臺灣博碩士論文加值系統

目標：台灣憂鬱症盛行率逐年攀升，維護民眾心理健康及生活福祉刻不容緩。嗅覺失能可能影響情緒及導致生活品質下降，過去嗅覺功能障礙研究多著重於臨床診斷及治療，台灣尚缺乏討論此類患者憂鬱及生活品質之文獻。因此本研究欲探討嗅覺功能障礙病因對憂鬱及生活品質之影響。
方法：本研究採橫斷式及量性設計，以醫院焦慮與憂鬱量表(HADS)及台灣版世界衛生組織生活品質問卷(WHOQOL-BREF)二信效度良好之結構式問卷，至中部兩家醫學中心耳鼻喉科門診，針對嗅覺功能障礙患者進行問卷調查，回收有效問卷255份。資料以SPSS 22進行 t 檢定、變異數分析、一般線性模式(GLM)及複迴歸分析。
結果：結果顯示嗅覺功能障礙患者罹患異常(Abnormal)憂鬱症狀比率為12.2％，邊緣性(Borderline abnormal)憂鬱症狀22.0％。複迴歸結果顯示，影響憂鬱及生活品質顯著相關因素包括年齡、社經地位、病因及健康行為(P < 0.05)。GLM分析發現，「病因為創傷」、「低社經地位」及「有抽菸者」呈現顯著較高憂鬱程度及較低之生活品質(P < 0.05)。
結論：嗅覺功能障礙的患者裡有三分之一（34.2%）的患者有憂鬱傾向，且創傷之病因所導致的嗅覺功能障礙明顯影響憂鬱及生活品質。衛生單位及醫療機構宜先針對創傷病因及其他高風險特性之病人，設計預防性健康介入措施，以及早預防憂鬱症發生及提升病人生活品質。

Objective: The prevalence of depression is climbing in Taiwan. Therefore, maintaining psychological wellbeing and quality of life for general public is imperative. Smell disorder may influence mood state and reduce quality of life. However, prior research on smell disorder mainly focused on its diagnosis and treatment. Few studies explored the relationship between smell disorder and depression as well as quality of life in Taiwan. This study aimed to investigate the association between the cause of smell disorder and depression and quality of life.
Methods: This cross-sectional study used two well-established structured questionnaires including the Hospital Anxiety and Depression Scale (HADS) and the Brief Form of the World Health Organization''s Quality of Life Questionnaire (WHOQOL-BREF, Taiwanese version). 255 outpatients with smell disorder seeking treatments in two medical centers in central Taiwan participated in the survey in 2016. Statistical methods included t-test, ANOVA, General Linear Model (GLM), and multiple regression. Data were analyzed in SPSS version 22.0.
Results: 12.2% and 22.0% of the patients with smell disorder reported abnormal depressive symptoms and borderline abnormal depressive symptoms, respectively. Multiple regression analysis indicated that age, socioeconomic status, cause of smell disorder, and health behavior were significantly associated with depression and quality of life (P < 0.05). GLM results revealed that trauma-caused smell disorder, low socioeconomic status, and smoking were significantly associated with higher depressive level and lower quality of life (P < 0.05).
Conclusion: Nearly one-third of patients with smell disorder presented mental health problems. Smell disorder caused by trauma may increase depressive symptoms and decrease quality of life. The health authorities and medical institution should address trauma-cause and other risk factors by designing an integrative care intervention to prevent development of depression and improve the quality of life among patients with smell disorder.

目錄
摘要 I
Abstract III
致謝 V
目錄 VI
表目錄 IX
圖目錄 XI
第一章　緒論 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
第二章　文獻探討 6
第一節　嗅覺功能障礙簡介 6
第二節　嗅覺功能障礙對憂鬱的影響 9
第三節　嗅覺功能障礙對生活品質的影響 11
第四節　影響嗅覺障礙對憂鬱及生活品質之其他相關因素 12
第五節　文獻小結 14
第三章　研究設計與方法 15
第一節　研究架構 15
第二節　研究對象與資料來源 16
第三節　研究工具 18
第四節　研究變項操作型定義 22
第五節　統計分析方法 32
第四章 研究結果 33
第一節　描述性分析 33
第二節　推論性統計 42
第五章　討論 68
第一節　嗅覺功能障礙患者病因對憂鬱及生活品質之相關性 68
第二節　影響嗅覺功能障礙患者憂鬱及生活品質之其他相關因素 71
第六章　結論與建議 73
第一節　結論 73
第二節　研究限制 75
第三節　研究建議 76
參考文獻 78
附錄一　個人基本資料 83
附錄二　台灣版世界衛生組織生活品質問卷(WHOQOL-BREF) 84
附錄三　醫院焦慮與憂鬱量表 86


表目錄
表3-3-1　本研究生活品質量表Cronbach α與國內文獻比較 19
表3-3-2　本研究醫院焦慮憂鬱量表Cronbach α與國內外文獻比較 21
表3-4-1　自變項操作型定義 22
表3-4-2　台灣簡明版世界衛生組織生活品質問卷之題項 25
表3-4-3　醫院焦慮憂鬱量表之題項 29
表4-1-1　受訪者性別分佈 33
表4-1-2　受訪者年齡分佈 34
表4-1-3　受訪者教育程度分佈 34
表4-1-4　受訪者職業類別分布 35
表4-1-5　受訪者社經地位分佈 36
表4-1-6　受訪者過去一年內健康狀況分佈 37
表4-1-7　受訪者過去一年內健康行為分佈 37
表4-1-8　嗅覺功能障礙患者病因類別分佈 38
表4-1-9　嗅覺障礙程度分佈 39
表4-1-10　憂鬱構面因素得分情形 40
表4-1-11　生活品質構面因素得分情形 40
表4-1-12　憂鬱分數分組分布情形 41
表4-2-1　嗅覺功能障礙人口學特質及嗅覺功能對憂鬱影響之差異性分析(t-test) 46
表4-2-2　嗅覺功能障礙人口學特質及嗅覺功能對生理範疇影響之差異性分析(t-test) 47
表4-2-3　嗅覺功能障礙人口學特質及嗅覺功能對心理範疇影響之差異性分析(t-test) 48
表4-2-4　嗅覺功能障礙人口學特質及嗅覺功能對台灣版環境範疇影響之差異性分析(t-test) 49
表4-2-5　嗅覺功能障礙人口學特質及嗅覺功能對台灣版社會範疇影響之差異性分析(t-test) 50
表4-2-6　嗅覺功能障礙人口學特質及病因對憂鬱影響之變異數分析(ANOVA) 53
表4-2-7　嗅覺功能障礙人口學特質及病因對生理範疇影響之差變異數分析 54
表4-2-8　嗅覺功能障礙人口學特質及病因對心理範疇影響之變異數分析 55
表4-2-9　嗅覺功能障礙人口學特質及病因對環境範疇影響之變異數分析 56
表4-2-10　嗅覺功能障礙人口學特質及病因對社會範疇影響之變異數分析 57
表4-2-11　嗅覺功能障礙人口學特質、病因及嗅覺障礙程度對憂鬱及生活品質之多變量分析(GLM) 62
表4-2-12　嗅覺功能障礙人口學特質、病因及嗅覺障礙程度對憂鬱及生活品質之相關性 (複迴歸) 66


圖目錄

圖1-1-1　台灣憂鬱症盛行率 2
圖3-1-1　本研究之理論架構 15

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