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研究生: 陳慈徽
Chen, Tzu-Hui
論文名稱: 初執業年輕護理師之生理與心理健康:全國代表性資料庫之世代追蹤研究
The effect of young nurses first practice on their own mental and physical health: A population representative database cohort study
指導教授: 李子奇
Lee, Tzu-Chi
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2019
畢業學年度: 107
語文別: 英文
論文頁數: 67
中文關鍵詞: 年輕護理師心理健康生理健康臺灣健保資料庫簡單配對
英文關鍵詞: Young nurses, Mental health, Physical health, Taiwan’s National Health Insurance dataset, Exact match
DOI URL: http://doi.org/10.6345/NTNU201900562
論文種類: 學術論文
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  • 研究重要性:醫療工作環境是多元又高度複雜的。本研究以台灣的全民健康保險資料庫探討畢業後初職業的護理師之心理和生理健康狀況。

    研究目標:與台灣的一般民眾相比評估年輕護理師的生理和心理健康狀態。

    研究資料庫:本研究使用台灣的全民健康保險資料庫。

    研究設計:世代研究7803位初執業護理師,年齡介於18至30歲,疾病由2000/01/01追蹤至2012/12/31,與一般民眾(非健康照顧工作者)進行性別、年齡、居住地和投保薪資的配對,追蹤下列生理心理疾病。

    主要結果測量:以國際疾病診斷分類碼第九版(ICD-9-CM)定義心理和生理疾病。心理疾病包含憂鬱、焦慮、失眠;生理疾病包含高血壓、骨骼肌肉疾病與下背痛、月經週期疾病。

    統計分析:卡方檢定或T檢定來測量病例組和對照組的人口學變項。以Cox proportional hazard regression (Cox比例風險模式)來測量初執業護理師可能產生的疾病風險值。

    結果: 初執業護理師比起非健康照顧者,有較高的風險值產生焦慮、失眠、高血壓、肌肉骨骼疾病與下背痛。本研究可作為政府部門或護理部門制定政策的參考,改善初執業護理師健康狀況並降低離職率。

    Importance: The healthcare workplace environment is multifaceted and highly complex. This study focuses on the impact of junior nurses’ first practices after their graduation and how this might impact on their own mental and physical health through analyses of Taiwan’s National Health Insurance database.

    Objectives: To assess young nurses’ mental and physical health situation compared with controls (non-health caregivers) in Taiwan.

    Database: This study was conducted using National Health Insurance Database (NHID), Taiwan.

    Study Design: A cohort study of 7,803 nurses whose age between 18 to 30 years included in this study from January 1st 2000 to December 31th 2012. These cases were compared with sex-, age-, residence-, and insurance premium matched controls (non-health caregivers). In order to follow mental and physical diseases as described below.

    Main outcome measure
    Mental and physical diseases were identified based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Mental diseases including depression, anxiety and insomnia. Physical disease included hypertension, musculoskeletal disease, low back pain and menstrual disorders.

    Statistics analysis: Chi-square or t tests would be used to examine differences in demographic and characteristics between cases and controls (non-health caregiver). Cox regression would be used to reveal the association between nurses and diseases.

    中文摘要 i Abstract ii Contents iii Table Contents iv Figure Contents v Chapter 1 Introduction 1 1.1 Background of study 1 1.2 Study aims and Objectives 2 Chapter 2: Literature review 3 2.1 Mental diseases 3 2.2 Chronic diseases 7 Chapter 3 Material and Methods 12 3.1 Ethics statement 12 3.2 Database 12 3.3 Cohort study 14 3.4 Exact Match 18 3.5 Variables definition 26 Chapter 4 Statistical analysis and Result 31 4.1 Statistical analysis 31 4.2 Result 32 Chapter 5 Discussion 59 5.1 Mental diseases associated with young nurses 59 5.2 Physical diseases associated with young nurses 60 5.3 Strength and Limitation 61 Chapter 6 Conclusion 62 Appendix 63 Appendix 1.1 Certificate of REC Approval 63 References 64

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