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[[alternative]]The Experiences During Labor and Birth in Expectant Fathers After Receiving Childbirth Education
No full text[[abstract]]背景：在過去的年代中，生產被視為「女人」事件，隨著時代的演變，生產是「家庭事件」。初產婦在準父親陪產生產支持下，產婦會有較正向的情緒反應，多數準父親願意參與陪伴待產經歷，但因缺乏信心且擔心準備不足。目前國內研究顯少有針對準父親接受生產教育課程的質性研究，故引發探討準父親接受生產教育課程陪伴配偶待產及生產期間的經驗及感受的動機。目的：本研究旨在探討曾接受生產教育課程的準父親陪伴配偶待產及生產之經驗。方法：本研究為質性研究之描述性現象學，採立意取樣，收案到5位時分析達資料飽和，已無新的主題出現，為確保研究的嚴謹度，再收2位，最後共7位受訪者，以確保資料的完整性；以半結構式的訪談指引進行一對一的深度訪談，資料分析乃採用Colaizzi現象學。結果：本研究發現7位曾接受12小時生產教育課程之準父親於陪伴配偶待產生產過程中之想法與感受，有四個經驗主題，分別為「努力承擔保護者的角色，以確保母胎安全」、「扮演支持者的角色，竭盡所能貢獻自己以協助完成生產任務」、「計畫與現實衝突下的妥協」、「參與生產教育課程的醒思與迴響」。結論/實務應用：本研究發現，這群準父親原本就有意願陪伴配偶一起經歷待產及生產過程，他們除了參加生產教育課學習到知識及技能後，返家後仍會不斷練習及獲得同儕群體的支持更具有信心，這群準父親是已經做好準備，嚴陣以待、且蓄勢待發，不但在配偶產程啟動後進入待產及生產期間仍持續關注配偶，且會應用所學技能盡心盡力地在照顧配偶，發揮了關鍵作用。支持角色從旁觀者變成全程陪伴的參與者，是有被賦予責任及實際發揮效能的神隊友，不僅有助於凝聚夫妻倆的感情，也間接提升父親們正向分娩的經驗。但本研究也發現，生產教育授課內容與實務執行時的衝突，包括醫護人員沒有聽過第二產程用力方式、生產姿勢的不同，及好像要剪會陰才能夠順利將嬰兒娩出，有可能是醫護人員對生產態度及價值信念非以家庭為中心，或是沒有接受實證知識更新，亦或是個人經驗論導致不採信。由此可見，以家庭為中心的生產教育課程的重要性，對家庭和國家社會的整體福祉產生深遠影響。[[abstract]]Background：In past decades, childbirth was regarded as a "women's" affair, but with the evolution of society, it has become a "family affair." When expectant fathers support their partners during childbirth, first-time mothers tend to have more positive emotional responses. While many expectant fathers are willing to participate in accompanying their partners through the childbirth experience, they often lack confidence and worry about being unprepared. Currently, there is a lack of qualitative research in the country regarding the childbirth education courses for expectant fathers. Therefore, there is a need to explore the motivations behind expectant fathers participating in childbirth education courses and how these courses impact their experiences and feelings during the period of accompanying their partners through childbirth.Purpose：This study aims to explore the experiences during labor and birth in expectant fathers after receiving childbirth education.Method：This qualitative study adopts a descriptive phenomenological approach, employing purposive sampling. Data saturation was achieved after interviewing 5 participants, where no new themes emerged. To ensure rigor, 2 additional participants were included, totaling 7 interviewees to ensure data completeness. Semi-structured interviews were conducted one-on-one using an interview guide, and data analysis followed the Colaizzi phenomenological methodResults：The study identified four thematic experiences among the 7 expectant fathers who underwent childbirth education and accompanied their spouses during childbirth; there were 1)"Striving to assume the role of protector to ensure the safety of mother and baby.", 2)"Taking on the role of supporter, making every effort to contribute and assist in completing the birthing process.", 3)"Compromising between plans and reality.", 4)"Reflecting on and responding to participation in childbirth education courses."Conclusion and application：This study found that these expectant fathers were initially willing to accompany their spouses through the childbirth process. After participating in childbirth education courses and gaining knowledge and skills, they continued to practice and received peer support at home, which increased their confidence. These fathers were well-prepared and actively engaged, not only remaining attentive to their spouses throughout the labor and delivery process but also applying their learned skills diligently to support them. They played a crucial role that transformed them from mere observers to active participants, fulfilling responsibilities and making significant contributions. This supportive role not only strengthened the bond between