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系統識別號 U0026-2308201210092700
論文名稱(中文) 台灣地區氣候條件對自殺之影響(1994年至2008年)
論文名稱(英文) Relationship between suicide and weather variations in Taiwan (1994 – 2008)
校院名稱 成功大學
系所名稱(中) 環境醫學研究所
系所名稱(英) Institute of Environmental and Occupational Health
學年度 100
學期 2
出版年 101
研究生(中文) 葉思妤
研究生(英文) Szu-Yu Yeh
學號 s76991047
學位類別 碩士
語文別 中文
論文頁數 67頁
口試委員 指導教授-蘇慧貞
口試委員-郭炤裕
口試委員-呂宗學
中文關鍵字 天氣  氣候變遷  自殺  羅吉斯迴歸  統合分析 
英文關鍵字 weather  climate change  suicide  logistic regression  meta-analysis 
學科別分類
中文摘要 科學證據指出全球氣候變遷已造成地區生態、環境系統之衝擊,並連帶影響心理健康,甚至導致自殺。然而,過去在氣候條件變化對於自殺的評估中,多數研究集中於溫帶地區,且無論在時間或空間的解析度上皆較廣泛。故本研究目的,即是以臺灣地區每日氣候監測與健康資料為例,探討同時具備熱帶及副熱帶氣候特性之臺灣,氣候變化對自殺的衝擊。
研究收集臺灣地區18縣市1994年至2008年,中央氣象局10項氣候條件與衛生署死因登記資料庫之自殺登記(ICD-9: 950–959及; ICD-10: X61–84 and Y870)資料,並依據性別(男、女)、年齡(0–18歲、19–64歲及65歲以上)及就業狀態(就職、未就職)分層,並且用以進行後續統計分析。研究將每日自殺登記,轉換為該日是否發生自殺,利用羅吉斯回歸,在校正季節與星期幾等時間干擾下,以評估氣候條件對自殺的影響。另加以利用統合分析,將18縣市整合為北、中、南、東及離島五區,以整合分析成果。
結果發現溫度相關變項(最高溫度、平均溫度及最低溫度)與紫外線指數對臺灣地區每日是否發生自殺之勝算比有顯著的影響,尤其以南部(OR=1.032–1.055, 95% CI: 1.015–1.085)與中部(OR=1.014–1.029, 95% CI: 1.002–1.043)影響最為顯著。而溫度對男性(OR=1.022–1.031, 95% CI: 1.003–1.040)較女性(OR=1.016–1.025, 95% CI: 1.001–1.029)影響自殺更為顯著。此外,研究亦發現溫度相關變項對於自殺的衝擊,對65歲以上族群與未就職者較64歲以下與有就職者更為劇烈。
研究利用長時間與全國性的資料,驗證後發現溫度相關變項對每日自殺的發生與否有顯著影響。然而,臺灣原本即處於高溫的熱帶及副熱帶地區,若在氣候持續暖化的情況下,自殺的發生與否,將可能因溫度的上升而增加其發生機率,故未來在心理健康預防及相關的調適策略的制訂上,皆建議納入季節性考量或是需注意溫度變化的衝擊。
英文摘要 Previous studies have been demonstrated that global warming would alter the regional climatic patterns, which would be related with mental health. However, only a limited number of studies used daily data to present the relationship in temperate region, and less in sub-tropical and tropical region. The study aimed to use Taiwan’s database to examine the association between weather variations and suicide in both of subtropical and tropical region.
Database integrated 10 daily weather factors from Taiwan CWB, such as precipitation, temperature and hours of sunshine; suicide death case of cause-of-death registry (ICD-9: 950–959; ICD-10: X61–84 and Y870) of 18 cities from the Department of Health for the period between 1994 and 2008. The study groups were categorized by gender (F/M), age (0–18, 19–64 and older than 65) and employment state (employed and unemployed). Logistic Regression and Meta-analysis was used to assess the relationships and merge the estimators between 10 weather factors and suicide.
The results indicated that there were significantly relationships between temperature-related factors (daily maximum, mean and minimum temperature), UV-index and suicide in Taiwan, especially in southern area (OR=1.032–1.055, 95% CI: 1.015–1.085) and central area (OR=1.014–1.029, 95% CI: 1.002–1.043). The significant association between temperature-related factors and suicide were more clearly in male (OR=1.022–1.031, 95% CI: 1.003–1.040) than female (OR=1.016–1.025, 95% CI: 1.001–1.029). Furthermore, the elderly and unemployment people were more sensitive to temperature than young and employment.
Our findings indicated temperature-related factors were observably associated with suicide in Taiwan. The results may supply the helpful information for the health prevention, intervention and policy to strengthen the adaptation of mental health under changing climate in Taiwan.
論文目次 摘 要 ii
Abstract iii
致 謝 iv
目錄 v
表目錄 vii
圖目錄 viii
第一章、緒論 1
第一節、研究背景 1
第二節、研究動機與目的 3
第二章、文獻回顧 5
第一節、國內外氣候變遷概況 5
第二節、氣候變遷與生理及心理健康 6
第三節、氣候條件與自殺 7
第四節、氣候條件與自殺之生理機制 9
第三章、材料與方法 10
第一節、研究資料 10
氣候條件資料 10
自殺死亡資料 10
第二節、資料分析 11
相關性檢定 (Correlation coefficient) 11
羅吉斯迴歸 (Logistic regression) 12
統合分析 (Meta-analysis) 12
地理資訊系統(Geographic Information System, GIS)應用 13
第四章、研究結果 14
第一節、描述性統計與相關性分析 14
氣候條件描述 14
第二節、統計分析 15
相關係數檢定結果 15
羅吉斯迴歸分析 15
統合分析成果 16
溫度相關變數閾值分析 19
地理資訊系統彙整成果 19
第五章、結論與討論 21
第一節、研究結論 21
第二節、討論 22
第三節、研究限制 24
參考文獻 63
附錄、氣候條件詳細說明 67
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