研究生: |
張雅苓 Chang, Ya-Ling |
---|---|
論文名稱: |
以戒菸行為意圖與尼古丁成癮探討戒菸個案之憂鬱─
以台北市某區域醫院為例 Smoking cessation intention and nicotine dependence as predictors of depression in patients in a hospital receiving smoking cessation services |
指導教授: |
李思賢
Lee, Szu-Hsien |
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: | 2017 |
畢業學年度: | 105 |
語文別: | 中文 |
論文頁數: | 51 |
中文關鍵詞: | 戒菸服務 、戒菸行為意圖 、尼古丁成癮 、憂鬱 |
英文關鍵詞: | Smoking cessation services, Smoking cessation intention, Nicotine dependence, Depression |
DOI URL: | https://doi.org/10.6345/NTNU202202915 |
論文種類: | 學術論文 |
相關次數: | 點閱:177 下載:18 |
分享至: |
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
目的:探討戒菸意圖及尼古丁成癮度與其憂鬱之相關性。
方法:研究對象為台北市某區域醫院20歲以上之戒菸個案,研究採問卷調查,共計回收71份有效問卷。研究工具以結構式問卷,採用跨理論模式行為改變階段、尼古丁成癮程度測試表(The Fagerstrom Test for Nicotine Dependence FTND)、短版10題憂鬱量表(Center for Epidemiological Studies Depression Scale, CESD-10量表)。
結果:69%之研究個案從未使用過戒菸藥物,認為可以用意志力戒菸;首次吸菸年齡在18歲以前佔53.52%;戒菸行為意圖與憂鬱程度並無顯著相關;教育程度與戒菸行為意圖呈現顯著正相關;菸齡與教育程度呈負相關;尼古丁成癮度、性別、婚姻狀況與憂鬱程度呈現顯著相關;婚姻狀況、首次吸菸年齡與尼古丁成癮度呈現負相關;菸量、有疾病史與尼古丁成癮度呈現正相關。
結論:教育程度越高,菸齡越低,戒菸行為意圖越好;已婚、首次吸菸年齡較低及有疾病史者之研究對象尼古丁成癮度較高;已婚、女性及尼古丁成癮度越高者,憂鬱程度越高。
建議:醫院及藥局須落實推動戒菸衛教及戒菸門診轉介,增加戒菸衛教諮詢之使用,提升吸菸個案之戒菸自我效能及戒菸行為意圖;避免青少年過早接觸菸品之機會,以減少尼古丁成癮情形,應從家庭菸害教育及父母戒菸做起;尼古丁成癮度較高及女性之個案應考量憂鬱程度,轉介具有戒菸衛教師資格之心理師評估憂鬱程度,探討個案之心理問題,協助排除戒菸之障礙。
關鍵字:戒菸服務、戒菸行為意圖、尼古丁成癮、憂鬱
Purpose:This study explores the relationship between smoking cessation, level of nicotine dependence and depression.
Method:71 case subjects are individuals over 20 years of age from a hospital in Taipei. The study is investigated by using the Fagerstrom Test for Nicotine Dependence (FTND), 10 questions from Center for Epidemiological Studies Depression Scale (CES-D).
Result: 69% of the 71 participants never used the smoking cessation medication and believed that smoking can be quitted by solely relying on willingness,53.52% of them smoked before 18 years old. There was no significant correlation between smoking cessation intention and the degree of depression. The educational level was significantly positively correlated with smoking cessation intention.The age of smoking was negatively correlated with education level. There was a significant correlation between nicotine dependence, gender, marital status and depression. Marital status, first smoking age were negatively correlated with nicotine dependence. Smoke and history of disease was positively correlated with nicotine dependence.
Conclusion: The higher the education level is, the better the smoking quite motivation is. Married individuals , the first smoking age before 18 years old and history of disease have higher dependence of nicotine . Married individuals , females and higher dependent of nicotine have higher level of depression.
Suggest:The study recommended that hospitals and pharmacies should implement the smoking cessation services and smoking cessation outpatient referral, increase the use of smoking cessation and health education counseling to enhance smoking cessation intention and self-efficacy; We should promote no smoking families to reduce the chances of having teenage smokers. The more severe depression case subjects who are related to higher nicotine dependence are recommended to be transferred to psychiatric professionals to deal with the psychological problems and to help them overcome the obstacles.
