研究生: |
詹靜惠 Ching-Hui Chan |
---|---|
論文名稱: |
過敏性鼻炎兒童醫療遵從行為及其相關因素之研究 Factors Related to Adherence Behavior in Children with Allergic Rhinitis |
指導教授: |
姜逸群
Chiang, I-Chyun |
學位類別: |
碩士 Master |
系所名稱: |
健康促進與衛生教育學系 Department of Health Promotion and Health Education |
論文出版年: | 2011 |
畢業學年度: | 99 |
語文別: | 中文 |
論文頁數: | 131 |
中文關鍵詞: | 醫療遵從行為 、過敏性鼻炎 、兒童 |
英文關鍵詞: | Adherence Behavior, Allergic Rhinitis, Children |
論文種類: | 學術論文 |
相關次數: | 點閱:227 下載:17 |
分享至: |
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
本論文研究目的在探討過敏性鼻炎兒童醫療遵從行為與其相關因素。以中部某醫學中心過敏性鼻炎兒童及其父母為研究對象,共得有效樣本136人。主要結果如下:
一、兒童醫療遵從行為,在兒童自我報告及其父母協同報告整體得分皆偏高且兩者具一致性。而在鼻阻力改善率方面,有改善只佔29.4%,疾病治療結果上改善不明顯。
二、過敏性鼻炎兒童父母疾病認知偏高。自我效能偏正向,其中「依醫囑用藥自我效能」把握程度高於「居家生活控制自我效能」。醫病互動關係亦偏正向。
三、影響過敏性鼻炎兒童醫療遵從行為相關因素為:年齡、父母親教育程度、家庭社經地位、父母疾病認知、父母自我效能及父母醫病互動關係。年齡小、父母專科大學以上、中高社經地位其醫療遵從行為較佳。父母疾病認知、自我效能、醫病互動與醫療遵從行為呈顯著正相關。
四、年齡、父母親教育程度、家庭社經地位、父母疾病認知、父母自我效能及父母醫病互動關係對過敏性鼻炎兒童「整體醫療遵從行為」的預測力為35%,其中「自我效能」是最有力的預測因子。
The purpose of this study was to explore the medical adherence behavior and associated factors of children with allergic rhinitis. Purposive sampling was used to recruit 136 allergic rhinitis children and their parents from the outpatient department of hospitals in central Taiwan. The main results are as follows:
1.About level of medical adherence behavior of allergic rhinitis children self reports and their parents reports were high. And both showed significant positive correlation. For treatment outcome survey, there was only 29.4% Improvement in Nasal resistance (nPEFR).
2.Allergic rhinitis children’s parents in knowledge score were in high level. They had positive self-efficacy, the more confidence in medicine adherence than life style adherence. They client-professional interaction also tend to positive.
3.The factors associated with the children adherence behavior were age,parents education status, family's social/economic status, parents allergic rhinitis knowledge, self-efficacy and client-professional interaction. The subjects has better adherence behavior when subject’s age under 9 years,parents education level above collage, middle-to-high family's social/economic status. Parents allergic rhinitis knowledge, self-efficacy and client-professional interaction with adherence behavior had positive correlation.
4.「age」、「parents education status」、「family's social/ economic status」、「parents allergic rhinitis knowledge」、「parents self-efficacy」、「parents client-professional interaction」can explain 35% of variance of allergic rhinitis children’s overall adherence behavior, and「self-efficacy」was the best prediciting factor.
