跳到主要內容

臺灣博碩士論文加值系統

(44.222.104.206) 您好!臺灣時間:2024/05/28 00:01
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

我願授權國圖
: 
twitterline
研究生:張馨芳
研究生(外文):Chang, Hsin-Fang
論文名稱:應用Apriori演算法探討不同類型失智患者對照護者壓力之影響-以中部醫學中心為例
論文名稱(外文):Applying Apriori Algorithm to Explore the Influence of Pressure on Caregivers from Different Types of Dementia Patients – A Case Study of A Medical Center in Central Taiwan
指導教授:吳信宏吳信宏引用關係
口試委員:吳信宏蔡文豐黃冠凱
口試日期:2020-05-22
學位類別:碩士
校院名稱:國立彰化師範大學
系所名稱:企業管理學系
學門:商業及管理學門
學類:企業管理學類
論文種類:學術論文
論文出版年:2021
畢業學年度:109
語文別:中文
論文頁數:76
中文關鍵詞:失智症阿茲海默症血管型失智症路易氏體疾病照護者Apriori演算法照護壓力
外文關鍵詞:DementiaAlzheimer DiseaseVascular DementiaDementia with Lewy BodiesCaregiversApriori AlgorithmCare Stress
相關次數:
  • 被引用被引用:1
  • 點閱點閱:121
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
台灣已進入高齡化社會,老年人長期照護日益重要且社會較關注失智症照護議題,但是照護者在照護失智患者時,卻因為沒有得到適當的幫助而成為「隱形病人」,此外,照護者面對不同類型失智患者壓力因素不一。所以本研究以中部某醫學中心的失智患者與照護者為例,主要分別探討照護者壓力、各類型失智患者與照護者人口統計變數之間的關聯性,以檢視不同類型失智患者及照護者有哪些變數會使照護者產生中度負擔至重度負擔。
本研究收集於2014年1月至2019年8月失智症個案管理資料共有692筆有效資料,應用Apriori演算法逐一分析阿茲海默症、血管型失智症及路易氏體疾病的失智患者與照護者之間的關聯性,後項為照護者壓力程度,其餘15類欄位,患者性別、年齡、失智症嚴重程度、自主活動、失智患者問題行為、精神症狀、照護者年齡、婚姻狀態、照護關係、教育程度、工作情形、照護項目、照護模式、照護頻率、和照護者情緒均為前項。在提升度均大於1條件下篩選規則,將阿茲海默症及血管型失智症支持度設定為2%、信賴度設定為90%;路易氏體疾病支持度設定為5%、信賴度設定為90%,進行個別分析探討。
研究結果表明阿茲海默症、血管型失智症與路易氏體疾病的變數有一些共同性,像是照護者教育程度、是否有工作、照護項目、照護模式、照護頻率及照護者情緒,這6類欄位皆與照護者壓力有高度相關性,意指不管失智患者罹患的是哪一種類型失智症,只要有出現這些變數,就會使照護者產生壓力,醫療管理人員能夠利用此依據,及早發現需要協助的失智患者及照護者,使照護者減輕其壓力及有喘息的空間,也可以間接讓失智患者在病期期間擁有更好的照護品質。
Taiwan has officially entered the aged society, making the long-term care for the elderly increasingly important, among which the public is more concerned about the issue of care for dementia patients. However, caregivers become "Invisible patients" because they do not receive proper help, and caregivers face different types of dementia patients with different stress factors. This study is based on the dementia patients and caregivers of a medical center in central Taiwan and mainly focuses on the correlation among caregivers’ stress, various types of dementia patients and caregivers’ demographic variables to examine the different types of dementia patients and caregivers that result in moderate to severe level of caregiving burden.
From January 2014 to August 2019, the study collected 692 valid data from the dementia database and then used Apriori algorithm to analyze the associations between each type of dementias and caregivers. The degree of caregivers’ stress as the output variable, whereas the remaining fifteen variables, including the gender of patient, age of the patient, severity of dementia, autonomous activity, problematic behavior and mental symptoms of the dementia patient, age of the caregiver, marital status, relationship with the patient, educational level, work situation, care item, care mode, care frequency and caregivers’ mood were input variables. Filtering rules with the degree of lift greater than 1, the support and confidence for Alzheimer Disease and Vascular Dementia were set to 2% and 90%, respectively while the support and confidence for Dementia with Lewy Bodies set to 5% and 90% for analyses.
