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研究生:林玟吟
研究生(外文):LIN,WEN-YIN
論文名稱:良性攝護腺肥大與憂鬱、焦慮相關性之探討
論文名稱(外文):Discussion on the relationship among Benign Prostate Hyperplasia , Depression and Anxiety.
指導教授:翁淑娟翁淑娟引用關係
指導教授(外文):WENG,SHU-CHUAN
口試委員:侯鎮邦翁淑娟許乃斌
口試委員(外文):HOU,CHEN-PANGWENG,SHU-CHUANHSU,NAI-BIN
口試日期:2021-01-21
學位類別:碩士
校院名稱:元培醫事科技大學
系所名稱:醫務管理系碩士班
學門:商業及管理學門
學類:醫管學類
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:68
中文關鍵詞:良性攝護腺肥大憂鬱焦慮
外文關鍵詞:Benign Prostate Hypertrophydepressionanxiety
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50歲以上男性為良性攝護腺肥大的好發族群,經常因為腺體逐漸腫大,導致患者生理上的不適,如壓迫尿道引起頻尿、尿液殘留,甚至引發尿失禁或尿路感染等,進而影響患者心情及自尊。因此本研究欲探討良性攝護腺肥大患者憂鬱、焦慮之狀態及影響因子。本研究在2020年7月至2020年11月期間,於北部某醫療院所泌尿科門診委請合作醫師篩選符合條件之個案,總共收回65名男性個案。依本研究之研究目的分析方式採用描述性統計、獨立樣本t檢定、單因子變異數分析、皮爾森相關檢定及逐步迴歸方法。研究結果顯示年齡為影響良性攝護腺症狀嚴重程度、客觀檢驗數值與憂鬱及焦慮傾向的重要因素,個案自覺的症狀嚴重程度分數與攝護腺體積大小(F=5.439,p<0.01)、尿流速(F=3.728,p<0.05)有統計上顯著差異。症狀嚴重程度分數與憂鬱(r=0.261,p<0.05)為正相關,憂鬱及焦慮(r=0.558,p<0.01)間也呈現正相關。逐步迴歸結果顯示,症狀嚴重程度會受到排尿困難(B=9.705,p<0.01)、尿急(B=5.874,p<0.05)、尿流中斷(B=5.958,p<0.05)以及教育程度(B=-4.937,p<0.05)影響,憂鬱程度會受年齡(B=-0.149,p<0.05)及症狀嚴重程度(B=0.11,p<0.05)影響,焦慮則只受年齡(B=-0.352,p<0.05)影響。根據結果發現良性攝護腺肥大患者的憂鬱及焦慮程度會受到年齡及症狀嚴重程度影響,並且個案憂鬱程度與焦慮程度之間會互相影響,當個案憂鬱程度越高其焦慮程度也隨著提升。建議醫師針對年齡較低及症狀嚴重程度分數較高的個案進行進一步的心理層面檢測,將心理層面影響納入醫療決策中,必要時進行轉診服務。
Men over 50 years of age have a high prevalence of benign prostate hypertrophy(BPH). The gradual enlargement of the glands often leads to physical discomfort in patients, such as frequent urination, residual urine, and even urinary incontinence or urinary tract infections due to compression of the urethra, which affect the patient's mood and self-esteem. Therefore, this study intends to investivate the state of depression and anxiety among patients with BPH and its influencing factors.This study was conducted from July 2020 to November 2020 in the urology clinic of medical center in north of Taiwan. Eligible patients were screened by physician. 65 male cases were recruied. Statistical analysis was carried out according to the research purpose, such as descriptive statistics, t test, ANOVA, Pearson correlation, and stepwise regression analysis.
The results showed that age was an important factor affecting the severity of benign glandular symptoms, clinical physiological value and depression and anxiety tendency. The severity score of the symptoms was statistically significant related to the size of the prostate glands (F=5.439, p<0.01), and the urine flow rate (F=3.728, p<0.05). The symptom severity score was positively associated with depression (r=0.261, p<0.05), and also positive correlated with depression and anxiety (r=0.558, p<0.01). In stepwise regression, the severity of symptoms would be affected by dysuria(B=9.705, p<0.01),urgency(B=5.874, p<0.05), interruption of urine flow (B=5.958, p<0.05), and education(B=-4.937, p<0.05). The degree of depression iwass affected by age (B=-0.149, p<0.05) and severity of symptoms(B=0.11, p<0.05). The degree of anxiety wais only affected by age (B=-0.352, p<0.05).

