臺灣博碩士論文加值系統

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

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