The results of the study showed that there were some similarities in terms of variables among Alzheimer Disease, Vascular Dementia and Dementia with Lewy Bodies, such as the caregiver’s education, work situation, care item, care mode, care frequency, and caregivers’ mood, all of which were highly correlated with the caregivers’ stress, The results indicated that no matter what type of dementia patients suffered, the caregivers would feel stressful as long as these variables were incurred. Medical management can use these findings to identify dementia patients and caregivers in need of assistance at an early stage, so that caregivers can reduce their stress and have breathing space that would result in better quality of care for patients with dementia.
摘要 I
Abstract II
誌謝 IV
目錄 V
表目錄 VI
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 3
第二章 文獻回顧 4
第一節 失智症概要 4
第二節 失智症危險因子、問題行為及精神症狀 7
第三節 照護者壓力與Zarit照護者負擔量表 8
第四節 關聯規則 11
第三章 研究方法 14
第一節 研究對象與資料來源 14
第二節 分析方法 19
第四章 研究結果 20
第一節 人口統計變數分析 20
第二節 Apriori演算法結果分析 30
第五章 結論 38
第一節 研究結論 38
第二節 管理意涵 40
第三節 研究限制與未來建議 41
參考文獻 42
一、 中文部分 42
二、 英文部分 44
三、 網路資源 48
附錄一 個案醫院失智患者與照護者問卷 49
附錄二 照護者壓力為中度負擔至重度負擔之詳細規則 50
一、 中文部分
王駿濠、蔡佳良(2009),以運動與身體活動預防失智症:文獻回顧,臺灣公共衛生雜誌,28(4),268-277。
王麗雲(2015),失智症家庭主要照顧者失落之經驗,慈惠學報,11,33-43。
行政院衛生福利部(2018),失智症防治照護政策綱領暨行動方案2.0(含工作項目)(2018年版),臺北市:衛生福利部。
吳瓊滿(1999),居家照顧者的負荷,美和專校學報,17,1-14。
巫瑩慧(2013),減少失智症危險因子和及早預防-享受健康的高齡,健康世界,333,20-23。
林克能,劉秀枝(2003),臨床失智症評量表,Acta Neurologica Taiwanica,12(3),154-165。
林美蓮、陳俞成、林高章、錢才瑋(2014),電腦化進行醫院臨床失智評量表之可行性分析-以南部某醫學中心檢查紀錄為例,醫務管理期刊,15(4),306-326。
林淑錦、白明奇(2006),失智症病患主要照顧者的壓力-以家庭生態觀點論之,長期照護雜誌,10(4),412-425。
林雅嫻(2019),探討女性阿茲海默症病患之照護目標與照護者壓力的影響因素-以中部某醫學中心為例,國立彰化師範大學企業管理學系碩士論文。
林敬程(2000),失智老人家庭照顧者之負荷與支持性服務需求之探討,高雄醫學大學行為科學研究所碩士論文。
邱啟潤、陳武宗(1997),誰來關懷照顧者,護理雜誌,44(6),25-30。
邱逸榛、何玉婷、陳琬庭、徐亞瑛(2004),簡介阿茲海默氏症與其照護,長期照護雜誌,7(4),289-304。
邱逸榛、李宜濃、徐文俊、陳獻宗、李佳琳、王鵬智(2010),失智症家庭照顧者睡眠障礙及其相關因素,護理雜誌,57(4),29-39。
邱銘章、湯麗玉(2009),失智症照護指南,臺北市:原水文化。
邱麗蓉、謝佳容、蔡欣玲(2007),失智症病患主要照護者的壓力源、評價和因應行為與健康之相關性探討,精神衛生雜誌,2(2),31-44。
翁政雄(2011),從購買意願資料中挖掘高度相關性的關聯規則,資訊管理學報,18(4),119-138。