couples but also enhanced the fathers' positive experience of childbirth. However, the study also identified conflicts between the content taught in childbirth education and practical implementation. These included healthcare providers being unfamiliar with certain techniques, differences in birthing positions, and instances where episiotomies seemed necessary despite contradicting the principles taught. These discrepancies might stem from healthcare providers' attitudes not prioritizing family-centered care, lack of updated evidence-based knowledge, or reliance on personal experience over evidence. Therefore, the importance of family-centered childbirth education has profound impact on the well-being of families and society
[[alternative]]Effects of Pulmonary Rehabilitation Exercise on Psychological Distress, Self-Efficacy, and Quality of Life in Patients with Advanced Lung Cancer
No full text[[abstract]]肺癌為國內癌症十大死因之首，因早期症狀不明顯，一旦診斷多數病人已為晚期肺癌。由於晚期肺癌容易轉移至其他器官導致有許多症狀產生，因治療和疾病帶來的困擾，加上其存活率低，嚴重影響身心健康進而影響生活品質。本研究主旨乃探討晚期肺癌病人介入肺部復健運動對心理困擾，自我效能和生活品質之影響。採單盲，隨機對照試驗，於北部醫學中心的內科收案納入104位符合納入標準的晚期肺癌病人，並隨機分派至實驗組51人及控制組51人。主要研究成果包含心理困擾、自我效能及生活品質，以結構式問卷收集4個時間點，分別為介入前基準線，及介入運動後第4週、第6週、第8週。次要研究果乃測量六分鐘步行距離和上下肢體之最大肌力測試，於基準線和介入運動後第8週測量。統計方法以t-test、廣義估計方程式比較兩組之間的研究成果。本研究結果顯示，在介入措施第8週後，主要研究成果焦慮方面，實驗組比控制組有較低的焦慮程度且達統計顯著差異（β=-1.75, [95%CI -3.07至-.44]）；憂鬱方面，實驗組比控制組有較低的憂鬱程度，但未達統計顯著差異（β=-.91, [95%CI，-2.37至.54 ]）；自我效能方面，實驗組比控制組有較高的自我效能，但未達統計顯著差異（β=2.55, [95%CI -.42至5.52]）；生活品質方面，實驗組比控制組有較好的生活品質，未達統計顯著差異（β=5.46, [95%CI -2.89至13.81]）。次要研究成果上肢肌力及下肢肌力等變項兩組皆無顯著差異，而六分鐘步行距離在控制干擾變項後，實驗組比控制組之步行距離明顯進步且達統計顯著差異（β= 28.496, [95%CI 4.07至52.92]）。肺部復健運動介入可明顯改善晚期肺癌患者的焦慮及六分鐘步行距離，而隨著時間進展，其實驗組之心理困擾、自我效能和生活品質等變項可以維持水平，但控制組各變項則明顯呈現下降趨勢，顯示運動方案為病人帶來的好處，是安全可行的。建議將肺部復健運動整合至晚期肺癌患者護理照護指引中，並透過跨團隊合作，制定個別性運動方案，同時鼓勵家人參與，以增加病人遵從性。[[abstract]]Lung cancer is the leading cause of cancer-related deaths in the country, with most patients diagnosed at an advanced stage due to the absence of early symptoms. Advanced lung cancer often metastasizes to other organs, leading to various symptoms. The challenges brought by the disease and its treatment, coupled with a low survival rate, severely affect patients' physical and mental health, thereby impacting their quality of life. This study aimed to evaluate the effects of pulmonary rehabilitation exercise on psychological distress, self-efficacy, and quality of life in patients with advanced lung cancer.The study employed a single-blind, randomized controlled trial design and was conducted in the medicine department of a medical center in northern Taiwan. A total of 104 patients with advanced lung cancer who met the inclusion criteria were enrolled. Participants were randomly assigned to either the experimental group (n=51) or the control group (n=51). The primary outcomes of the study included psychological distress, self-efficacy, and quality of life, which were measured at four time points: baseline (pre-intervention), and at the 4th, 6th, and 8th weeks post-intervention. Secondary outcomes included the six-minute walk distance (6MWD) and maximal muscle strength of the upper and lower limbs, measured at baseline and at the 8th week post-intervention. Statistical methods such as t-tests and generalized estimating equations (GEE) were used to compare the outcomes between the two groups. The results showed that, at the 8th week post-intervention, the experimental group had significantly lower anxiety levels compared to the control group (β=-1.75, [95%CI -3.07 to -0.44]); however, the reduction in depression levels was not statistically significant (β=-0.91, [95%CI -2.37 to 0.54]). The experimental group also showed higher self-efficacy (β=2.55, [95%CI -0.42 to 5.52]) and better quality of life (β=5.46, [95%CI -2.89 to 