中文文獻
王保進(2002)。視窗版SPSS與行為科學研究。台北:心理出版社。
石雅莉(2004)。第1型糖尿病童醫療遵從行為之現況分析。未出版碩士論文,長庚大學,台北。
田開瑋、黃美淑、黃竫芬、許蕙美、黃美智(1999)。氣喘兒童家庭的評估與調適。護理雜誌,46(4),81-85。
台灣氣喘衛教學會(2008)。過敏性鼻炎診療指引。線上檢索日期:2010 年3月10日。網址:http://www.asthma-edu.org.tw/asthma/ member7.aspx
杜玉卿、葉淑惠(2007)。不遵從的概念分析。高雄護理雜誌,24(2),95- 110。
李復華(1997)。老年人不遵從服用藥物原因之探討。護理雜誌,44(4),69 -74。
李茹萍、邱豔芬(1998)。肺結核病人之服藥遵從性。護理雜誌,45(1),63 -68。
何青吟(2001)。鼻炎的治療A過敏性鼻炎的治療:3.免疫療法。中華民國耳鼻喉科醫學雜誌,36(5),25-26。
何千惠(2004)。第2型糖尿病病人自我效能及社會支持與遵醫囑行為之相關研究。未出版碩士論文,國立台灣師範大學,台北。
林美玲(2003)。氣喘兒童醫療遵從行為與相關因素之探討。未出版碩士論文,長庚大學,台北。
林生傳(2000)。教育社會學。台北:巨流圖書公司。
林雅如(2007)。過敏性鼻炎之治療策略。成醫藥誌,17(4),14-17。
林佳慧(2007)。糖尿病血糖自我監測行為及其相關因素之探討。未出版碩士論文,慈濟大學,花蓮。
吳新華(1996)。兒童適應問題。台北:五南圖書出版公司。
吳家興、林瑞雄、謝貴雄(1998)。台灣北部國中學生氣喘盛行率調查。中華衛誌,17(3),214-225。
吳佳蓉、陳清惠、葉忍莉(2002)。老年患者服藥行為影響因素的探討。長庚護理,13(2),166-172。
吳維峰、林應然、吳振龍(2004)。氣喘與過敏性鼻炎之關聯及治療。北市醫學雜誌,1(3),13-19。
吳曼阡(2005)。高血壓個案健康體能與血壓控制行為及其相關因素之探討-以花蓮吉安鄉為例。未出版碩士論文,慈濟大學,花蓮。
吳明隆(2007)。SPSS操作與應用-問卷統計分析實務。台北:五南出版社。
胡文郁、曾春典、戴玉慈、余玉眉(1996)。高血壓患者服藥遵從行為及其相關因素之探討。中華公共衛生雜誌,15,319-332。
胡懷文、陳美伶、廖玟君(2008)。大腸直腸癌病患口服化學治療服藥遵從性之初探性研究。中山醫學雜誌,19(2),159-173。
洪翠双(2006)。恐懼訴求等多項因素對青光眼患者點眼藥遵醫囑行為影響之研究。未出版碩士論文,淡江大學,台北。
高碧霞(2003)。由護理人員觀點談氣喘兒童健康照護之議題。台灣兒童過敏氣喘免疫學會學會通訊,4(3),20-21。
徐世達(2009)。過敏性鼻炎治療準則。台灣氣喘衛教學會通訊,14,13-18。
陳靜敏、何美華、簡逸毅(2000)。婦女接受荷爾蒙補充療法的遵從行為與其更年期症狀緩解之相關研究。新台北護理期刊,2(2),41-54 。
陳智華、吳淑玲、劉雪娥(2003)。B肝帶原者之B肝知識與追蹤檢查情形之探討。慈濟護理雜誌,2(4),66 – 74。
許志宏(2001)。鼻炎的治療A過敏性鼻炎的治療:1.過敏原的避免2.藥物治療。中華民國耳鼻喉科醫學雜誌,36(5),23-24。
許志全、呂克桓(2002)。過敏性鼻炎的治療。臺灣兒童過敏氣喘及免疫學會學會通訊,3(1),15-16。
曾淑津(1994)。醫療遵從行為。長庚護理,5(2),77-82。
程子芸(1996)。慢性疾病對兒童家庭適應。護理雜誌,43(4),49-54。
程佩玉(2005)。社區氣喘學童之主要照顧者其氣喘照護行為健康信念關係之研究。未出版碩士論文,國立台灣大學,台北。
童小綺(2004)。腸胃科住院病童家屬之溝通滿意與疾病認知對遵醫囑行為之影響。未出版碩士論文,長庚大學,台北。
