臺灣博碩士論文加值系統

背景目的：糖尿病是全球廣泛盛行的慢性病，其合併症不但讓病患飽受病痛折磨，更是造成國家醫療費用龐大的支出。文獻指出人格特徵與罹患疾病具有關聯性。如此，糖尿病患者與人格特質是否也存在著微妙關係？本研究欲瞭解人格特質與糖尿病之相關性，凸顯糖尿病患者既有或潛在的心理層面問題，以提供臨床醫療預防措施介入前評估之參考方向。
方法：本研究採問卷調查法，立意抽取中部某醫學中心新陳代謝科門診以ICD-9-CM前3碼為250之一年內新診斷的糖尿病就診病患，以及健檢中心無糖尿病史之民眾為研究對象。年齡需年滿20歲以上至65歲以下，意識清楚、能以國台語溝通、無精神疾患。研究收案期間從2013年3月1日至2013年4月30日間，共收案糖尿病患211位；非糖尿病患213位。由研究者面訪，測量工具為「人格特質量表」，包括：完美主義、D型人格及活動熱情。統計方法採Mann-Whitney U test、Kruskal-Wallis test、卡方檢定及邏輯斯迴歸。
結果：糖尿病組於「完美主義」、「D型人格」及「強迫式熱情」中位數明顯高於非糖尿病組，達顯著統計意義；而「調和式熱情」則無顯著差異。表示糖尿病人較非糖尿病人具有明顯負向情緒之人格特質。完美主義、D型人格及活動熱情對罹患糖尿病機率之預測力分別為73.3%、62.7%及61.6%。
結論：糖尿病症非純粹生理性之病變使然，負向人格特質更是糖尿病症潛伏之長期影響因子。本研究結果可提供臨床糖尿病高危險群篩檢評估的參考指標，並作為健康照顧系統中三段五級之早期糖尿病衛生教育與介入的重點措施，以提供糖尿病患完整而全面之照護。

Purpose：Type 2 diabetes mellitus (T2DM) is a chronic disease of global problem. The complications of T2DM not only affect the life quality of the patients but also consume much medical cost. However, the progression of T2DM is not only associated with biologic factors. We should find out the mental and organic core correlated with disease development and then search for the new treatment of T2DM. The published data pointed out the personal characteristics were associated with some kinds of psychiatric disorders and organic problems. The study aim is to evaluate the association between the T2DM and personal characteristics and to find out the potential mental problem in T2DM. This may provide the baseline referral of T2DM patients before intervention of medical precautions.
Method:We used the questionnaire to study the newly diagnosed T2DM patients within 1 year and the patients without T2DM, who accepted the health examination in 1 year, in a medical center in central Taiwan. We enrolled the aged below 65, oriented, and smoothly communicated patients without any psychiatric disorder. The period of enrollment was from 1st, March, 2013 to 30th, April, 2013. Overall 211 subjects with T2DM and 213 subjects without T2DM were enrolled. We visited all subjects with questionnaire of personality characteristics, including perfectionism, type D personality, and passion. We used the Mann-Whitney U test, Kruskal-Wallis test, Chi-square test, and logistic regression for analyses.

Results: and Discussion：Significantly more patients had the perfectionism, type D personality, and obsessive passion in T2DM group than the group without T2DM.However, no significant difference in harmonious passion between 2 groups. More T2DM patients might have negative personality characteristics than the subjects without T2DM. Perfectionism、Type D personality and passion of probability predict diabetes were 73.3%、62.7%、61.6%.
Conclusion and Suggestions:T2DM might be not purely affected by organic disorder and negative personality characteristics might be the potential long-term factor associated with T2DM development. The results of this study might provide a evaluative factor of selection of the patients with high-risk of T2DM. Moreover, the results might support to take the mental problem as an important aspect of intervention of DM education and to provide more intact and advanced care for T2DM patients.

摘要..............................................I
ABSTRACT.........................................II
圖目錄............................................VI
表目錄...........................................VII
第一章　前言......................................1
第一節　研究背景與動機............................. 1
第二節　研究重要性.................................4
第三節　研究目的...................................5
第四節　名詞釋義...................................6
第二章　文獻回顧...................................8
第一節　糖尿病.....................................8
第二節　背景因素與糖尿病相關研究.....................11
第三節　人格特質的定義及意涵 ........................13
第四節 完美主義人格的意涵與疾病的相關研究.............15
第五節　D型人格的意涵與疾病的相關研究 ................19
第六節 活動熱情的意涵與疾病的相關研究 ................21
第三章　研究方法...................................24
第一節　研究架構與假設..............................24
第二節 研究流程...................................25
第三節 研究對象...................................26
第四節　研究工具...................................26
第五節 施測過程...................................29
第六節 資料分析方法................................30
第七節 研究倫理...................................36
第四章　結果與討論.................................37
第一節 樣本資料分析................................37
第二節 量表分析...................................39
第三節 背景因素與糖尿病及非糖尿病患者差異結果分析與討論 49
第四節 完美主義與糖尿病及非糖尿病患者差異結果分析與討論 51
第五節 D型人格與糖尿病及非糖尿病患者差異結果分析與討論 54
第六節 活動熱情與糖尿病及非糖尿病患者差異結果分析與討論 57
第五章　結論......................................60
第一節 研究主要發現................................60
第二節 學術意涵...................................62
第三節 管理意涵...................................63
第四節 研究限制...................................63
第五節 研究建議...................................64
參考文獻 .........................................65
中文部分..........................................65
英文部分 .........................................69
附錄：正式問卷.....................................82

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