13.81]) compared to the control group, although these differences were not statistically significant. Regarding secondary outcomes, there was no significant difference in upper and lower limb muscle strength between the two groups. However, after adjusting for confounding variables, the six-minute walk distance significantly improved in the experimental group compared to the control group (β=28.496, [95%CI 4.07 to 52.92]). In conclusion, pulmonary rehabilitation exercise can significantly reduce anxiety and improve the six-minute walk distance in patients with advanced lung cancer. Over time, the experimental group maintained stable levels of psychological distress, self-efficacy, and quality of life, while these variables showed a marked decline in the control group. This suggests that the exercise program is beneficial, safe, and feasible for patients. It is recommended that pulmonary rehabilitation exercise be integrated into the care guidelines for patients with advanced lung cancer. Additionally, collaborative efforts across multidisciplinary teams should focus on developing individualized exercise plans and encouraging family involvement to enhance patient adherence
[[alternative]]The associations between fear of cancer recurrence, spiritual well-being, and depression in Gynecological Cancer Survivors
No full text[[abstract]]研究目的：探討婦癌存活者的擔憂復發、靈性安適及憂鬱的相關性、憂鬱的重要預測因子，及瞭解靈性安適是否在擔憂癌症復發及憂鬱間扮演緩衝因子，期藉此研究結果能提供醫護人員針對婦癌存活者面對擔憂復發、靈性安適，憂鬱狀況，提供個別護理措施、處置指引與諮詢，提升婦癌存活者的整體照護品質。研究設計：以橫斷面相關性設計，採方便取樣，於北部某醫學中心婦產科門診收案， 111 位診斷為婦科癌症完成積極治療三個月後且無復發情形之婦癌婦女參與本研究。以結構式問卷收集，包括基本資料、擔憂癌症復發量表、靈性安適量表及貝克憂鬱量表，所收集之資料採用SPSS 20.0套裝軟體及PROCESS進行資料分析。研究結果：結果顯示婦癌存活者自覺健康狀況、睡眠品質與擔憂復發呈負相關；自覺健康狀況及家庭/同儕支持度與靈性安適呈正相關；自覺健康狀況、家庭支持度與憂鬱呈負相關；自覺經濟壓力、睡眠品質與靈性安適呈負相關，與憂鬱呈正相關；擔憂復發與靈性安適呈顯著負相關，與憂鬱呈顯著正相關；靈性安適與憂鬱呈顯著負相關；憂鬱的預測因子為自覺健康狀況、經濟壓力及靈性安適，解釋力共達38.9%；靈性安適為擔憂復發影響憂鬱的中介效果。結論與建議：靈性安適是婦癌存活者的重要資產，可作為應對壓力和適應不良的緩衝措施，減少因擔憂復發，所造成的憂鬱之情緒反應，對提升生活品質具正向效應。醫護人員應及時識別並透過心理諮詢、支持小組等方式減少患者擔憂復發之情緒；並藉由靈性關懷、心理支持、宗教信仰等方式，提升其靈性安適狀態，以減少憂鬱的發生；更應建立綜合的支持系統，包括家庭支持、社會支持和醫療服務，幫助婦癌存活者提高靈性安適，從而促進其心理健康及提升整體生活品質。[[abstract]]Objective: The study aims to explore the relationships between fear of cancer recurrence, spiritual well-being, and depression in gynecological cancer survivors. It also seeks to identify the key predictors of depression and examine whether spiritual well-being acts as a buffering factor between fear of cancer recurrence and depression. Expecting the findings of this research can provide healthcare professionals with guidance on offering individualized care, interventions, and counseling to gynecological cancer survivors who deal with concerns about recurrence, spiritual well-being, and depression, and enhance the overall quality of care for these survivors. Methods: This study employed a cross-sectional correlational design using convenience sampling. The samples consisted of 111 women diagnosed with gynecological cancer who completed their primary treatment at least three months later and had no recurrence, recruited from an obstetrics and gynecology outpatient clinic at a medical center in northern Taiwan. Data were collected using structured questionnaires, including basic demographic information, the Fear of Cancer Recurrence Inventory, the Spiritual Well-Being Scale, and the Beck Depression Inventory. The collected data were analyzed using SPSS 20.0 software package and the PROCESS. Results: Perceived health status and sleep quality were negatively correlated with fear of cancer recurrence. Perceived health status and family/peer support were positively correlated with spiritual well-being. Perceived health status and family support were negatively correlated with depression. Perceived economic stress and sleep quality were negatively correlated with spiritual well-being