This study found that age and severity of symptoms were important risk factor of degree of depression and anxity to patients with BPH, and the degree of depression and anxiety of the case will interact with each other. The higher the case degree of depression , the higher of the anxiety tendency. It is recommended physicians conduct further psychological tests for cases with lower age or severity of symptoms of BPH, incorporate psychological impact into medical decision-making, and provide referral services if necessary.

口試委員會審定書 I
致謝 II
中文摘要 III
Abstract IV
目錄 VI
圖目錄 VII
表目錄 VIII
第一章 緒論 1
1.1研究背景與動機 2
1.2研究問題及目的 3
第二章 文獻探討 4
2.1良性攝護腺肥大 4
2.2憂鬱及焦慮 11
2.3良性攝護腺肥大與憂鬱及焦慮相關研究 15
第三章 研究方法與材料 19
3.1資料來源與取樣流程 19
3.2研究對象 19
3.3研究架構 20
3.4研究假設 21
3.5變項定義 22
3.6統計分析 26
第四章 研究結果 28
4.1基本人口學、症狀嚴重程度與憂鬱及焦慮量表分數之現況 28
4.2基本人口學對臨床生理數值之影響 36
4.3基本人口學對症狀嚴重程度之影響 40
4.4基本人口學對憂鬱及焦慮量表分數之影響 42
4.5 IPSS症狀程度與臨床生理數值之相關性 46
4.6 IPSS症狀程度與憂鬱及焦慮量表分數之相關性 47
4.7基本人口學、症狀嚴重程度與憂鬱及焦慮量表分數之相關性 49
4.8影響症狀嚴重程度分數、憂鬱及焦慮之相關因素 50
第五章 研究結論與建議 52
5.1研究結論 52
5.2研究限制與建議 54
參考文獻 55
附錄一 60
附錄二 66
附錄三 67


一、英文部份
1.Barry, M. J., Fowler, F. J., Jr., O'Leary, M. P., Bruskewitz, R. C., Holtgrewe, H. L., Mebust, W. K., & Cockett, A. T. (1992). The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol, 148(5), 1549-1557; discussion 1564. doi: 10.1016/s0022-5347(17)36966-5
2.Berges, R., & Oelke, M. (2011). Age-stratified normal values for prostate volume, PSA, maximum urinary flow rate, IPSS, and other LUTS/BPH indicators in the German male community-dwelling population aged 50 years or older. World J Urol, 29(2), 171-178. doi: 10.1007/s00345-010-0638-z
3.Berry, S. J., Coffey, D. S., Walsh, P. C., & Ewing, L. L. (1984). The development of human benign prostatic hyperplasia with age. J Urol, 132(3), 474-479. doi: 10.1016/s0022-5347(17)49698-4
4.Breyer, B. N., Kenfield, S. A., Blaschko, S. D., & Erickson, B. A. (2014). The association of lower urinary tract symptoms, depression and suicidal ideation: data from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Survey. J Urol, 191(5), 1333-1339. doi: 10.1016/j.juro.2013.12.012
5.Chapple, C. R., Wein, A. J., Abrams, P., Dmochowski, R. R., Giuliano, F., Kaplan, S. A., . . . Roehrborn, C. G. (2008). Lower urinary tract symptoms revisited: a broader clinical perspective. Eur Urol, 54(3), 563-569. doi: 10.1016/j.eururo.2008.03.109
6.Coyne, K. S., Wein, A. J., Tubaro, A., Sexton, C. C., Thompson, C. L., Kopp, Z. S., & Aiyer, L. P. (2009). The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU Int, 103 Suppl 3, 4-11. doi: 10.1111/j.1464-410X.2009.08371.x
7.Dunphy, C., Laor, L., Te, A., Kaplan, S., & Chughtai, B. (2015). Relationship Between Depression and Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. Rev Urol, 17(2), 51-57. doi: 10.3909/riu0658
8.Hakenberg, O. W., Pinnock, C. B., & Marshall, V. R. (1997). Does evaluation with the International Prostate Symptom Score predict the outcome of transurethral resection of the prostate? J Urol, 158(1), 94-99. doi: 10.1097/00005392-199707000-00025