彭莉琴、鄭惠美(2001)。某醫學中心中風高血壓病人遵醫囑服藥行為階段及相關因素之探討。衛生教育學報,81-97。
彭莉琴(2001)。某醫學中心中風高血壓病人遵醫囑服藥行為階段及相關因素之探討。未出版碩士論文,國立台灣師範大學,台北。
黃松元、林武雄、黃琪璘、陳政友、劉貴雲、王幼金、賴香如(1990)。影響台北市國小學童健康生活危險因子研究。台北市衛生局與 國立台灣師範大學衛生教育學系之研究報告。
黃淑貞(1999)。使用社區藥局病人遵醫囑行為之研究(行政院衛生署委託研究計畫計畫編號:DOH88-TD-1069)。台北:行政院衛生署。
黃淑貞、余萬能(2001)。社區藥局與診所取藥病人遵醫囑行為研究。公共衛生,27(4),245-260。
黃淑貞、姜逸群、賴香如、洪文綺、陳曉玟、邱雅莉、袁寶珠(2003)。台灣地區國小學童健康行為現況及其與社會人口學變項之相關研究。衛生教育學報,19,155-177。
黃文雄、張海山、卓奇勳(2006)。過敏性鼻炎治療新趨勢。臺灣兒童過敏氣喘及免疫學會學會通訊,7(1),6-7。
黃美娟、林麗娟、洪志秀。(2008)。第二型糖尿病自我照顧行為及相關因素之探討。長期照護雜誌,12(2),191-201。
張立德、林佑蓉、唐進勝(2006)。臺北縣八鄉鎮國小學童氣喘盛行率之調查。輔仁醫學期刊,4(2)61-72。
楊易宏、劉雪娥(2005)。「堅持」的概念分析。榮總護理,22(3),281- 287。
楊玨璿(2009)。某醫學中心門診高血壓病人服藥遵守行為之探討-自我效能及行動線索之影響。未出版碩士論文,國立台灣大學,台北。
鄭英裕(2001)。某區域教學醫院門診糖尿病患者遵醫囑行為及其相關因素之探討。未出版碩士論文,台北醫學大學,台北。
鄭允宜(2008)。癌症病人止疼痛藥服藥遵從性。未出版碩士論文,台北醫學大學,台北。
鄭秀月、李茹萍(2008)。戒菸門診個案持續戒菸行為與自我效能之研究。台灣醫學,13(3),223-230。
潘國揚(2002)。兒科加護病房醫病溝通與病患家屬需求及滿意度之探討。未出版碩士論文,慈濟大學,花蓮。
蔣立琦(1999)。氣喘兒童父母自我處理效能及其相關因素之研究。未出版博士論文,國立台灣師範大學,台北。
劉淑娟(1998)。罹患慢性病老人服藥遵從行為及其相關因素之探討。護理研究,7(6),581-593。
劉博仁、李采娟(2005)。過敏性鼻炎患者接受免疫療法之生活品質。台灣醫學,9(4),455-466。
賴泉源、莊永鑣、吳克修、黃文雄(2008)。過敏性鼻炎。臺灣兒童過敏氣喘及免疫學會學會通訊,9(4),10-15。
顏大欽(2003)。孩童過敏性鼻炎的治療原則。臺灣兒童過敏氣喘及免疫學會學會通訊,4(1),14-15。
謝昌成、陳建甫、劉鎮嘉(2006)。過敏性鼻炎。基層醫學,21(12),346-351。
戴辛翎(2005)。遵從行為概念分析-血液透析病患之體重控制。腎臟與透析,17(1),69-73。
蕭彤宇(2003)。癲癇兒童醫療遵從行為與相關因素之探討。未出版碩士論文,長庚大學,台北。
魏惠怡(1999)。護理指導對氣喘患孩處方遵從率的影響。未出版碩士論文,國立台灣大學,台北。
顧明修、呂克桓(2003)。過敏性鼻炎的治療。臺灣兒童過敏氣喘及免疫學會學會通訊,4(2),21-22。
英文文獻
Apter,A.J.,Reisine,S.T.,Affleck,G.,Barrows, E.,& ZuWallack ,R.(1998).Adherence with twice-daily dosing of inhaled steroids. American Journal of Respiratory and Critical Care Medicine,157,1810-1817.