and positively correlated with depression. Fear of cancer recurrence was significantly negatively correlated with spiritual well-being and significantly positively correlated with depression. Spiritual well-being was significantly negatively correlated with depression. The predictors of depression were perceived health status, financial stress, and spiritual well-being, with a tatal explanatory power of 38.9%. Spiritual well-being mediated the effect of fear of cancer recurrence on depression.Conclusions and Recommendations: Spiritual well-being is a crucial asset for gynecological cancer survivors. It can be served as a buffer to cope with stress and maladaptation, reduce the emotional response of depression caused by fear of cancer recurrence and has a positive effect on improving the quality of life. Healthcare professionals should promptly identify and reduce patients' emotional concerns about recurrence through psychological counseling and support groups. Enhancing spiritual well-being to reduce the occurrence of depression through spiritual care, psychological support, religious faith, etc. Additionally, a comprehensive support system, including family support, social support, and medical services, should be established to enhance spiritual well-being and mental health, and improve overall quality of life and for gynecological cancer survivors
Development and Testing of the Hypertensive Nephropathy Self-Care Knowledge Scale
No full text[[abstract]]Background and Purpose: There is currently no scale to measure the self-care knowledge of patients with hypertensive nephropathy. This study aimed to develop the Hypertensive Nephropathy Self-Care Knowledge (HN-SCK) scale for these patients and to test its reliability and validity. Methods: A methodological study was conducted in two stages. In stage 1, the content of the HN-SCK scale was developed after reviewing the literature and based on Orem's Self-Care Model. In stage 2, data were collected from June 2021 to November 2021, and a convenience sample of 240 patients in the nephrology department of a hospital was recruited. Exploratory factor analysis was used to test the construct validity of the scale using principal component analysis with orthogonal rotation. The scale's reliability was tested using Cronbach's ? and Pearson's correlation coefficient. Results: The HN-SCK scale comprises 12 items. Three factors were extracted, namely, disease cognition, dietary management, and notes for daily life, with Cronbach's coefficients (?) of 0.72, 0.87, and 0.71, respectively. The total explained variance was 57.65%. Implications for Practice: The scale has excellent reliability and validity. It can preliminarily assess patients' self-care knowledge so that health care professionals can provide them with relevant knowledge in a timely manner and thereby improve their self-care level and assist them in coexisting with their disease status
Clinical stage-specific prognostic impact of adequate lymphadenectomy in early-stage lung cancer
No full text[[abstract]]Objectives: To assess the prognostic impact of adequate lymphadenectomy and determine the optimal nodal assessment for different clinical stages of lung cancer.
Methods: We retrospectively reviewed 1214 patients with clinical stage I-III non-small cell lung cancer who had preoperative positron emission tomography/computed tomography and curative surgery (2006-2017). Patients were categorized based on whether they had adequate (R0) or inadequate lymphadenectomy [R(un)]. Propensity score matching was conducted to minimize bias. Primary end points were recurrence-free survival (RFS), overall survival (OS), and cancer-specific survival. Secondary end points included outcomes stratified by clinical stages.