9.Huang, C. Y., Chiu, K. M., Chung, S. D., Keller, J. J., Huang, C. C., & Lin, H. C. (2011). Increased risk of depressive disorder following the diagnosis of benign prostatic enlargement: one-year follow-up study. J Affect Disord, 135(1-3), 395-399. doi: 10.1016/j.jad.2011.07.001
10.Jeong, W. S., Choi, H. Y., Nam, J. W., Kim, S. A., Choi, B. Y., Moon, H. S., & Kim, K. S. (2015). Men With Severe Lower Urinary Tract Symptoms Are at Increased Risk of Depression. Int Neurourol J, 19(4), 286-292. doi: 10.5213/inj.2015.19.4.286
11.Laumann, E. O., Kang, J. H., Glasser, D. B., Rosen, R. C., & Carson, C. C. (2008). Lower urinary tract symptoms are associated with depressive symptoms in white, black and Hispanic men in the United States. J Urol, 180(1), 233-240. doi: 10.1016/j.juro.2008.03.055
12.Lee, Y. I., Kim, J. W., Bae, S. R., Paick, S. H., Kim, K. W., Kim, H. G., . . . Park, H. K. (2013). Effect of urgency symptoms on the risk of depression in community-dwelling elderly men. Korean J Urol, 54(11), 762-766. doi: 10.4111/kju.2013.54.11.762
13.Martin, S., Vincent, A., Taylor, A. W., Atlantis, E., Jenkins, A., Januszewski, A., . . . Wittert, G. (2015). Lower Urinary Tract Symptoms, Depression, Anxiety and Systemic Inflammatory Factors in Men: A Population-Based Cohort Study. PLoS One, 10(10), e0137903. doi: 10.1371/journal.pone.0137903
14.McConnell, J. D., Barry, M. J., & Bruskewitz, R. C. (1994). Benign prostatic hyperplasia: diagnosis and treatment. Agency for Health Care Policy and Research. Clin Pract Guidel Quick Ref Guide Clin(8), 1-17.
15.McVary, K. T., Roehrborn, C. G., Avins, A. L., Barry, M. J., Bruskewitz, R. C., Donnell, R. F., . . . Wei, J. T. (2011). Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol, 185(5), 1793-1803. doi: 10.1016/j.juro.2011.01.074
16.Milsom, I., Kaplan, S. A., Coyne, K. S., Sexton, C. C., & Kopp, Z. S. (2012). Effect of bothersome overactive bladder symptoms on health-related quality of life, anxiety, depression, and treatment seeking in the United States: results from EpiLUTS. Urology, 80(1), 90-96. doi: 10.1016/j.urology.2012.04.004
17.Powers, D. V., Gallagher-Thompson, D., & Kraemer, H. C. (2002). Coping and depression in Alzheimer's caregivers: longitudinal evidence of stability. J Gerontol B Psychol Sci Soc Sci, 57(3), P205-211. doi: 10.1093/geronb/57.3.p205
18.Spielberger, C. D. (1971). Notes and comments trait-state anxiety and motor behavior. J Mot Behav, 3(3), 265-279. doi: 10.1080/00222895.1971.10734907
19.Vesely, S., Knutson, T., Damber, J. E., Dicuio, M., & Dahlstrand, C. (2003). Relationship between age, prostate volume, prostate-specific antigen, symptom score and uroflowmetry in men with lower urinary tract symptoms. Scand J Urol Nephrol, 37(4), 322-328. doi: 10.1080/00365590310014760
20.Zhang, J., & Gao, Q. (2012). Validation of the trait anxiety scale for state-trait anxiety inventory in suicide victims and living controls of Chinese rural youths. Arch Suicide Res, 16(1), 85-94. doi: 10.1080/13811118.2012.641440


