探討醫事人員罹患大腸直腸癌盛行率以及併發憂鬱症之情況

Prevalence of colorectal cancer and complicated with depression in health personnel.

李俊賢(Chun-Hsien Li)

指導教授 ： 羅英瑛

義守大學/醫學院/醫務管理學系/碩士(2016年)

摘要

國內大腸直腸癌人數持續增高，而醫事人員的執業環境可能因輪班造成飲食、運動與睡眠都難以符合正常規律；且長期處在高壓的工作環境可能導致肝指數GPT異常，以上這些原因都有可能讓醫事人員罹患代謝症候群的風險增加，而近期研究先後指出代謝症候群是大腸直腸癌的危險因子。因此本研究欲探討醫事人員罹患大腸直腸癌之其盛行率是否高於非醫事人員，也探討罹患大腸直腸癌後併發憂鬱症的狀況是否不同。
本研究屬於回顧性研究，採用全民健康保險研究資料庫2005年百萬歸人檔內的門診處方及治療明細檔與住院醫療費用清單明細檔，以及醫事人員基本資料檔，分析醫事人員罹患大腸直腸癌以及有無併發憂鬱症之情況。
研究結果顯示，醫事人員罹患大腸直腸癌之盛行率為9 ‰並未高於非醫事人員的14.1 ‰，在不同醫事人員之執業類別罹患大腸直腸癌之盛行率有差異。而在醫事人員罹患大腸直腸癌後併發憂鬱症之比率雖有低於非醫事人員，但未達顯著水準；而其中發現罹患大腸直腸癌後併發憂鬱症與性別有關係，並且女性未罹患憂鬱症是男性的0.438倍。
研究結論與建議方面，醫事人員的執業環境存在致癌的危險因子，雖然本研究中其盛行率未高於非醫事人員，但仍須對醫事人員的健康更加注意，盡量避免或減少不良的工作環境所帶來健康狀態上的影響。而對於罹癌之醫事人員，雖然其具有高度醫療知識與醫療資訊，且在取得醫療服務中屬於知情消費者，但併發憂鬱症的機會與非醫事人員並無顯著差異，仍需關心且留意其心理狀態。

關鍵字

大腸直腸癌 ； 醫事人員 ； 憂鬱症

並列摘要

Background and purpose
Number of patient with colorectal cancer in Taiwan is continuously rising. The work environment for medical personnel may not match with the regular routine in diet, exercise, and sleep due to shift rotation, and the long-term exposure under highly stressful environment may lead to abnormal GPT index for poor liver function. Due to these causes, the risk of metabolic disorder for medical personnel may increase, as the recent studies showed it as a risk factor for colorectal cancer. Therefore, the research would attempt to investigate the prevalence rate and compare the difference between medical personnel and non-medical personnel with colorectal cancer, as well as the similarity or difference in the complication of depression.
Methods
The research was retrospective in nature by using the outpatient prescriptions, detail list of treatment, hospitalization expenditure balance, and basic information of medical personnel in the 2005 National Health Insurance Research Database, to analyze the condition of colorectal cancer in medical personnel and existence of complication of depression.
Results
The research result showed the prevalence rate 9 ‰ of colorectal cancer in medical personnel, which was not higher than the rate 14.1 ‰ in non-medical personnel. And, there was difference in prevalence rate of colorectal cancer in medical personnel of different departments. The incidence rate of depression in medical personnel with colorectal cancer was lower than the non-medical personnel, but the difference was not statistically significant. And, there was correlation between sex and incidence rate of depression. The number of female without depression was higher than male by a factor of 0.438.
Conclusions and suggestions
In the aspect of conclusion and recommendation, the work environment of medical personnel did contain carcinogenic risk factors. Although the prevalence rate was not higher than non-medical personnel, they might still need to pay attention to health in order to avoid or reduce any impact on the health status due to poor work environment. As for medical personnel with cancer, even though they might already have knowledge on the treatment and were informed consumers, the chance of complication of depression was not different from non-medical personnel, and thus, the psychological state must be under watch.

並列關鍵字

Colorectal cancer ； Medical personnel ； Depression

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