Results: Multivariate Cox analysis identified preoperative carcinoembryonic antigen level, tumour size, uptake of tumour on positron emission tomography/computed tomography, R(un) [hazard ratio (HR) = 2.16; P < 0.001), angiolymphatic invasion, lymph node involvement and postoperative adjuvant therapy as independent predictors of RFS. The matched cohort included 440 R0 and 440 R(un) patients, with a median follow-up of 94 months. Significant differences were found in 10-year RFS (77.2% vs 61.3%, P < 0.001), OS (75.8% vs 64.3%, P < 0.001) and cancer-specific survival (83.8% vs 74.2%, P < 0.001). Despite longer operative time for R0 (210 vs 195 min, P = 0.008), perioperative complications, hospital stay length and blood loss were similar. Subgroup analysis showed R(un) as an independent predictor of RFS in clinical stages IA3 (HR = 2.53, P = 0.001), IB (HR = 1.71, P = 0.046), and II (HR = 2.44, P < 0.001), but not in IA1 or IA2. R0 had significantly better RFS than R(un) in matched cohort of stages IA3 (P = 0.003), IB (P = 0.001) and II (P = 0.001).
Conclusions: Adequate lymph node assessment improves prognosis in patients with clinical stages ? IA3. A uniform nodal assessment approach should be reconsidered for different clinical stages
The Mediating Role of Psychological Well-Being in the Relationship Between Self-Management and Quality of Life in Patients With Hypertension
No full text[[abstract]]This study applied a cross-sectional design to examine the relationship between self-management, psychological well-being, and quality of life in patients with hypertension and evaluated the mediation effect of psychological well-being on self-management and quality of life. Through purposive sampling, this study enrolled 255 patients with hypertension from the cardiology department of a teaching hospital in Taiwan. Mediation effects were estimated using linear regression and the Sobel test. Age, number of chronic diseases, waist circumference, self-management, and psychological well-being explained 18.7% of the total variance in quality of life. Psychological well-being partially mediated the effects of self-management on quality of life, with a total effect of 19.2%. Psychological well-being is an important factor correlated with self-management and quality of life in patients with hypertension
[[alternative]]A study on Meaning of Life and the Attitude Toward death of the elderly in the Community Long Term Care Stations.
No full text[[abstract]]研究背景：近年來隨著高齡化社會的來臨，有關老人問題的相關期刊論文研究也漸漸的出現，顯示有許多人正關心著老年期的心理歷程。據此，本研究期待整理出參與據點活動的社區高齡者之生命意義感與死亡態度之間的關係，幫助我們更多的了解長輩內在的需求，以及調整及因應更符合高齡者需求的助人工作之方向，以利更好的陪伴高齡者們，感受著內心的平安，走完人生旅程。研究目的：了解參與社區活動之不同人口學背景高齡者的生命意義感、了解參與社區活動之不同人口學背景高齡者的死亡態度、探討參與社區活動之高齡者的生命意義感與死亡態度之間的關係。研究方法：本研究以新北市社區據點之65歲以上之社區老人為研究對象，採問卷調查法，問卷發放173人，回收有效問卷146人。研究結果：在生命意義感中「自覺健康狀況」為「很好」的高齡者、與子女同住的高齡者、參加據點活動超過兩年的高齡者，生命意義感較高。在死亡態度方面，獨居的高齡者較有同住者的高齡者更逃避思考與死亡有關的課題。尋求意義可以視為對死亡恐懼有反向的預測力。研究結論：參與社區據點活動的高齡者，參與的時間越長，其生命意義感較高，對死亡的恐懼較低，從研究者的觀察，對於參與社區據點活動高齡者來說，這是一項重要的社會參與，對老年生活產生意義。[[abstract]]Background: In recent years, more journal articles and studies related to elderly issues have emerged, indicating growing concern about the psychological processes of older adults. This study aims to explore the relationship between the sense of meaning in life and attitudes towards death among elderly individuals who participate in community activities. The goal is to better understand the inner needs of the elderly and to adjust and align support services to better meet their needs, ultimately helping to provide more meaningful companionship and inner peace as they journey through the later stages of life.Objectives: To understand the sense of meaning in life among elderly