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系統識別號 U0026-0902201813584300
論文名稱(中文) 印尼偏遠社區之停經婦女睡眠品質及其相關因素探討
論文名稱(英文) Quality of Sleep and Related Factors among Post Menopausal Women in Indonesian Rural Communities
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 106
學期 1
出版年 107
研究生(中文) 潘艾妲
研究生(英文) Ida Ayu Ningrat Pangruating Diyu
學號 T26057022
學位類別 碩士
語文別 英文
論文頁數 114頁
口試委員 指導教授-王琪珍
口試委員-許玉雲
口試委員-王新台
中文關鍵字 none 
英文關鍵字 quality of sleep  postmenopausal women  menopausal symptoms  rural 
學科別分類
中文摘要 背景:睡眠品質不好是更年期後婦女的一個重大問題,降低了他們的生活品質。中低收入國家農村更年期後婦女的睡眠品質的文獻資料相當缺乏。
目的:探討印尼農村更年期後婦女睡眠品質不好的相關因素。
方法:在印尼農村進行了一項橫斷面研究,招募了392名45-64歲的更年期後婦女。採用“生殖老化階段”(STRAW + 10)篩檢標準,以確定誰是更年期後患者,“貝克抑鬱量表”(BDI-II)評估並去除嚴重抑鬱症患者。調查問卷包含社會人口,健康相關習慣和健康狀況的一般問卷。以匹茲堡睡眠品質指數(PSQI)評估睡眠品質,用更年期評分量表(MRS)測量更年期症狀。統計分析以多因子Logistic回歸分析睡眠品質差(PSQI> 5)和預測變量之間的關係。以未調整和調整的優勢比(OR)和相關的95%置信區間(CI)表示睡眠品質的相關情形。
結果:印尼偏遠地區更年期後婦女睡眠品質不好的盛行率高達52.8%,而更年期後婦女平均年齡為56.2(SD = 5.4)歲。具有以下特徵的印尼更年期後婦女發生較差的睡眠品質的危險因子包括較高嚴重程度的軀體症狀為1.25(95%CI = 1.06-1.48,p = 0.010),心理症狀的嚴重程度較高為1.16(96%CI 1.01-1.34,p = 0.041)和泌尿生殖系統症狀為1.25(95%CI為1.06-1.48,p = 0.000)。此外,異常體重指數(OR = 2.09,95%CI = 1.30-3.37,P = 0.002)和沒有運動(OR = 1.67,95%CI = 1.03-2.70,P = 0.038)之印尼農村更年期後婦女睡眠品質不好的風險較高。
結論:印尼農村更年期後婦女睡眠品質不好的盛行率高,需要進行教育,以確定更年期症狀警報信號的早期預警徵兆,並設計適當的治療措施,以促進其運動習慣,提高認識維持健康的體重指數來改善高風險人群的睡眠品質
英文摘要 Background: The effects of menopausal symptoms on sleep quality among postmenopausal women have been widely studied in developed countries, whereas there is a dearth of literature exploring the effects in rural areas of low-middle income areas.
Objective: A descriptive study investigated the prevalence and the correlates of poor sleep quality among postmenopausal women in rural Indonesia. In addition, ranking predictors among the sets of somatic, psychological and urogenital symptoms was undertaken.
Method: “The Stages of Reproductive Ageing Workshop” (STRAW +10) was used to screen for postmenopausal status and “Beck Depression Inventory (BDI-II) was used to assess depressive status. A total of 392 postmenopausal women with aged 45-64 years and free of severe depressive symptoms were recruited from rural Indonesia villages. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality with scores more than 5 deemed as poor sleep quality and Menopause Rating Scale (MRS) was used to assess degree of severity for menopausal symptoms. Multiple logistic regression for analyzing the relationship between poor sleep quality and predictor variables were performed.