Allergic Rhinitis and its impact on Asthma (2007). The ARIA Pocket Guide summarizes the information in the 2008 ARIA Report in a convenient. Retrieved March 10,2010,from http://www.whair.org/Documents&Resources.php.
Auslander,W.F.,Thomposon,S.,Dreitzer,D.,White,N.H.,& Santiago,J.V.(1997).Disparity in glycemic control and adherence between African-American and Caucasian youths with diabetes. Diabetes Care,20(10),1569-1575.
Bandura,A.(1977).Social learning theory. Englewood Cliffs. Prentice-Hall.
Bandura,A.(1998).Self-Efficacy : The Exercise of Control. New York: Oxford University.
Baroody,F.M.(2003).Allergic Rhinitis: Broader Disease Effects and implication for Management. Otolaryngology Head and Neck Surgery, 128(5),616-631.
Bender,B.Milgram,H.,&Rand,C.(1997).Nonadherence in asthmatic Patient:is there a solution to the problem. Annals of Allergy,Asthma,&Immunology,97,177-186.
Bender,B.,Milgrom,H.,Rand,C.& Ackerson,L.(1998). Psychological factors associated with medication nonadherence in asthmatic children. Journal of Asthma,35 (4),347-353.
Bender,B.,Wamboldt,F.S.,O'Connor,S.L.,Rand,C.,Szefler,S., Milgrom,H.,& Wamboldt,M.Z.(2000)Measurement of children's asthma medication adherence by self report, mother report, canister weight, and doser CT. Annals of Allergy,Asthma,&Immunology,85,416-421.
Berger,W.E.(2003).Overview of allergyrhinitis. Annals of Allergy,Asthma, & Immunology,90,7-12.
Berger,W.E.(2004).Allergic rhinitis in children: diagnosis and management strategies.Paediatr Drugs,6,233-250.
Bobrow,E.,AvRuskin,T.,& Siller,J.(1985).Mother-daughter interaction and adherence to diabetes regimens. Diabetes Care,8(2),146-151.
Brooks,C.M.,Richards,J.M.,Kohler,C.L.,Seng-Jaw,S.,Beverly, M.,Richards,A.W.,& William,C.B.(1994).Assessing adherence to asthma medication and inhaler regimens: a psychometric analysis of adult self-report scales. Medical Care,32(3),298-307.
Buck,D.,Jacoby,A.,Baker,G.A.,& Chadwick,D.W.(1997).Factors influencing compliance with antiepileptic drug regimes. Seizure,6(2),87-93.
Burhart,P.V.,Jacqueline,M.,Dunbar-Jacob,J.,& Jeffrey,M.R. (2001).Accuracy of children's self-report adherence to treatment. Clinical Scholarship,1,27-32.
Carr, W.W. (2008). Pediatric allergic rhinitis: current and future state of art. Allergy & Asthma Proceedings,19,197- 207.
Chiang,L.C.,Huang,J.L.,& Chao,S.Y.(2005). A Comparison, by Quantitative and Qualitative Methods,Between the Self- Management Behaviors of Parents with Asthma. Journal of Nursing Research,13(2),323-333.
Chigier,E.(1992).Compliance in adolescents with epilepsy or diabetes. Journal of Adolescents Health,13(5),375-379.
Conn,V.S.,Hafdahl,A.R.,Cooper,P.S.,Ruppar,T.M.,Mehr,D.R., & Russell,C.L.(2009).Interventions to Improve Medication Adherence Among Older Adults: Meta-Analysis of Adherence Outcomes Among Randomized Controlled Trials. The Gerontologist,49(4),447-462.
Cox,L.E.(2009).Predictors of Medication Adherence in an AIDS Clinical Trial: Patient and Clinician Perceptions. Health & Social Work,34(4),257-264.