individuals with different demographic backgrounds who participate in community activities; to understand their attitudes towards death; and to explore the relationship between their sense of meaning in life and their attitudes towards death.Methods: This study targets community-dwelling elderly individuals aged 65 and above in community centers in New Taipei City. A survey method was employed, with 173 questionnaires distributed and 146 valid responses collected.Results: Regarding the sense of meaning in life, elderly individuals who perceive their health status as "very good," live with their children, or have been participating in community activities for more than two years tend to have a higher sense of meaning in life. In terms of attitudes towards death, elderly individuals who live alone are more likely to avoid thinking about death-related issues compared to those who live with others. The search for meaning can be seen as a predictor of lower fear of death.Conclusion: Among elderly individuals who participate in community activities, those who have been involved for a longer period tend to have a higher sense of meaning in life and a lower fear of death. Based on the observations of the researchers, participation in community activities is an important form of social engagement for the elderly, contributing to a meaningful elderly life
[[alternative]]The Study of Travel Motivation, Wellbeing and Risk Perception toward Travel Intention－The Case of Non-group Family Travel
No full text[[abstract]]隨著民眾生活方式改變，自助旅遊與半自助旅遊(也稱為非團體式旅遊)就變得非常重要。甚者，現代人越來越在乎旅行中心理層面的感受，尤其是與家人一同旅遊時，家中成員旅遊的心理狀態將會反映出幸福程度，而幸福程度可能又回饋到旅遊上；除此之外，旅遊風險也是家庭旅遊的變數之一，在選擇旅遊時，感受到的風險較少，家庭旅遊的意圖也會受到影響。因此本研究主要探討兩大部分：(1)在疫情的情況下，家庭成員在選擇非團體旅遊下的旅遊意圖以及動機(2)在非團體旅遊的條件下，旅遊動機、幸福感以及風險知覺是否會影響家庭的旅遊意圖。本研究之研究對象以近期有旅遊計畫的核心家庭成員，問卷採用網路問卷調查方式，問卷預計收集450份，調查期間為111年3月至5月，收案樣本數341份，有效樣本數275份。研究方法運用SPSS 25 for Windows軟體進行敘述性統計(Descriptive Statistics) 、t檢定、ANOVA及多元線性迴歸分析(Multiple regression analysis)了解不同人口學變項。研究結果顯示在非團體式家庭旅遊的條件下，多元線性迴歸分析所有變項的標準化係數(Beta)中旅遊動機解釋力最為明顯，影響也最為顯著，幸福感僅次於動機，風險知覺則是最後，因此可以得出在疫情時代的非團體式家庭旅遊中旅遊動機是會影響國人的旅遊意圖。也建議如有學者研究相關議題時可朝幸福感及風險知覺研究。[[abstract]]As people's lifestyles have been forced to change, self-guided tour and Semi-FIT have become more important. Even people recently pay more attention on their psychological experiences in their trip, especially family trip. In their family trip, their mental state can feedback on their happiness, and the intention of traveling might be affected by their happiness. When it comes to planning a family trip, the risk of traveling is also a variable people consider about, and lower risk or danger also affect the motivation of traveling. This study mainly focuses on two discussions:(1) The motivation of independent travel for family members (2) Will it affect the motivation of traveling when choosing an independent travel, safety of trip and happiness.This research focus on family members who have the motivation of traveling. The survey was conducted by online questionnaires. 450 questionnaires were expected to be distributed between March 2022 to May 2022. A total of 341 valid samples were collected, with 275 being eligible for analysis. SPSS 20 for Windows was used for data analysis, including descriptive statistics, t-tests, ANOVA, and multiple linear regression analysis to analyze different demographic variables.The results show that under the conditions of non-group family travel, travel motivation’s standard coefficient (Beta) of all variable of multiple regression analysis have strongest explanatory power, happiness’s explanatory power is lower than travel motivation and risk perception is the last. Therefore, we can conclude that non-group families in the duration of Covid-19 will affect people’s intention to travel, we also recommend that scholars study related topics in the direction of happiness and risk perceptio