Key words: Smoking cessation services, Smoking cessation intention, Nicotine dependence, Depression
中文文獻
王美惠、李維玲、賴宜萍(2015)。運用跨理論模式協助一位高學歷個案戒菸之照護經驗。護理雜誌,62(1),98-102。
王長偉(2012)。臺灣老年人憂鬱傾向之發展軌跡及影響因素:18年之長期追蹤研究。臺灣大學健康政策與管理研究所學位論文, 1-110。
行政院、經濟建設委員 (2012)。黃金十年 國家願景。行政院經濟建設委員會。
江宜珍、李蘭(2010)。社會網絡與社會支持。李蘭, 晏涵文, 陳富莉, 陸玓玲, 吳文琪, 江宜珍: 健康行為與健康教育。台北: 巨流圖書股份有限公司, 124-38。
行政院衛生署(2012)。臨床戒菸服務指引。新北市:行政院衛生署國民健康局。
李庚霖、區雅倫、陳淑惠、翁儷禎(2009)。”臺灣地區中老年身心社會生活狀況長期追蹤調查短版”CES-D 量表之心理計量特性。中華心理衛生學刊,22(4),383-410。
余民寧、劉育如、李仁豪(2008)。臺灣憂鬱症量表的實用決斷分數編製報告。教育研究與發展期刊,4(4),231-258。
余民寧、陳柏霖 (2010)。 健康促進與憂鬱之關係。高雄師大學報: 教育與社會科學類, 29, 73-99。
邱南英 (2012)。吸菸的行為和心理因素、戒菸的心理障礙。 血管醫學防治季刊,11, 2-3。
周易瑩、洪翠妹、楊翠媛、蘇淑芳、張珏、謝佳容(2012)。社區精神分裂症病患吸菸與戒菸失敗之主觀經驗。中華心理衛生學刊,25(4), 517-544。
孫筱婷、黃芷苓(2015)。中老年男性戒菸行為的相關因素。台灣醫學,19(5), 458-466.
曹國璽 (2011)。老人經濟壓力, 社會支持及憂鬱傾向之相關研究。國立臺北教育大學心理與諮商學系學位論文, 1-70.
張迪真,詹惠雅,姜遠萍(2010)。應用跨理論模式照護一位糖尿病患飲食之護理經驗。護理雜誌,57(2_S),87-92。
張智嵐、袁聖琇、黃美芳 (2008)。探討憂鬱症成因與症狀之性別差異。輔導季刊,44(1),33-42。
陳肇男、林惠玲(2015)。家庭、社會支持與老人心理福祉:二十世紀末的台灣經驗。中央研究院聯經出版社,185-190。
莊凱迪、蔡佳芬(2008)。老年人的憂鬱症。臺灣老誌,3, 182-90。
黃慧文、陳稚尹、黃芷苓(2011)。青少年的規律吸菸和吸菸依賴影響因素之探討。護理雜誌,58(1),28-36。
黃秋敏(2011)。探討慢性精神疾病患者戒菸方案之成效: 以跨理論模式為基礎。臺北醫學大學護理學系碩士暨碩士在職專班學位論文,1-218。
黃秀媚、李景美、陳政友、黃松元、苗迺芳、李淑卿 ... & 康杏如 (2011)。 高中職吸菸學生戒菸行為意圖及其影響因素之研究。學校衛生,(59), 27-58。
賈台寶、邱政元、林幸嫻、黃奕孝、洪瀚濰、洪敦益、余偉綸(2013)。應用跨理論模式探討職場戒菸協助的困難度。勞工安全衛生研究季刊,21(4),387–403。
賴志冠(2010)。戒菸的最新藥物治療。門診戒菸治療醫師訓練教育課程基本教材,臺北:行政院衛生福利部國民健康署。
劉嘉年(2009)。社會經濟狀況、一般健康狀態、健康行為與社區成年民眾憂鬱情緒的關係。臺灣公共衛生雜誌,28(4),300-311。
衛生福利部國民健康署(2015)。台灣菸害防制年報。行政院衛生福利部國民健康署。
簡武雄、丘亮、董道興、賴曉芳、楊美珠、徐翌爲…彭倩倩(2010)。台灣北部某區域教學醫院戒菸門診介入之成效評估。台灣家庭醫學雜誌,20(4),181-191。
蔡韻竹、蔡憶文(2015)。我國菸害防制政策制定的政治分析。臺灣公共衛生雜誌,34(5),447-462。
英文文獻
Abdullah, A. S. M., Ho, L. M., Kwan, Y. H., Cheung, W. L., McGhee, S. M., & Chan, W. H. (2006). Promoting smoking cessation among the elderly: what are the predictors of intention to quit and successful quitting? Journal of Aging and Health, 18(4), 552-564.
Albert, D. A., Severson, H. H., & Andrews, J. A. (2006). Tobacco use by adolescents: the role of the oral health professional in evidence-based cessation programs. Pediatric dentistry, 28(2), 177-187.
Chabrol, H., Niezborala, M., Chastan, E., & de Leon, J. (2005). Comparison of the Heavy Smoking Index and of the Fagerstrom Test for Nicotine Dependence in a sample of 749 cigarette smokers. Addictive behaviors, 30(7), 1474-1477.
Danesh, D., Paskett, E. D., & Ferketich, A. K. (2014). Peer Reviewed: Disparities in Receipt of Advice to Quit Smoking From Health Care Providers: 2010 National Health Interview Survey. Preventing chronic disease, 11.
