焦慮性疾患患者醫療服務利用情形及相關因素探討

Medical Services Utilization and Related Factors Among Patients with Anxiety Disorders

朱垣寧(Yuan-Ning Chu)

指導教授 ： 張秀如

臺北醫學大學/護理學院/護理學研究所/碩士(2012年)

https://doi.org/10.6831/TMU.2012.00021

摘要

論文名稱：焦慮性疾患患者醫療服務利用情形及相關因素探討
研究所名稱：臺北醫學大學護理學研究所
研究生姓名：朱垣寧
畢業時間：一○○學年度第二學期
指導教授：張秀如 臺北醫學大學護理學系 副教授
目的：本研究旨在了解台灣地區焦慮性疾患患者的醫療服務利用情形及自覺健康狀況，並探討影響焦慮性疾患患者醫療服務利用情形及自覺健康狀況的相關因素。
方法：本研究採資料庫分析方式，以2005年國民健康訪問暨藥物濫用調查的資料庫串聯全民健康保險研究資料庫為架構，將受訪個案分為焦慮性疾患組及對照組，並運用個案於2005年國民健康訪問暨藥物濫用調查的填答結果及全民健康保險研究資料庫的資料來作分析探討。
結果：1、台灣地區焦慮性疾患患者之就醫總次數、非就診精神科次數及就診精神科次數皆高於一般民眾，有達到統計上之顯著差異；而台灣地區焦慮性疾患患者的自覺健康狀況在所有面向之分數皆低於一般民眾，有達到統計上之顯著差異2、台灣地區焦慮性疾患患者之就診精神科次數低於其他精神疾患患者，有達到統計上之顯著差異；而台灣地區焦慮性疾患患者的自覺健康狀況在身體疼痛及情緒功能限制面向之分數低於其他精神疾患患者，有達到統計上之顯著差異3、台灣地區焦慮性疾患患者之工作情形、非就診精神科次數及就診精神科次數可以預測其自覺健康狀況4、台灣地區焦慮性疾患患者之年齡及自覺健康狀況可以預測其就醫總次數5、台灣地區焦慮性疾患患者之年齡、性別、家庭收入是否為全國後百分之40及自覺健康狀況可以預測其非就診精神科次數6、台灣地區焦慮性疾患患者之自覺健康狀況可以預測其就診精神科次數。
結論：焦慮性疾患患者之就醫總次數、非就診精神科次數及就診精神科次數皆明顯高於一般民眾，顯示其的確有較高的醫療服務利用次數，而焦慮性疾患患者之就診精神科次數卻是低於其他精神疾患患者的，這也顯示其的確因為焦慮性疾患所造成的生理症狀，而較常尋求非精神科之醫療服務，因此也造成了醫療資源的浪費；而研究結果顯示年齡較大、女性、家庭收入較差及自覺健康狀況較差是焦慮性疾患患者非就診精神科次數較高的預測因素，因此建議相關單位能加強宣導焦慮性疾患的相關訊息及知識，也建議其他科別的醫護人員也要具備足夠的焦慮性疾患相關專業知識及敏感性，以利於轉介可能的焦慮性疾患患者至精神科接受治療。

關鍵字

焦慮性疾患 ； 醫療服務利用情形 ； 自覺健康狀況

並列摘要

Title of Thesis: Medical Services Utilization and Related Factors among Patients with Anxiety Disorders
Institution: Graduate Institute of Nursing, Taipei Medical University
Author: Chu, Yuan-Ning
Thesis directed by: Chang, Hsiu-Ju, PhD., Associate Professor
Objective: The aims of this study were to explore the medical services utilization and subjective health state of patients with anxiety disorders in Taiwan, and to investigate the related factors.
Method: A database analysis was used in this study. The study was connected 2005 National Health Interview Survey and National Health Insurance Research Database as a framework. All cases were separated into anxiety disorders group and comparison group, and the study used the results of 2005 National Health Interview Survey and the data of National Health Insurance Research Database to analyze.
Result: 1. In Taiwan, the frequencies of total medical services utilization, non-psychiatric medical services utilization and psychiatric medical services utilization of patients with anxiety disorders were significantly higher than that of general people. Also, the scores for subjective health state which patients with anxiety disorders got were significantly lower than general people in all aspects. 2. The frequencies of psychiatric medical services utilization of patients with anxiety disorders were significantly lower than that of patients with non-anxiety psychiatric disorders. Scores for subjective health state of patients with anxiety disorders were significantly lower than patients with non-anxiety psychiatric disorders obviously in physical pain and emotional functional limitations. 3. Work state, frequencies of non-psychiatric medical services utilization and psychiatric medical services utilization significantly predicted subjective health state of patients with anxiety disorders.4. Age and subjective health of patients with anxiety disorder were the related factors of the patients’ total number of medical services utilization.
5. Age, sex, family income and subjective health state were the predictive factors of frequencies of non-psychiatric medical services utilization of patients with anxiety disorders.6. Subjective health state was the predictive factor of frequencies of psychiatric medical services utilization of patients with anxiety disorders.
Conclusion: The physiology symptoms of anxiety disorders would make patients with anxiety disorders not seek appropriate medical services, and have higher total frequencies of medical services utilization. Therefore, it was the reason why caused waste of medical resource. We found that older, female, low- income and poor subjective health state highly affected higher total frequencies of non-psychiatric services utilization. In conclusion, we suggested that government organizations should strongly promoted the information and knowledge of anxiety disorders more often. Non-psychiatric professionals had to be provided with enough related professional knowledge and sensitivity of anxiety disorders to make necessary referral for possible patients with anxiety disorders to accept adequate treatment.

並列關鍵字

anxiety disorders ； medical services utilization ； subjective health state

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