[[alternative]]Investigation of construct validity in the Geriatric Depression Scale
No full text[[abstract]]背景與目的：憂鬱是老年人口常見的心理疾病，根據衛福部111年老年人死因統計結果顯示，每十萬人口中有28.4位的老年人死因為自殺，其中又以70%為憂鬱症患者，顯示自殺與憂鬱症有高度關聯，可見老年憂鬱症除了影響生活機能，嚴重者還可能導致生命危險。透過良好的評估工具量表來評估老人憂鬱的程度，以正確判斷老人憂鬱情形。過去已驗證再測信度 (test-retest reliability)、內部一致性 (internal consistency)、區辨效度 (discriminative validity)。尚未有研究建構效度，因此本研究目的是老人憂鬱量表 (Geriatric Depression Scale, GDS)驗證於老人的建構效度 (construct validity)，包括收斂效度 (convergent validity)，以確認量表之臨床應用價值，提供臨床專業人員在面對老人憂鬱或研究相關議題時，可使用本研究驗證過之老人憂鬱量表，迅速且正確判斷老人憂鬱情形。研究方法：本研究收案200位65歲以上意識清楚的養護機構老人，並填寫3種憂鬱量表分別為： GDS完整版、貝克憂鬱量表第二版 (Beck Depression Inventory-Second Edition, BDI-II)、流行病學研究中心之憂鬱量表 (Center for Epidemiological Studies Depression Scale, CES-D)。使用羅序分析 (Rasch analysis)，檢驗GDS之單向度建構 (unidimensionality)，且GDS完整版及各短版，與BDI-II和CES-D之相關性，以確定GDS之收斂效度。研究結果：本研究採用羅序分析兩個合適度統計值：近合適度 (infit mean square) 和遠合適度 (outfit mean square)，檢驗GDS題目是否符合單向度建構，不符合判定標準之題目，則刪除。本研究顯示30題GDS數據中11題、16題、19題、22題、27題、29題，共6題不符合判定標準之題目，刪題後，繼續執行羅序分析，此24題符合單向度建構合適度統計值之標準0.5~1.5之間。而本研究顯示GDS 30題完整版、24題刪減版與各短版15題、10題、5題、4題與BDI-II及CES-D之收斂效度呈現中度相關 (r = 0.41~0.62)。結論：根據本研究羅序分析之比較結果，GDS完整版量表刪題後24題量表符合單向度建構，此24題分數加總能代表老年人心理狀態。建議長期照護相關專業人員使用24題之GDS，以明確地評估老年人之憂鬱狀況。 [[abstract]]Background and purpose: Depression is a common mental illness among the elderly population. According to statistics on the causes of death among the elderly from the Ministry of Health and Welfare in 2022, out of every 100,000 people, 28.4 elderly people died from suicide, and 70% of them were patients with depression, showing that suicide and depression are highly correlated. It seems that depression not only impacts life function, but can also be life-threatening for elderly people. Therefore, it is important to evaluate the degree of depression in elderly people through a good assessment tool. Some previous researches have verified the test-retest reliability, internal consistency and discriminative validity of the Geriatric Depression Scale (GDS) but there is no research on the construct validity. The purpose of this study was to verify the construct validity of the GDS in the elderly, and certify the value of the GDS in clinical application. This research provides clinical professionals with a validated depression scale to quickly and accurately determine the degree of depression in elderly people or for conducting research on related issues. Methods: This study enrolled 200 institutionalized elderly people over 65 years old and they each filled out three depression scales: the full version of the GDS, the Beck Depression Inventory-Second Edition (BDI-II), and the Center for Epidemiological Studies Depression Scale (CES-D). Rasch analysis was used to test the unidimensionality of the full version and each short-forms of the GDS, and to verify the convergent validity estimating correlations among the GDS, BDI-II, and CES-D.Results: The study used two goodness of fit statistics from Rasch analysis: infit mean square and outfit mean square. The two methods were used to test whether each aspect of an item corresponded to the one-way construct and if the item did not meet the criteria, then it was deleted. This study showed 6 items in total, item 11 ,16 ,19 ,22, 27 and 29, did not correspond to the one way construct out of the 30 items of the GDS. After deleting the items, Rasch analysis was conducted again, showing that 24 items in total corresponded to the one way construct ranging between 0.5~1.5. This study demonstrates the complete 30-item