高潔純(2004),機構失智長者的問題行為,長期照護雜誌,8(2),251-261。
敖昱婷(2019),罹患失智症老人的家庭調適歷程及家庭韌力之研究,國立屏東大學教育心理與輔導學系碩士論文。
梁家欣、程蘊菁、陳人豪(2014),失智症之重點回顧,內科學誌,25(3),151-157。
許淑敏、邱啟潤(2003),家庭照顧者的壓力源與因應行為-以一個支持團體為例,護理雜誌,50(5),47-55。
郭芷寧(2017),失智症與共病關係之研究,國立臺北大學經濟學系碩士論文。
郭穎樺、劉文良、甄瑞興(2014),中文修訂版照顧者負擔量表測量失智症主要照顧者負擔之信效度,北市醫學雜誌,11(1),63-76。
陳廷斌、王培寧(2018),失智症與其共病症,臨床醫學月刊,81(1),6-9。
陳秀靜、林楠凱、林慧琦、游惠怡、陳誼恬、魏江峯(2011),機構中服務輕、中度失智症患者的輔助科技使用狀況分析,社會發展研究學刊,9,1-18。
陳玟均(2019),利用資料探勘探討失智症患者於照護者壓力之影響-以中部醫學中心為例,國立彰化師範大學企業管理學系碩士論文。
陳玟均、王文甫、呂郁蕙、張凱茗、陳富滿、葉瓊鈺、林哲瑋、康宜靜、張倩蜜、王釧如、吳信宏(2019),利用Apriori演算法探討失智症患者於照護者壓力之影響-以中部醫學中心為例,品質學報,26(6),395-418。
陳垂呈(2010),疾病診斷異常之偵測:關聯規則之應用,輔仁管理評論,17(1),121-141。
陳垂呈、陳宗義(2008),利用資料探勘技術偵測疾病之異常診斷,高雄師大學報:自然科學與科技類,25,47-64。
陳昱名(2013),老年失智症病患家庭照顧者之照顧負荷,崇仁學報,7,1-22。
陳惠姿、李孟芬(2000),台灣失智者的照護現況與展望,應用心理研究,7,191-199。
傅立成、許永真、陳淑惠、洪一平、陳佳慧、廖峻鋒、吳治勳、陳錫中、彭熙寧、莊雯莉、陳達夫、邱銘章(2018),失智症照護的創新生活科技,福祉科技與服務管理學刊,6(4),365-390。
曾雪鳳(2014),失智症照顧者壓力、負荷與生活品質之探討,國立臺北護理健康大學生死與健康心理諮商系碩士論文。
黃仁鵬、錢依佩、郭煌政(2006),高效率之遞增式資料探勘演算法-ICI,電子商務學報,8(3),393-413。
黃正平(2006),失智症之行為精神症狀,台灣精神醫學,20(1),3-18。
黃楚雲、黃錦章(2012),巴金森失智症與路易氏體失智症,應用心理研究,55,59-98。
黃楷雯、陳清惠(2012),找回生活動力:一位失智老人的護理經驗,長庚護理,23(1),73-79。
楊嘉玲、孫惠玲(2003),照顧者負荷概念分析,馬偕護理專科學校學報,3,15-27。
楊蕙菁(2018),一個失智家庭的休閒經驗敘說,國立臺灣師範大學運動休閒與餐旅管理研究所碩士論文。
廖慧媛、李梅英、施孟儀(2016),傳統儒家文化薰陶下的「失智症照護」-以建順體系中山日照間照護中心為例,長期照護雜誌,20(3),245-252。
齊于箴、劉芳、蕭伃伶(2017),照顧服務員的失智症照護知識與態度之探討,長期照護雜誌,21(1),37-52。
歐陽文貞(2014),DSM-5中認知障礙的更正,DSM-5通訊,4(1),16-19。
蔡靜怡(2015),公共圖書館失智症照護者健康資訊服務模式之探討,國立臺灣大學圖書資訊學系碩士論文。
謝沛錡、林麗嬋(2014),失智症的機構照護:由日間照護到護理之家,應用心理研究,60,85-113。
龔旭陽、林美賢、林靖祐、賴威光(2010),針對重要稀少性資料之一種有效率關聯式探勘方法設計,資訊管理學報,17(1),133-155。
二、 英文部分
Agrawal, R., Imielinski, T., and Swami, A. (1993). Mining association rules between sets of items in large database. Proceedings of the ACM SIGMOD Conference on Management of Data, 207-216.
Algase, D. L. (2007). Advances in dementia care: A themed issue. Research and Theory Nursing Practice, 21(1), 3-4.
Almberg, B., Grafström, M., and Winblad, B. (1997). Caring for a demented elderly person-burden and burnout among caregiving relatives. Journal of Advanced Nursing, 25(1), 109-116.