Evins, A. E., Cather, C., Culhane, M. A., Birnbaum, A., Horowitz, J., Hsieh, E., ... & Goff, D. C. (2007). A 12-week double-blind, placebo-controlled study of bupropion sr added to high-dose dual nicotine replacement therapy for smoking cessation or reduction in schizophrenia. Journal of clinical psychopharmacology, 27(4), 380-386.
Husky, M. M., Mazure, C. M., Paliwal, P., & McKee, S. A. (2008). Gender differences in the comorbidity of smoking behavior and major depression. Drug and alcohol dependence, 93(1), 176-179.
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & FAGERSTROM, K. O. (1991). The Fagerström test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. Addiction, 86(9), 1119-1127.
Horst, W. D., Klein, M. W., Williams, D., & Werder, S. F. (2005). Extended use of nicotine replacement therapy to maintain smoking cessation in persons with schizophrenia. Neuropsychiatric disease and treatment, 1(4), 349.
Jacobsen, L. K., D'Souza, D. C., Mencl, W. E., Pugh, K. R., Skudlarski, P., & Krystal, J. H. (2004). Nicotine effects on brain function and functional connectivity in schizophrenia. Biological psychiatry, 55(8), 850-858.
Kandel, D. B., Griesler, P. C., & Hu, M. C. (2015). Intergenerational patterns of smoking and nicotine dependence among US adolescents. American journal of public health, 105(11), e63-e72.
Keltner, N. L., & Lillie, K. (2009). Nicotinic receptors: implications for psychiatric care. Perspectives in Psychiatric Care, 45(2), 151- 155.
Lin, Y. A., Tsai A. C. (2011). Predictors of smoking cessation among older male smokers in Taiwan.Taiwan J Public Health, 30, 36-44.
Miyauchi, M., Kishida, I., Suda, A., Shiraishi, Y., Fujibayashi, M., Taguri, M., ... & Hirayasu, Y. (2017). Long term effects of smoking cessation in hospitalized schizophrenia patients. BMC psychiatry, 17(1), 87.
Olivier, D., Lubman, D. I., & Fraser, R. (2007). Tobacco smoking within psychiatric inpatient settings: biopsychosocial perspective. Australian & New Zealand Journal of Psychiatry, 41(7), 572-580.
Pratt, L. A., & Brody, D. J. (2010). Depression and smoking in the US household population aged 20 and over, 2005-2008. NCHS data brief, (34), 1-8.
Powers, D. V., Thompson, L., Futterman, A., & Gallagher-Thompson, D. (2002). Depression in later life: Epidemiology, assessment, impact, and treatment. Handbook of depression, 560-580.
Prochaska, J. O.., & DiClemente, C. C (1983). Stages and processes of self-change of smoking: toward an integrative model of change. Journal of consulting and clinical Psychology, 51(3), 390-395.
Peng, Y. C., Yu, P. T., Fu, H. S., & Lyu, S. Y. (2009). Smoking behavior and perception of smoking cessation among elderly community residents of Shi-Hu township, Miaoli. Taipei City Medical Journal, 6(1), 23-34.
Perez-Rios, M., Santiago-Perez, M.I., Alonso, B., Malvar, A., Hervada, X., & de Leon, J.(2009). Fagerstrom test for nicotine dependence vs heavy smoking index in a general population survey. BMC public health, 9(1), 493.
Ramsay, P. P., Shortell, S. M., Casalino, L. P., Rodriguez, H. P., & Rittenhouse, D. R. (2016). A longitudinal study of medical practices’ treatment of patients who use tobacco. American journal of preventive medicine, 50(3), 328-335.
Radloff, L. S. (1977).The CES-D scale: A self-report depression scale for research in generalpopulation. Applied Psychological Measurement, 1, 385-401.
Robson, D., & Gray, R. (2005). Can we help people with schizophrenia stop smoking? Mental Health Practice, 9(4), 14-18.
Simon, R. W. (2002). Revisiting the relationships among gender, marital stress, and Ment al Health. American Journal of Sociology, 107(4), 1065-1096.
World Health Organization.(2003). WHO Framework Convention on Tobacco Control (WHO FCTC). Available at: http:// www.who.int/fctc/en/index.html.
World Health Organization, & Research for International Tobacco Control. (2008).WHO report on the global tobacco epidemic, 2008: the MPOWER package. World Health Organization.
World Health Organization.(2013). WHO report on the global tobacco epidemic, 2013:enforcing.bans on tobacco advertising, promotion and sponsorship. World Health Organization.
Ziedonis, D. M., & George, T. P. (1997). Schizophrenia and nicotine use: report of a pilot smoking cessation program and review of neurobiological and clinical issues. Schizophrenia Bulletin, 23(2), 247.