健檢民衆常見身體症狀之因素分析探討：先導型研究

Factor-Analysis of Common Somatic Symptoms in Individuals from Health Examination: A Preliminary Study

蔡崇煌(Chung-Huang Tsai) ； 周俊德(Chun-De Chou) ； 楊欽堯(Chin-Yao Yang) ； 劉永昌(Yung-Chang Liu)

《臺灣家庭醫學研究》 6卷1期 (2008/01) Pp. 24-34

https://doi.org/10.29475/TFMR.200801.0003

摘要

多樣抱怨的病人常困擾著大部份醫師及病患自己，過去之研究發現某些症狀會有因素結構的群聚現象。本研究為了了解常見身體症狀之盛行及因素結構，從2007年5月至12月間，以台中市某區域醫院接受全身健康檢查個案為對象，選取20歲以上，平均為47.9±11.8歲，排除拒填及資料不全者後，共收集有效樣本579人，其中男性有367人(63.4%)。症狀問卷參考精神醫學診斷問卷表－中文修訂版(DIS-CM)常見之生理症狀及國內外之研究，列出參加健檢常見之22種身體症狀。結果顯示大部份症狀以女性盛行率較男性高，其中以便祕或拉肚子、身體某些部位覺得麻木刺痛、胃痛或腹部不舒服、頭暈、心悸、頭痛、感到身體的某一部份軟弱無力、感到手或腳重重的、胃口不好、一陣陣發冷或發熱等10項症狀達統計學上的顯著差異。因素分析結果共有17種症狀符合條件進入分析，成功組成4種因素，其中因素1（肌肉骨骼症狀）包含了肌肉酸痛、身體某些部位覺得麻木刺痛、腰酸背痛、手腳關節酸痛、頸部酸痛或僵硬、感到手或腳重重的、感到身體的某一部份軟弱無力等。因素2（頭部症狀）包含了頭暈、頭痛、耳嗚、一陣陣發冷或發熱等4項。因素3（心肺症狀）包含呼吸困難或窒息感、胸悶或胸痛、心悸、心怦怦跳或心跳很快。因素4（胃腸症狀）包含便祕或拉肚子、胃痛或腹部不舒服、胃口不好，4種因素解釋變異量(%)依次為21.0、13.9、12.9及11.1。因此若患者有一處身體症狀，應再考量是否有他處之不適。本研究發現大部份參加健檢者有頗多身體症狀，過去國內少有對此族群相關之報導，再者因素分析結果與國外非健檢的研究類似，因此本常見身體症狀之描述性研究，不但可提供國內健檢單位的參考，亦可提供其他臨床醫師的參考。

並列摘要

Multiple complaints bother most of the physicians and the patients themselves. The studies in the past had conveyed the factor clustering structures based on the symptomatology. The aim of the present study was to investigate the prevalence and factor structure among those who underwent health examinations in a regional hospital in Taichung between May and December 2007. Subjects who were less than 20 years old and those who refused to fill out the questionnaire were excluded from this study. A total of 579 participants with 367 (63.4%) males and 212 (36.6%) females (mean [47.9±11.8] years) were enrolled. The questionnaire comprised twenty-two common somatic symptoms summarized from the diagnostic interview schedule-Chinese modified version (DIS-CM) and past similar analyses. The results showed symptoms were more prevalent in females than in males. There were ten somatic symptoms that showed significant difference, including constipation/diarrhea, numbness/tingling, GI upset, dizziness, palpitation, headache, weakness, limbs heavy sensation, poor appetite, and cold/hot sensation. Of the 22 symptoms, 17 symptoms were entered into the factor analysis which ended up with the most appropriate solution in four model factors. The first factor (musculoskeletal symptoms) comprised muscle pain, numbness, lumbago, limbs pain, neck pain, limbs heavy sensation and weakness. The second factor (head symptoms) comprised dizziness, headache, tinnitus and cold/hot sensation. The third factor (cardiopulmonary symptoms) comprised dyspnea, chest tightness/pain and palpitation. The fourth factor (gastrointestinal symptoms) comprised constipation/diarrhea, GI upset and poor appetite. They account for 21.0, 13.9, 12.9 and 11.1 of the total variance respectively. If one symptom was complained about, the other somatic symptoms would be accompanied. It was quite prevalent in individuals seeking physical examination with many somatic symptoms. However, there were few domestic studies on this subject conducted in the past. The results of our study were paralleled with the foreign similar studies, though made on occasions other than regular physical check-up. Therefore, this descriptive study can not only be offered as a reference for the health examination department, but also for other clinics.

並列關鍵字

factor analysis ； health examination ； prevalence ； somatic symptom