期望對入伍新兵急性化膿性扁桃腺炎住院復原之影響

目的：新兵入伍時，由於多種原因以致容易發生上呼吸道感染，而合併發生急性化膿性扁桃腺炎的比例也變多。大部分的病例都可經由抗生素治療而痊癒，但在臨床上發現治療病程的發展卻時常有相當差異。為了評估給予此類病患較多的預後期望是否能降低對疾病與疼痛的不安或恐懼，進而可預估復原的早日到來，故設計此一研究。方法：自2004年7月至2006年1月間，經門診或急診由主治醫師診斷為急性化膿性扁桃腺炎，而住院治療的病患中，入院時及住院過程中並無其他合併症，並配合完成複查及追蹤的病患共68名。自確定住院開始，隨機分為實驗組及對照組各34名，經由常規治療並記錄住院過程中吞嚥疼痛改善的情形。結果：研究結果發現，實驗組比對照組有較快的復原病程，對於疾病亦感覺較多期望對其復原有所助益。由統計結果可明顯比較出相同的住院日數下實驗組的病患比對照組的病患對疼痛感覺有較明顯改善。結論：本次研究顯示罹患急性化膿性扁桃腺炎的新兵病患獲得較多的正向預後資訊復，對疾病或症狀的復原可預期有正向的影響。本結論在軍陣醫學的臨床運用、軍事教育訓練或軍醫院對軍人病患的治療上可以提供重要的參考。

關鍵字

期望；新兵；急性化膿性扁桃腺炎；疾病復原

並列摘要

BACKGROUND: Most cases of acute suppurative tonsillitis occur in school-age children and grouping-lift young. Management involves selection of appropriate antimicrobial therapy for patients with treatable disease. By our experience, this disease often influent the training course of drafted soldiers. Almost of the disease can be controlled well by antibiotics and not noting any complication. But why is medical treatment sometimes effective and other times not? The effects of psychological factors in psychosomatic conditions have been rarer. METHODS: To investigate whether the personal attention paid to a soldier can affect his or her subjective recovery from acute suppurative tonsillitis, a controlled study was performed on 68 soldiers consulting or transferring to our hospital for this disease. The criteria for inclusion in this study were that the visiting doctor, on the basis of diagnostic acute suppurative tonsillitis on out-patient department or emergency room. At the admission a randomly assigned experimental group (n=34) was given more detailed information about the diagnosis, treatment and prognosis and also a more extensive examination than a control group (n=34). RESULTS: Patients' opinions about the severity of their throat symptoms after medication compared with the day of consultation. At a follow-up interview during 4 days of admission, there was a clear difference between the groups in this respect: the throat symptoms in the experimental group felt that their symptoms had improved than the control group significantly. And more felt that the treatment had helped them and significantly more they had received sufficient information about their expectation of prognosis than the control group significantly. The experimental group also gave significantly more positive answers than the control group when asked whether the treatment had helped. CONCLUSIONS: Those patients who received more detailed information had a more positive experience of the effect of the treatment. We considered that this study has demonstrated that a conscious attempt to maximize the expectation effect in acute suppurative tonsillitis dose in fact influence that clinical course of the disease recorded as the degree of improvement experienced after treatment. Therefore the expectation effect of soldiers was shown to influence the clinical course of admission on recovery from acute suppurative tonsillitis.

並列關鍵字

expectation ； enrolling soldier ； acute suppurative tonsillitis ； recovery of disease

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期望對入伍新兵急性化膿性扁桃腺炎住院復原之影響

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