Ballesteros, J., Santos, B., González-Fraile, E., Muñoz-Hermoso, P., Domínguez-Panchón, A. I., and Martín-Carrasco, M. (2012). Unidimensional 12-item Zarit caregiver burden interview for the assessment of dementia caregivers’ burden obtained by item response theory. Value in Health, 15(8), 1141-1147.
Braun, M., Scholz, U., Bailey, B., Perren, S., Hornung, R., and Martin, M. (2009). Dementia caregiving in spousal relationships: A dyadic perspective. Aging & Mental Health, 13(3), 426-436.
Chen, M. S., Han, J., and Yu, P. S. (1996). Data mining: An overview from a database perspective. IEEE Transactions on Knowledge and Data Engineering, 8(6), 866-883.
Clissett, P., Porock, D., Harwood, R. H., and Gladman, J. R. (2013). The challenges of achieving person-centred care in acute hospitals: A qualitative study of people with dementia and their families. International Journal of Nursing Studies, 50, 1495-1503.
Conde-Sala, J, L., Garre-Olmo, J., Turró-Garriga, O., Vilalta-Franch, J., and López-Pousa, S. (2010). Differential features of burden between spouse and adult-child caregivers of patients with Alzheimer’s disease: An exploratory comparative design. International Journal of Nursing Studies, 47(10), 1262-1273.
Etters, L., Goodall, D., and Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: A review of the literature. Journal of the American of Nurse Practitioners, 20(8), 423-428.
Finkel, S. I., Costa e Silva, J., Cohen, G., Miller, S., and Sartorius, N. (1997). Behavioral and psychological signs and symptoms of dementia: A consensus statement on current knowledge and implications for research and treatment. International Psychogeriatrics, 8(53), 497–500.
Fuh, J. L., Wang, S. J., Liu, H. C., Liu, C. Y., and Wang, H. C. (1999). Predictors of depression among Chinese family caregivers of Alzheimer patients. Alzheimer Disease and Associated Disorders, 13(3), 171-175.
González‐Salvador, M, T., Arango, C., Lyketsos, C, G., and Barba, A, C. (1999). The stress and psychological morbidity of the Alzheimer patient caregiver. International Journal of Geriatric Psychiatry, 14(9), 701-710.
Hallberg, J., Kikhia, B., Bengtsson, J. E., Sävenstedt, S., and Synnes, K. (2009). Reminiscence processes using life-log entities for persons with mild dementia. Proceedings of the First International Workshop on Reminiscence Systems, 499, 16-21.
Han, J., Kamber, M., and Pei, J. (2011). Data Mining: Concepts and Techniques (3rd ed). Waltham, MA: Morgan Kaufmann Publishers.
Hughes, C. P., Berg, L., Danziger, W., Coben, L. A., and Martin, R. L. (1982). A new clinical scale for the staging of dementia. The British Journal of Psychiatry, 140(6), 566-572.
Hurd, M. D., Martorell, P., Delavande, A., Mullen, K. J., and Langa, K. M. (2013). Monetary costs of dementia in the United States. The New England Journal of Medicine, 368, 1326-1334.
Hwang, J. P., Yang, C. H., and Tsai, S. J. (2003). Phantom boarder symptom in dementia. International Journal of Geriatric Psychiatry, 18(5), 417-420.
Jhang, K. M., Chang, M. C., Lo, T. Y., Lin, C. W., Wang, W. F., and Wu, H. H. (2019). Using the Apriori algorithm to classify the care needs of patients with different types of dementia. Patient Preference and Adherence, 13, 1899-1912.
Kurtz, M. E., Kurtz, J. C., Given, C. W., and Given, B. A. (2004). Depression and physical health among family caregivers of geriatric patients with cancer-a longitudinal view. Medical Science Monitor, 10(8), 447-456.
Lazarus, R. S. and Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer Publishing Company.
Lee, Y. C., Huang, C. H., Lin, Y. C., and Wu, H. H. (2017). Association rule mining to identify critical demographic variables influencing the degree of burnout in a regional teaching hospital. The TEM Journal, 6(3), 497-502.
Lin, L. N. and Wu, S. C. (2014). Measurement structure of the caregiver burden scale: Findings from a national community survey in Taiwan. Geriatrics and Gerontology International, 14, 176-184.
Lu, L., Wang, L., Yang, X., and Feng, Q. (2009). Zarit caregiver burden interview: Development, reliability. Psychiatry and Clinical Neurosciences, 63, 730-734.