二、中文部份
1.Rollo May(1950)。新世紀叢書 138心理,朱侃如,焦慮的意義。新北市:立緒文化出版社。
2.李庚霖、區雅倫、陳淑惠、翁儷禎(2009)。臺灣地區中老年身心社會生活狀況長期追蹤調查,短版CES-D量表之心理計量特性。中華心理衛生學刊,22,383-410。
3.亞洲大學附屬醫院衛教資訊(2015)。什麼是焦慮症。取自https://www.auh.org.tw
/NewsInfo/HealthEducationInfo?docid=1639
4.林中正、周明智(2003)。良性前列腺肥大患者前列腺體積與臨床參數的相關性研究(博士論文).。取自https://hdl.handle.net/11296/3v28x8
5.社團法人臺灣憂鬱症防治協會(2019)。105年到107年台灣憂鬱症就醫現狀與問題。取自http://www.depression.org.tw/knowledge/info.asp?/71.html
6.侯菊鸝(2004)。焦慮症。取自http://www.tccf.org.tw/old/magazine/care/2004_0528
_10.htm
7.健康醫學院(2020)。如何幫助憂鬱症走出來,認識憂鬱症的定義、前兆、症狀與治療。取自https://www.medschool.cc/article/depression
8.莊豐賓(2018)。男人進入初老階段慢性疾病和性功能的關係。台灣男性學醫學會,9(5)。取自http://www.tand.org.tw/Publications/into.asp?/595.html
9.郭建宏(2020)。男人不能說的泌密良性攝護腺肥大。取自https://www.ysp.com.tw
/tw/magazine/1286
10.黃一勝(2014)。良性攝護腺肥大。台灣泌尿科醫學會。取自http://www.tua.org.tw/tua/images/upload/book/002_BenignProstaticHyperplasia.pdf
11.衛生福利統計處(2020)。取自https://dep.mohw.gov.tw/DOS/lp-1720-113-xCat-1-2-20.html
12.衛生福利部國民健康署(2018)。民國104年中老年身心社會生活狀況長期追蹤調查。取自https://www.hpa.gov.tw/Pages/List.aspx?nodeid=108
13.衛生福利部國民健康署(2018)。民國一百零四年中老年身心社會生活狀況長期追蹤調查成果報告。取自https://www.hpa.gov.tw/Pages/List.aspx?nodeid=242
14.謝宜軒、林益卿、蔡佩渝(2016)。良性攝護腺增生的診斷與治療。家庭醫學與基層醫療,31,15-22。

15.謝政興(2007)。良性攝護腺肥大。取自https://www.urokingdom.com/
%E6%B3%8C%E5%B0%BF%E5%B0%88%E6%AC%84/%E6%94%9D%E8%AD%B7%E8%85%BA%E7%96%BE%E7%97%85/%E8%89%AF%E6%80%A7%E6%94%9D%E8%AD%B7%E8%85%BA%E8%82%A5%E5%A4%A7-benign-prostatic-hyperplasia/
16.蘇慶豐、林健良(2017)。廣泛性焦慮症。家庭醫學與基層醫療,32(4),96-101。

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