架構 16
第三節 資料來源 17
第四節 研究設計 19
第五節 統計分析 22
第四章 研究結果 32
第一節 變項分佈概況 34
第二節 相關性分析結果 57
第五章 討論 96
第一節 腦中風疾病負擔分佈與趨勢 96
第二節 腦中風疾病負擔與各層面因子相關性 97
第三節 研究限制與未來研究方向 100
第六章 結論與建議 101
第一節 結論 101
第二節 建議 101
參考文獻 102
參考文獻
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