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題 名 | 成年人慢性病壓力與憂鬱相關之探討=Illness-related Stress and Depression in Adult Patients with Chronic Medical Diseases |
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作 者 | 梁繼權; 呂碧鴻; 李明濱; 湯麗玉; | 書刊名 | 中華民國家庭醫學雜誌 |
卷 期 | 8:3 1998.09[民87.09] |
頁 次 | 頁124-133 |
分類號 | 410.14 |
關鍵詞 | 成年人; 慢性病; 壓力; 憂鬱; Chronic disease; Depression; Stress; |
語 文 | 中文(Chinese) |
中文摘要 | 在慢性病病患中,憂鬱是一個常見而嚴重的問題,本研究希望了解慢性病病人憂鬱症狀的發生狀況及疾病壓力與憂鬱症狀間之相互關係。本研究以臺大醫院家庭醫學科門診慢性病成年人為研究對象,以問卷調查法收集資料,共得有效樣本270人,年齡以中年人為主,女性稍多,大部份為已婚,教育程度以未受教育及國小程度較多,疾病種類以高血壓最多。其結果顯示鄭氏憂鬱量表之平均得分為54.8 ± 11.4,有134人(42.8%)得分超過55分,女性及低教育程度者有較多的憂鬱症狀。慢性疾病壓力方面,年輕人有較高之慢性疾病壓力頻度,老年人有較高之慢性疾病壓力嚴重度,已婚者則有較低的壓力嚴重度。自覺疾病嚴重度方面,老年人比中年人覺得自己的疾病較為嚴重。憂鬱程度與疾病壓力及自覺疾病嚴重度三者有明顯相關。在各種慢性病疾病壓力因素中,以身體症狀、工作與經濟因素,與及治療疾病所帶來的壓力與憂鬱的關係最明顯。前向逐步邏輯迴歸法分析與憂鬱相關的因素,結果發現只有教育程度及慢性病疾病壓力嚴重度進入模型。慢性病疾病壓力愈嚴重愈容易發生憂鬱,而教育程度愈高者則較不易發生憂鬱。本研究發現憂鬱在門診慢性病病人中十分常見,而且和疾病的壓力和自覺疾病嚴重度有密切關係,一些簡單的問卷可以協助醫師發現需要特別注意的病患,在適當的時機提供協助。 |
英文摘要 | Depression is a major and common problem in patients with chronic medical disease. The purpose of this study is to understand the prevalence of depression in chronic disease patients in primary care setting and the relationship between depression and illness-related stress among these patients. Two hundred and seventy chronic disease patients in the National Taiwan University Hospital Family Medicine Clinic were interviewed with a structural questionnaire including basic dempographic data, a Chinese version of the Zung's Self-Rating Depression Scale (ZDS), the Chronic-Illness Stress Inventory (CISI), and a rating of self-perceived disease severity. One hundred and seventy-two (63.7%) of the patients were between 40 and 64 years in age, female predominance (58.5%), mostly were married (75.9%) and have no or only middle school education (50.4%). Most of the patients have hypertension (63.6%), followed by diabetes (31.1%). The mean score of the ZDS was 54.8±11.4. With 134 patients (42.8%) reached the 55 cutoff point for the diagnosis of depression. Female and patients of low education level had higher ZDS score than male and patients of higher education level. For the disease stress, young age patients had the highest score in the frequency subscale of the DISI where elderly had the highest score in the severity subscale of the CISI. Married patients had the lowest CISI score than patients of other marital status. For the self-perceived disease severity, more elderly patients perceived themselves in poorer health than middle age patients. ZDS score was highly correlated with the frequency and severity subscale of the DISI, and the self-perceived disease severity. Physical symptoms, job and economic factors, and stress related to disease management had the highest correlation with depression. Multi-variate analysis with the logistic regression model revealed that only education level and the severity subscale of the CISI were related to depression. Patients with higher education level had a protective effect of depress, and patients with higher severity score of the CISI had higher risk of being depress. Our study revealed that depression is a common condition in chronic disease patients in primary care. Questionnaire can be a simple and useful tool to identify those at high risk and further management may prevent the adverse consequences. |
本系統中英文摘要資訊取自各篇刊載內容。