GDS, the reduced 24-item version, and the shorter versions of 15, 10, 5, and 4 items had moderate correlations (r = 0.41~0.62) with the BDI-II and CES-D, showing moderate correlations.Conclusion: According to the comparative results from Rasch analysis, the 24-item version of the GDS met the criteria for a one-way construct scale. The total score can represent the psychological status of elderly individuals. The 24-item GDS is recommended for clinical and institutional or community professionals, as it can provide a accurate analysis and evaluation of the elderly's depression status
[[alternative]]The correlation between the workload and labor health inspections of foreign migrant workers in Taiwan
No full text[[abstract]]目的：本研究目的在探討外籍移工過勞狀況對健康檢查各個生理指標間的相關性，並藉由過勞量表的資料分析個人過勞及工作過勞變項間的關係。方法：研究對象為20-50歳之在職外籍移工，共計120名。生理指標採用勞工健康檢查項目、勞動部研發之過勞量表問卷週查。統計以各變項之描述性分析後，使用成對樣本t檢定比較個人疲勞與工作疲勞差異，再進行皮爾森積差相關分析，最後以逐步迴歸分析過勞量表(個人過勞、工作過勞)對各個生理指標間的影響。並設定α=.05為顯著水準，進行統計考驗。結果：外籍移工120名，所有研究對象皆為男性，年齡介於24-47歲，平均為32.3歲。個人疲勞得分介於0-54分，平均得分為22.3分，屬於低負荷程度的疲勞、工作疲勞分數介於0-64分，平均得分為17.8分，亦屬於低負荷程度的疲勞。成對樣本t檢定結果顯示個人疲勞顯著高於工作疲勞。皮爾森積差相關分析發現個人疲勞跟工作疲勞為高度相關，在生理指標統計結果，個人疲勞與BMI、血紅素都達到低度相關。最後將個人疲勞及工作疲勞分別進行逐步迴歸分析，結果最顯著影響個人疲勞的是工作疲勞、BMI及血紅素，在工作疲勞方面，主要的影響因素則有個人疲勞及BMI。結論：根據過勞量表結果發現製造業外籍移工主要過勞原因來自個人疲勞，個人疲勞上升會使工作疲勞也上升，兩者呈現中度相關。個人疲勞與血紅素呈現正相關、與BMI為負相關，另外，工作疲勞BMI呈現正相關；這些生理指標皆與飲食、營養相關，建議企業藉由幫助員工適應異鄉環境、飲食習慣、飲食控制，藉由改善BMI及血紅素來降低員工過勞情形。[[abstract]]Objective: This study aims to investigate the correlation between overwork conditions and various physiological indicators in health check-ups among foreign workers, and to analyze the relationship between personal and work-related overwork variables using data from the Overwork Questionnaire. Methods: The study subjects were 120 employed foreign workers aged 20-50. The physiological indicators were obtained from labor health check-up items and the Overwork Questionnaire developed by the Ministry of Labor. Descriptive analysis was initially conducted on each variable, followed by paired sample t-tests to compare differences between personal fatigue and work-related fatigue. Pearson correlation analysis was then performed, and stepwise regression analysis was used to assess the impact of personal and work-related overwork on various physiological indicators. The significance level was set at α = .05. Results: The 120 male foreign workers had an age range of 24-47 years, with an average age of 32.3 years. Personal fatigue scores ranged from 0 to 54, with an average score of 22.3, indicating a low level of fatigue. Work-related fatigue scores ranged from 0 to 64, with an average score of 17.8, also indicating a low level of fatigue. Paired sample t-tests showed that personal fatigue was significantly higher than work-related fatigue. Pearson correlation analysis revealed a high correlation between personal fatigue and work-related fatigue. In terms of physiological indicators, personal fatigue was mildly correlated with BMI and hemoglobin. Stepwise regression analysis indicated that the most significant factors affecting personal fatigue were work-related fatigue, BMI, and hemoglobin. The main factors influencing work-related fatigue were personal fatigue and BMI. Conclusion: According to the Overwork Questionnaire results, the primary cause of overwork among foreign workers in the manufacturing industry is personal fatigue, which is significantly influenced by work-related fatigue, BMI, and hemoglobin. Work-related fatigue is influenced by personal fatigue and BMI. It is recommended that companies help employees adapt to the new environment, learn the local language, and control their diet to improve BMI and hemoglobin, thereby reducing overwork conditions