精神症狀、藥物使用對中、高齡的慢性思覺失調症病患其健康促進生活型態之影響

Influence of Psychiatric Symptoms and Use of Psychotropic Medications on the Health-Promoting Lifestyle of Chronic Schizophrenics during Middle and Old Ages

10.6847/TJPMHN.201812_13(2).02

謝佳容(Chia-Jung Hsieh)；苗迺芳(Nae-Fang Miao)；鍾佳芳(Chia-Fang Chung)；洪翠妹(Tsui-Mei Hung)

中 ； 高齡 ； 思覺失調症 ； 健康生活型態 ； 精神症狀 ； 藥物 ； middle and old ages ； schizophrenia ； health-promoting lifestyle ； psychiatric symptoms ； medication

精神衛生護理雜誌

13卷2期（2018 / 12 / 01）

5 - 18

繁體中文

背景：過去有關健康生活型態的研究，鮮少是以慢性思覺失調症病患為對象。目的：探討精神症狀、藥物治療對其健康促進生活型態的影響，同時也探討不同社會人口變項的中、高齡者思覺失調症患者在健康促進生活型態的差異，以及研究對象的體位量測、三高疾病與健康促進生活型態之關係。方法：為橫斷性研究設計，以北部某精神專科醫院四十歲（含）以上慢性思覺失調症患者為研究對象，採分層叢集隨機抽樣的原則，取樣共計210位，研究工具包括基本人口學變項、病史與精神科藥物與三高藥物的種類、健康行為、服用精神科藥物感受、精神症狀量表、體位量測和健康生活型態量表。以獨立樣本t檢定、變異數分析、皮爾森相關分析以及階層迴歸等方式進行統計分析。結果：本研究對象健康促進生活型態得分屬中等程度，但「運動」得分最低。負性精神症狀與健康促進生活型態呈負相關；自評藥物改善病情的感受情形、自評藥物副作用處置的滿意度與健康促進生活型態呈正相關。在控制相關變項後，影響健康促進生活型態的預測因素有負性症狀、具有規律運動習慣，共可解釋27%變異量。結論：本研究發現慢性思覺失調症患者建立健康促進生活型態的重要性，需為病患進行體重管理，改善肥胖，以降低心血管疾病的風險。

Background: Previous studies on healthy lifestyles have neglected patients with chronic schizophrenia. Objective: This study explored the influence of psychiatric symptoms and use of psychotropic medications on the health-promoting lifestyle (HPLS) of middle- and oldage patients with chronic schizophrenia. We alsoinvestigated the differences in HPLSs with different social demographic variables and determined the association of anthropometric measures, diabetes,hypertension, and dyslipidemia with the HPLS in these patients. Methods: Inthis cross-sectional study, a cluster stratified random sampling method was used. A total of 210 patients with chronic schizophrenia aged over 40 years were recruited from a psychiatric teaching hospital located in northern Taiwan. Parameters included the participants' basic demographic variables, medical history and medication types, the Psychiatric Symptoms Scale, health behaviors, medication perception, anthropometric measures, and the Health-Promotion Lifestyle Scale. The statistics were subjected to independent sample t-test, variance analysis, Pearson correlation analysis, and hierarchical regression analysis. Results: The participants' mean score indicated a moderate level of HPLS. Among the six subscales, the participants scored the highest in nutrition and the lowest in sports. A significant negative correlationbetween negative psychiatric symptoms andthe HPLS was observed. The participants'self-evaluation of their feelings of how psychotropic medications improved their health conditionand their self-evaluation of their satisfaction with the treatment of drug side effects were positively correlated with their HPLSs. After controlling for sex variables and health measurement variables, the predictors of an HPLS included negative symptoms and a regular exercise habit. The two predictors explained 27%of the variance. Conclusions: The study results indicate the importance of establishing an HPLS for patients with chronic schizophrenia during middle and old ages. Patients requireassistance with controlling their weight and reducing their obesity to reduce the risk of cardiovascular disease.

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