青少年過敏症與情緒、身體意象、生活品質、人際及行為之關係

Effects of adolescent allergy on emotion, body image, quality of life, interpersonal relationship and aggression

張芸瑋(Yun-Woei Chang)

指導教授 ： 陳怡樺

臺北醫學大學/公共衛生暨營養學院/公共衛生學研究所/碩士(2011年)

https://doi.org/10.6831/TMU.2011.00160

摘要

在過去數十年間，過敏性疾病的盛行率在全球都持續的攀高。過去研究指出，過敏性疾病會影響心理狀態，身體質量指數、且可能進而影響行為表現，處於青春期的青少年心理情緒狀態較不穩定，而且課業生活壓力大，再加上對自己體型、身體意象的重視，可能因過敏性疾病造成其身心困擾。因此本研究擬探討青少年過敏症（包括氣喘、過敏性鼻炎與異位性皮膚炎）與情緒、行為、身體意象、人際關係與生活品質狀態之關係。
本研究編製兼具本土特色與國際比較之自陳式青少年過敏症及其相關因子調查問卷，隨後以分層隨機抽樣方式，分兩階段抽樣。首先，在台北市及新北市分別隨機抽選3個區，每個區再隨機抽選出3所學校，共有1,395位八年級（國中二年級）生參加青少年過敏症與情緒、行為、身體意象、人際關係暨生活品質等狀態的健康調查。本研究調查於99年九月至十月期間進行，抽取之八年級學生於各班級教室進行團體自陳式問卷施測。
本研究發現，在調查的八年級研究對象中，有氣喘、異位性皮膚炎及過敏鼻炎的學童各佔12.7%、13.7%、36.7%；在控制相關因子後，現存氣喘及異位性皮膚炎患者相較於無過敏症狀者，有顯著較高焦慮（氣喘：OR＝2.062，CI＝1.257-3.380）或憂鬱傾向（異位性皮膚炎：OR＝1.801，CI＝1.129-2.873）、生活品質較差（氣喘：OR＝1.838，CI＝1.063-3.180；異位性皮膚炎：OR＝2.379，CI＝1.415-3.997）且較易有身體攻擊行為表現（氣喘：OR＝1.846，CI＝1.074-3.172；異位性皮膚炎：OR＝1.993，CI＝1.206-3.293）；而於現存過敏鼻炎患者中，除有較差的生活品質（OR＝1.608，CI＝1.145-2.259）外，還有較高言語攻擊行為表現（OR＝1.577，CI＝1.125-2.211）。進一步分析有過敏症狀的人當中，依嚴重度來分，在過敏鼻炎患者中，重度皆較輕度或無任何過敏疾病者有較高的情緒問題（OR＝1.968，CI＝1.208-3.204）、較差的生活品質（OR＝2.865，CI＝1.688-4.861）及身體意象等（OR＝1.684，CI＝1.030-2.754），但在氣喘及異位性皮膚炎嚴重度的發現結果不一致。此外，依症狀數來看，可以發現若症狀數愈多，愈易有負面情緒傾向（OR＝1.729，CI＝1.032-2.896）、生活品質較差（OR＝2.909，CI＝1.675-5.052）及易有身體攻擊行為表現（OR＝1.951，CI＝1.119-3.401）。最後，依性別分層看不同過敏症對身心發展狀態的影響則有所差異。
過去研究較少針對不同過敏症狀與情緒、身體意象、生活品質、人際及行為做探討，由本篇研究的發現，可以讓醫師及家長做借鏡，能多注意過敏症學童其情緒與生活品質及行為問題的衍生，並藉由研究結果協助規劃執行後續介入計劃，冀能具體幫助過敏症學生提升其身心健康。

關鍵字

過敏 ； 情緒 ； 身體意象 ； 生活品質 ； 人際關係 ； 行為 ； 青少年

並列摘要

In the past few decades, the prevalence rates of allergic disorders including asthma, atopic dermatitis, and allergic rhinitis, have increased annually throughout the world. The emotion, body image, life quality, and behaviors among youth with allergy may be seriously affected. Adolescence is a transitional stage from childhood to adulthood characterized with unstable physical and psychological status. Allergic diseases may be more likely to increase physical and psychological maladjustment during this sensitive period in life. Therefore, this study was aimed to investigate the effects of adolescent allergy (including asthma, atopic dermatitis and allergic rhinitis) on emotion, body image, quality of life, interpersonal relationship and aggression.
We conducted a cross-sectional survey from September to October, 2010 in Taipei City and New Taipei City to investigate the effects of adolescent allergy on emotion, body image, quality of life, interpersonal relationship and aggression, using a self-reported questionnaire. With a stratified random sampling method, a total of 1,395 8th grade junior high school students were selected and invited for participation.
We found that the prevalence rates of current asthma, atopic dermatitis and allergic rhinitis were 12.7%, 13.7%, 36.7%, respectively. After adjusting for potential confounders, current asthma and atopic dermatitis were associated with increased risks of higher anxiety (asthma: OR= 2.062, 95% CI= 1.257-3.380) and depression symptoms (atopic dermatitis: OR= 1.801, 95% CI= 1.129-2.873), poorer quality of life (asthma: OR = 1.838, 95% CI= 1.063-3.180; and atopic dermatitis: OR = 2.379, 95% CI =1.415-3.997), and more physical aggression (asthma: OR = 1.846, 95% CI= 1.074-3.172; and atopic dermatitis: OR = 1.993, 95% CI =1.206-3.293). Then, current allergic rhinitis were associated with increased risks of poorer quality of life (OR = 1.608, 95% CI= 1.145-2.259), and more physical aggression (OR = 1.577, 95% CI= 1.125-2.211). In terms of the severity of the symptoms, students with severe allergic rhinitis were found to display higher levels of anxiety and depression (OR= 1.968, 95% CI= 1.208-3.204) and lower levels of quality of life (OR= 2.865, 95% CI= 1.688-4.861) and body image (OR= 1.684, 95% CI= 1.030-2.754), compared with those with mild symptoms or no symptoms. In addition, inconsistent results were found for those with severe asthma and atopic dermatitis, compared with those with mild symptoms. In further analysis on the numbers of allergic illnesses, we found that the more the numbers of the allergic illnesses, the worse the youth’s emotion status (OR= 1.729, 95% CI= 1.032-2.896), quality of life (OR= 2.909, 95% CI= 1.675-5.052) and physical aggression (OR= 1.951, 95% CI= 1.119-3.401). Finally, gender differences were identified for the effects of different allergic disorders on adolescent physical and mental health status.
Our study comprehensively investigated the emotion, body image, quality of life, interpersonal relationship and aggression among youth with different atopic disorders. Based upon our findings, it is imperative for teachers, parents, and doctors to pay more attention to the anxiety, depression, quality of life, and aggressive behaviors among youth with atopic diseases. Future intervention may thus be designed and implemented to promote both the physical and psychological health for adolescents with allergy.

並列關鍵字

allergies ； emotion ； body image ； quality of life ； interpersonal relationship ； aggression ； adolescents

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