Mintzer J. E., Mirski D. F., and Hoernig K. S. (2000). Behavioral and psychological signs and symptoms of dementia: A practicing psychiatrist's viewpoint. Dialogues in Clinical Neuroscience, 2(2), 139-155.
Moon, H. and Adams, K. B. (2012). The effectiveness of dyadic interventions for people with dementia and their caregivers. Dementia, 12(6), 821-839.
Nagatomo, I., Akasaki, Y., Uchida, M., Tominaga, M., Hashiguchi, W., and Takigawa, M. (1999). Gender of demented patients and specific family relationship of caregiver to patients influence mental fatigue and burdens on relatives as caregivers. International Journal of Geriatric Psychiatry, 14(8), 618-625.
Ory, M. G., Hoffman, R. R., Yee, J. L., Tennstedt, S., and Schulz, R. (1999), Prevalence and impact of caregiving: A detailed comparison between dementia and nondementia caregivers. The Gerontologist, 39(2), 177-186.
Palmquist, J. and Ketola, L. (1999). Turning data into knowledge. Marketing Research, 11(2), 28-32.
Parks, S. H. and Pilisuk, M. (1991). Caregiver burden: Gender and the psychological costs of caregiving. American Journal of Orthopsychiatry, 61(4), 501-509.
Plassman, B. L., Langa, K. M., Fisher, G. G., Heeringa, S. G., Weir, D. R., Ofstedal, M. B., Burke, J. R., Hurd, M. D., Potter, G. G., Rodgers, W. L., Steffens, D. C., Willis, R. J., and Wallace, R.B. (2007). Prevalence of dementia in the United States: The aging, demographics, and memory study. Neuroepidemiology, 29(1-2), 125-132.
Sanderson, M., Wang, J., Davis, D. R., Lane, M. J., Cornman, C. B., and Fadden, M. K. (2002). Co-morbidity associated with dementia. American Journal of Alzheimer's Disease and Other Dementias, 17(2), 73-78.
Schubert, C. C., Boustani, M., Callahan, C. M., Perkins, A. J., Carney, C. P., and Christopher, M. M. (2006). Comorbidity profile of dementia patients in primary care: Are they sicker? Journal of the American Geriatrics Society, 54(1), 104-109.
Song, J. A. and Oh, Y. (2015). The association between the burden on formal caregivers and behavioral and psychological symptoms of dementia (BPSD) in Korean elderly in nursing homes. Archives of Psychiatric Nursing, 29(5), 346–354.
Tang, B., Yu, Y., Liu, Z., Lin, M., Chen, Y., Zhao, M., and Xiao, S. (2017). Factor analyses of the Chinese Zarit burden interview among caregivers of patients with schizophrenia in a rural Chinese community. BMJ Open, 7(9), e015621.
Vetter, P. H., Krauss, S., Steiner, O., Kropp, P., Möller, W. D., Moises, H. W., and Köller, O. (1999). Vascular dementia versus dementia of Alzheimer's type: Do they have differential effects on caregivers' burden? The Journal of Gerontology, 54(2), 93-98.
Volicer, L., Harper, D. G., Manning, B. C., Goldstein, R., and Sarlin, A. (2001). Sundowning and circadian rhythms in Alzheimer’s disease. The American Journal of Psychiatry, 158, 704-711.
World Health Organization (2012). Dementia: A Public Health Priority. United Kingdom: World Health Organization.
Yan, G. J., Wang, W. F., Jhang, K. M., Lin, C. W., and Wu, H. H. (2019). Association between patients with dementia and high caregiving burden for caregivers from a medical center in Taiwan. Psychology Research and Behavior Management, 12, 55-65.
Zarit, S. H., Orr, N. K., and Zarit, J. M. (1985), The Hidden Victims of Alzheimer’s Disease: Families under Stress. New York: New York University Press.
三、 網路資源
台灣失智症協會(2018),認識失智症,2019年3月27日,
http://www.tada2002.org.tw/About/IsntDementia
電子全文 電子全文(網際網路公開日期:20250811)
連結至畢業學校之論文網頁點我開啟連結
註: 此連結為研究生畢業學校所提供,不一定有電子全文可供下載,若連結有誤,請點選上方之〝勘誤回報〞功能,我們會盡快修正,謝謝!
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
無相關期刊