Results: The mean age was 56.2 (SD=5.4) years for the Indonesian postmenopausal women living in rural areas. A high prevalence of poor sleep quality, 52.8%, was observed. The women who had higher severity of somatic symptoms (odds ratio [OR] 1.25, 95% confident interval [CI] 1.06-1.48; p=0.010), psychological symptoms (OR 1.16; 95% CI 1.01-1.34; p=0.041) and urogenital symptoms (OR 1.25; 95% CI 1.06-1.48; p<0.001) had higher risks to develop poor sleep quality. So did abnormal BMI (OR 2.09; 95% CI 1.30-3.37; p=0.002) and no exercise (OR 1.67; 95% CI 1.03-2.70; p=0.038). A further analysis shows that hot flashes/sweating, anxiety, and sexual problems were most strongly associated with poor sleep quality.
Conclusions: The high prevalence of poor sleep quality among postmenopausal women in rural Indonesia calls for education and management of menopausal symptoms. Lifestyle intervention programs to promote exercise habit and to maintain healthy body mass index were needed.
論文目次 CHINESE ABSTRACT ……………………………………………………….... I
ABSTRACT……………………………………………………........................... III
ACKNOWLEDGEMENTS …………………………………………………….. V
TABLE OF CONTENTS………………………………………………………... VI
LIST OF TABLES……………………………………………………………..... IX
LIST OF FIGURE ……………………………………………………………… X
CHAPTER ONE INTRODUCTION……………………………………………. 1
1.1 Research Background……………………………………………...... 1
1.2 Research Purpose…………………………………………………..... 3
CHAPTER TWO LITERATURE REVIEW…………………………………..... 5
2.1 Postmenopausal women…………………………………………....... 5
2.2 Sleep Quality………………………………………………………… 7
2.3 Factors Associated with Sleep Quality in Postmenopausal Women……………………………………………………………...... 14
2.4 Sleep in Rural Area………………………………………………….. 52
CHAPTER THREE RESEARCH DESIGN AND METHODELOGY………… 54
3.1 Study Design and Sample………………………………………….... 54
3.2 Research Framework and Study Variable………………………….... 55
3.3 Measurement and Instrument……………………………………....... 56
3.4 Research Procedure ………………………………………………..... 59
3.5 Statistical Analysis………………………………………………....... 59
CHAPTER FOUR RESULT…………………………………………………..... 61
4.1 Sample Characteristics ……………………………………………..... 61
4.2 Menopausal Symptom ……………………………………………...... 61
4.3 Factors Associated with Poor Sleep Quality ……………………….... 61
CHAPTER 5 DISSCUSION ………………………………………………......... 67
5.1 Discussion…………………………………………………………..... 67
5.2 Limitation…………………………………………………………..... 72
5.3 Conclusion and Recommendation ………………………………....... 72
REFERENCES………………………………………………………………...... 74
APPENDICES…………………………………………………………………... 83
Appendix A: Permission to Use Menopause Rating Scale ……………... 83
Appendix B: Permission to Use Pittsburgh Sleep Quality Index ……….. 84
Appendix C: Permission to Use Beck Depression Inventory II………..... 85
Appendix D: IRB Approval …………………………………………...... 86
Appendix E: Research Permission Letter ………………………………. 87
Appendix F: Informed Consent (English)……………………………….. 88
Appendix G: Informed Consent (Indonesia)…………………………….. 90
Appendix H: Research Questionnaire (Demographic-characteristics, Life Habits and Health History (English)…………………. 92
Appendix I: Research Questionnaire (Demographic-characteristics, Life Habits and Health History (Indonesia)……………………. 95
Appendix J: Research Questionnaire Menopause Rating Scale (English)………………………………………………….... 98
Appendix K: Research Questionnaire Menopause Rating Scale (Indonesia)……………………………………………….... 99
Appendix L: MRS: Domains, Factors, Items, Code number and Scoring…………………………………………………….. 100
Appendix M: Research Questionnaire Pittsburg Sleep Quality Index (English)…………………………………………………… 102
Appendix N: Research Questionnaire Pittsburg Sleep Quality Index (Indonesia)………………………………………………… 105
Appendix O: Form Administration, Instructions, References and Scoring PSQI……………………………………………… 109
Appendix P: Variables and Statistical Method………………………….. 111
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