Daryl,M.& Ralph,H.(1997).Improving patient compliance. Medical Clinics of North America,61,879-889.
Derbin,K. & Perkins,A.(Eds)(2002).Common problems in behavior health. New York: McGraw Hill.
Dracup,K.A.& Meleis,A.I.(1982).Compliance: an interactionist approach. Nursing Research,31(1),31-36.
Dunbar-Jacob,J.,Erlen,J.A.,Schlenk,E.A.,Ryan,C.M.,Sereika, S.M.&Doswell,W.M.(2000).Adherence in chronic disease. Annual Review of Nursing Research,18,48-90.
Gavin,L.A.,Wamboldt,M.Z.,Sorokin,N.,Levy,S.Y.,& Wamboldt,F. S.(1999).Treatment alliance and its association with family functioning, adherence, and medical outcome in adolescents with sever, chronic asthma. Society of Pediatric Psychology,24(4),355-358.
Gopinath,B.,Radhakrishnan,K.,Sarma,P.S.,Jayachandran,D.,& Alexander,A.(2000).A questionnaire survey about doctor- patient communication, compliance and locus of control among south Indian people with epilepsy. Epilepsy Research.39(1),73-82.
Jacobson,M.A.,Hauser,S.T.,Wolfsdorf,J.L.,Houlihan,J.,Milley ,J.E.,Herskoeitz,R.D.,Wertlieb,D.,& Watt,E.(1987). Psychologic predictors of compliance in children with recent onset of diabetes mellitus. Journal of Pediatrics,110(5),805-811.
Jonasson,G.,Carlsen,K-H.,& Mowinckel,P.(2000).Asthma drug adherence in a long clinical trial. Arch Disease Children,83,330-333.
Kantor,J.R.,& Smith,N.W.(1975).The Science of Psychology: An Interbehavioral Survey. Chicago, Illinois: The principle press Inc.
Kyngas,H.&Hentinen,A.(1997).A theoretical model of Compliance of young diabetics. Journal of Clinical Nursing,8,73-80.
Kyngas,H.,Hentinen,M.,& Barlow,J.H.(1998).Adolescent's perceptions of physicians, nurses, parents and friends: help or hindrance in compliance with diabetes self- care.Journal of Advanced Nursing,32(6),1499-1506.
Kyngas,H.,Duffy,M.E.,& Kroll,T.(2000).Conceptual analysis of compliance. Journal of Clinical Nursing,9(1),5-12.
Kyngas,H.(2000).Compliance with health regimens of adolescents with epilepsy. Scizure,9(3),598-604.
Lee,C.F.,Sun,H.L.,Lu,K.H.,Ku,M.S.,& Lue,K.H.(2009) The comparison of cetirizine, levocetirizine and placebo for the treatment of childhood perennial allergic rhinitis. Pediatric Allergy and Immunology,20,493-499.
Lin,C.C.&Liang,C.C.(1997).The Relationship Between Health Locus of Compliance of Hemodialysis patients. The Kaohsiung Journal of Medical Science,13,243-254.
Matsui,D.M.(1997).Drug compliance in pediatrics. Pediatrics Clinics of North America,44(1),1-14.
McQuaid,E.L.,Kopel,S.J.,Klein,R.B.,&Fritz,G.K.(2003). Medication Adherence in Pediatric Asthma: Reasoning, Responsibility,and Behavior.Journal of Pediatric Psychology,28(5),323-333.
Meujer,A.M.&Oppenheimner,L.(1995).The Excitation-Adaptation Model of Pediatric Chronic Illness. Family Process,34, 441-454.
Michael,S.& Blaiss,M.D.(2008).Pediatric allergic rhinitis: Physical and mental complications.Allergy & Asthma Proceedings,29,1-6.
Mitchell,W.G.,Scheier,L.M.,& Baker,S.A.(2000).Adherence to treatment in children with epilepsy: who“follows doctor's order ”Epilepsia,41(12),1616-1625.
