使用路徑分析方法探討氣喘危險因子、氣喘控制和氣喘生活品質之間的相關性

The associations among risk factors, asthma control, and quality of life in adult asthma: using path analysis

蕭惠文(Hui-Wen Hsiao)

指導教授 ： 王姿乃

高雄醫學大學/健康科學院/公共衛生學研究所/碩士(2014年)

https://doi.org/10.6832/KMU.2014.00003

摘要

前言：氣喘的危險因子包含肥胖、抽菸、過敏原以及環境因子等，而這些因子可能會導致氣喘症狀發生，如哮喘、呼吸困難、胸悶以及夜咳，而這些症狀可能會進一步地影響到生活品質。研究指出氣喘控制為氣喘生活品質的預測因子。因此本研究探討成人氣喘的危險因子、氣喘控制和生活品質之間的相關性。
材料方法：本研究係屬橫斷型研究，研究對象來自南臺灣醫學中心的十八歲以上的成年氣喘個案，共收案359位個案。基本人口學資料及預測因子的收集是採用自行設計的問卷，氣喘控制評估使用具有高信效度的測試問卷(Asthma Control Test TM , ACT)，而生活品質則是使用改編的臺灣版本氣喘生活品質評估問卷(Taiwanese version of an asthma quality-of-life questionnaire, TAQLQ)。本研究使用多元線性回歸及路徑分析方法探討各變項之間的相關性。
結果：由結構方程模式中的路徑分析出來的模式，具有良好的配適度，X2(df)= 43.81(38)，P=0.238，RMSEA (90% CI) = 0.021 (0.001- 0.044)。而研究結果發現幾項預測因子，如較高的IgE值、過敏反應、哮喘頻率、醫療資源使用、BMI值較高，工作環境及工作症狀都直接或間接地影響到氣喘控制及生活品質。另外抽菸則是與肺功能有相關，但是跟氣喘控制及氣喘生活品質是沒有相關的。以校正後的β係數比較，氣喘控制對於氣喘生活品質是較重要的預測因子。
結論：本研究發現多項預測因子和氣喘控制、氣喘生活品質有相關性，因此避免或減低暴露於危險因子可使氣喘受到良好控制並有助於氣喘生活品質的提升。

關鍵字

路徑分析 ； 氣喘控制 ； 氣喘生活品質

並列摘要

Background：The risk factors of asthma include exposure to allergens, obesity, smoke, and environment. Asthma causes symptoms, such as wheezing, dyspnea, chest tightness, and nocturnal syndrome, which further affect the quality of daily life. Previous studies reported that asthma control is a strong predictor of quality of life. Thus, the aim of this study is to explore the relationships among risk factors, Asthma Control Test TM (ACT) scores and quality of life (QoL) in asthmatic patients.
Methods：This cross-sectional study included 359 asthmatic patients above 18 years of age from a medical center in southern Taiwan. The predictors and outcome variables were collected using a questionnaire. ACT scores were used to determine the level of disease control, and QoL was assessed using the Taiwanese version of an asthma quality-of-life questionnaire (TAQLQ) which was revised from the Asthma Quality of Life (AQLQ). The data were analyzed by multiple linear regression and path analysis.
Results： The structural equation model for predicting QoL provided a good fit ((X2 (df) = 43.81(38); RMSEA (90% CI) = 0.021 (0.001- 0.044)). Higher IgE with more allergic response, the frequency of wheeze, healthcare utilization, higher BMI, work environment and work symptoms are directly or indirectly associated with asthma control and quality of life. Smoke is associated with lung function but not asthma control and QoL. Path analysis revealed that better asthma control was related to higher quality of life.
Conclusion：Our research demonstrated that risk factors, such as higher IgE with more allergic response, higher BMI with more work symptom, poor work environment with more work symptom, impair the life quality of asthmatic adults. Patients avoiding exposure to these risk factors would have well asthma control and improvement of QoL.

並列關鍵字

asthma risk factors ； path analysis ； asthma control ； asthma quality of life

參考文獻

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