健檢老人疼痛及心肺症狀與其相關因子之探討

A Study of Pain and Cardiopulmonary Symptoms and their Related Factors among the Elderly

蔡崇煌(Chung-Huang Tsai) ； 王雪鳳(Cynthia Wang) ； 林義鈜(I-Hong Lin) ； 吳萬慶(Wong-Ching Wu) ； 陳宇嘉(Yu-Chia Chen) ； 林高德(Cau-De Lin)

《台灣家庭醫學雜誌》 10卷4期 (2000/12) Pp. 173-181

https://doi.org/10.7023/TJFM.200012.0173

摘要

老年人因身心各方面的改變，使身體不適的症狀大幅增加，因此了解老人常見的身體症狀將有助於對老人疾病的診斷及處置，本研究即探討老人身體症狀發生的情形，並進一步以因素分析的統計方法轉化15種常見之身體症狀成具有概念化意義之因素，一為疼痛症狀(Pain symptoms)、一為心肺症狀(cardiopulmonary symptoms)。目前有研究發現不同部位之身體疼痛，具有相似的特性，因此本研究即根據此理論分析二種抽取出的因素與社會人口變項、睡眠障礙及精神疾患的關係。
本研究結果顯示疼痛症狀中以要酸背痛(37.0%)所佔比率最高，頭痛(14.9%)所佔比率較低，心肺症狀中以頭暈(30.0%)比率最高，呼吸困難(9.6%)所佔比率較少。由疼痛症狀與社會人口變項、睡眠障礙及精神疾病之多元迴歸模式分析驗証可發現，女性及夫妻同住、有睡眠障礙及精神疾病者較易罹患疼痛症狀，對心肺症狀而言，年齡較大之女性、自覺有經濟壓力要有睡眠障礙及精神疾病者罹患情形較嚴重。
老年人之常見身體症狀，可能是器質性因素所導致，但亦不可忽略社會人口變項、睡眠障礙及精神疾病等變項對其影響，探討疼痛症狀可提供醫師及研究人員對不同部位疼痛的概念及處置更有意義的參考價值，心肺症狀分析所得之結果可做為研究者更進一步的驗証及未來研究的參考。

並列摘要

As aging process progresses, the accompanying physical and psychological changes of the elderly will increase their physical discomfort. Understanding the elderly’s common somatic symptoms will help physicians with the diagnosis and management of the elderly’s illness. This study discusses over elderly’s somatic symptom occurrences, and adopts a statistics-based factor analysis to transform 15 commonly occurred symptoms to factors of conceptive meanings as pain symptoms and cardiopulmonary symptoms. According to some past studies, the physical pains found at different part of body have some meaniful resemblance. This study would like to use that model to analyze the relationship between these two selected factors with socio-demographics, sleep disturbance, and psychiatric disorders.
The result of this study revealed that among all pain symptoms, low back pain had the highest prevalence rate (37.0%), while headache (14.9%) had a lower frequency; among cardiopulmonary symptoms, dizziness (30%) had the highest, while short of breath had a lower prevalence rate (9.6%). From the differences and associations between pain symptom with socio-demographic, sleep disturbance, and psychiatric disorder, we found that female, separately-living couples and those patients suffering from sleep disturbance or psychiatric disorder would experience more pain symptoms. As to cardiopulmonary symptoms, older women, those who were susceptible to economical pressure or those patients suffered from sleep disturbance, and psychiatric disorder had much more serious symptoms.
Common somatic symptoms of the elderly may result from underlying organic etiologies, but we can’t ignore the influence from socio-demographics, sleep disturbance and psychiatric disorders. Exploring pain symptoms will provide physicians and researchers significant references to deal with pain over different parts of the body; moreover, this study, as well as the results from analyzing cardiopulmonary symptoms will possibly direct or lead to further studies for the researchers.

並列關鍵字

somatic symptoms ； pain symptoms ； cardiopulmonary symptoms ； sleep disturbance