Morgan,W.J.,Crain,E.F.,Gruchalla,R.S.,O'Connor,G.T.,Kattan, M.,& Evans,R.I.(2004).Results of a home-based environmental intervention among urban children with asthma. New England Journal of Medicine,351,1068-1080.
National Center for Health Statistics (2002).Allergies/Hay Fever. National Health Interview Survey 2002. Retrieved March 10,2010,from http://www.cdc.gov/nchs/fastats /allergies.htm.
Osterberg,L.& Blaschke,T.(2005).Adherence to Medication. The England Journal of Medicine,353(5),487-497.
Pryse-Phillips,W.,Jardune,F.,& Bursey,F.(1982).Compliance with drug therapy by epileptic patients. Epilepsia,23 (3),267-274.
Pfister-Minogue,K.(1993).Enhancing patient compliance: a guide for nurse. Geriatric Nursing,14,124-132.
Resnick,B.& Jenkins,L.S.(2000).Testing the Reliability and Validity of the Self-Efficacy for Exercise Scale.Nursing Research,49(3),154-159.
Russell,C.L.,Conn,V.S.,& Jantarakupt,P.(2006).Older Adult Medication Compliance: Integrated Review of Randomized Controlled Trials. American Journal of Health Behavior, 30(6),636-650.
Sackett,D.L.& Haynes,R.B.(1976).Introduction and the magnitude of compliance and noncompliance. In:Compliance with therapeutic regimens.The Johns Hopkinson University Press, Baltimors, MD,1-25.
Shi,Q.,Pothiban,L.,Wonghongkul,T.,Panya,P.,& Ostwald,S.K. (2008). Effect of a Hospital-based Clinic Intervention on Glycemic Control Self-efficacy and Glycemic Control in Chinese Patients with Type 2 Diabetes Mellitus. Chiang Mai University Journal Nautral Science,7(1),1-11.
Skoner,D.P.(2001).Allergy rhinitis: Definition, epidemiology ,pathophysiology,detection,and diagnosis.The Journal of
Allergy and Clinical Immunology,108,S2-S8.
Snodgrass,S.R.,Vedanarayanan,V.V.,Parker,C.C.,& Parks,B.R. (2001)Pediatric patients with undetectable anticonvulsant blood levels: comparison with compliant patients. Journal of Child Neurology,16(3),164-168.
Stempel,D.A.& Woolf,A.(2002).The Cost of treating Allergic Rhinitis.Current allergy and asthma reports,2(3),223-230.
Stuck,B.A.,Czajkowski,J.,Hagner,A.,Klimek,L.,Verse,T.,& Hormann,K.,(2004).Changes in daytime sleepiness, quality of life, and objective sleep patterns in seasonal rhinitis: A controlled clinical trial. The Journal of Allergy and Clinical Immunology,113,663-668.
Takaki,S.,Kurokawa,T.,& Aoyama,T.(1985).Monitoring Drug Noncompliance in Epileptic Patients: Assessing Phenobarbital Plasma Levels. Therapeutic drug monitoring ,7(1),87-91.
Tettersell,M.J.(1993).Asthma patient's knowledge in relation to compliance with drug therapy.Journal of Advanced Nursing,18,103-113.
Vinuya,R.Z.,(2002).Upper airway disorders and asthma: A syndrome of airway inflammation. Annals of Allergy, Asthma,&Immunology,88(l),8-15.
Vitolins,M.Z.,Rand,C.S.,Rapp,S.R.,Ribisl,P.M.& Sevick,M.A. (2002). Measuring adherence to behavioral and medical interventions.Controlled Clinical Trials,21(5),s188-s194.
Whitehouse,W.,& Morris,B.(1997).Paediatric out-patient antiepileptic drug doses recorded in the medical charts are not reliable: implications for the notion of noncompliance. Seizure, 6(1), 41-42.
Wilson,D.R.,Lima,M.T.,& Durham,S.R.(2005).Sublingual immunotherapy for allergic rhinitis:systematic review and meta-analysis. Allergy,60,4-12﹒