影響中老年女性鼻炎及鼻竇炎患者使用醫療之因子

Factors Associated with the Use of Treatment Modalities among Middle-aged and Elderly Women with Rhinitis and Rhinosinusitis

顏廷廷(Ting-Ting Yan) ； 梁凱莉(Kai-Li Liang) ； 葉月嬌(Yueh-Chiao Yeh)

《台灣老年醫學暨老年學會雜誌》 16卷4期 (2021/11) Pp. 314-332

https://doi.org/10.29461/TGGa.202111_16(4).0005

摘要

目的：探討影響中老年女性鼻炎及鼻竇炎患者症狀之因子，以及患者症狀與使用醫療之相關性。方法：以中台灣某醫學中心耳鼻喉科門診之女性患者為對象。收案之診斷乃醫師根據鼻鏡檢查以及患者自述超過兩週以上之症狀，年齡小於40歲以及同時合併鼻部腫瘤之患者則排除在外，以半結構式問卷進行面對面問卷訪談，再利用單因子變異數分析中文版鼻及鼻竇炎症狀評估量表得分與醫療使用之相關因子。結果：212位受訪者平均年齡為57.1歲，平均量表得分為176.2。體重肥胖者、沒有運動者以及偶爾或每天喝提神飲料者，其量表總分較高，亦即症狀較嚴重。另外，自覺健康狀態不好或非常不好、罹患疾病數目大於3種、罹患偏頭痛或藥物／食物過敏、沒有規律生理期、月經生理期大於28天或有痛經等的患者症狀亦較嚴重。使用藥物方面，使用感冒藥、止痛藥或安眠藥者症狀較嚴重；而症狀嚴重者亦會使用針灸及三伏貼等輔助療法。進一步分析影響量表之各分項得分相關因子，發現與多項因子具有交互作用關係。結論：未來研究可針對罹患鼻炎及鼻竇炎的中老年婦女，控制體重、增加運動以及使用輔助療法等，探討是否能改善其在睡眠及生活上的影響。本研究亦可為醫療決策單位對照護患者提供衛教資訊之參考。

關鍵字

鼻炎及鼻竇炎 ； 西醫 ； 輔助療法 ； 中醫 ； 中老年婦女

並列摘要

Purpose: To investigate the factors influencing patients' symptoms and their utilizations of treatment modalities among middle-aged and elderly women with rhinitis and rhinosinusitis in Taiwan. Methods: Subjects were recruited from the outpatient department of otolaryngology in a medical center in central Taiwan, and diagnosis was based on rhinoscopy examination and patients' reports of typical symptoms persisting for two weeks or more. Patients under 40 years of age or with nasal malignances were excluded from the study. A semi-structured questionnaire was answered during a face-to-face interview. One-way analysis of variance (ANOVA) was used to identify the factors correlated with the subjects' scores on the Chinese version of the 31-item Rhinosinusitis Outcome Measure (CRSOM-31) and their previous choices of treatment modalities. Results: The average age of the 212 subjects was 57.1 years, and the average CRSOM-31 symptom-impact score read 176.2. Severe disease symptoms were found in patients with the following conditions: obese, lacking regular exercise, self-perceived health fair or poor, with 3 or more chronic conditions, headache, drug or food allergy, irregular menstrual cycle or menstrual cycle longer than 28 days, and a history of dysmenorrhea. In terms of their uses of medicines, more severe symptoms were detected among patients who had used common cold medicines, painkillers, sleeping pills, or complementary and alternative medicines (CAMs), such as acupuncture and Sanfu acupoint herbal patching. Moreover, there were different combinations of independent factors associated with the average sub-scores of CRSOM-31 among participants. Conclusion: Further studies are needed to investigate whether patients will be able to relieve their symptoms to improve sleeping quality and reduce the adverse impacts of rhinitis and rhinosinusitis on the quality of life by controlling their body weight, maintaining a habit of regular exercise, and using CAMs. Additionally, results of the study can be adopted to assist clinical decision making units in providing female patients with rhinitis and rhinosinusitis effective patient education and treatment strategies.

並列關鍵字

rhinitis and rhinosinusitis ； western medicines ； complementary and alternative medicines ； Traditional Chinese Medicines ； middle-aged and elderly women