| 摘要: | 背景：過去調查鼻及鼻竇炎患者使用傳統西醫治療或輔助療法以治療其鼻炎症狀的研究不多，導致對鼻及鼻竇炎患者之醫療利用的知識較缺乏。所以，本研究目的為探討影響台灣鼻及鼻竇炎患者使用輔助醫療之因子。 研究設計：橫斷式問卷調查。 研究對象及方法：以中台灣某醫學中心耳鼻喉科門診病人，經醫師診斷為鼻及鼻竇炎的患者為對象。診斷方法是以鼻內視檢查及患者自述其症狀至少持續2週以上為主。17歲以下的患者或罹患鼻癌的病人排除在本研究之外。問卷訪談內容包括：患者基本社會人口學資料、生活型態、自覺健康狀態、疾病及生活品質、鼻及鼻竇炎症狀評估量表以及過去使用醫療情形等。資料分析包括以描述性統計、單因子變異數及多因子線性複迴歸分析影響鼻及鼻竇炎患者量表得分及使用輔助醫療種類的相關因子。 結果：本研究於2011年7月至2011年9月期間共完成有效本樣283份，有效問卷回收率為98.3% 受訪對象41.3%為女性，58.7%為男性。平均年齡為48.2歲。平均量表得分±標準差為175.7±104.9。多因子線性複迴歸分析結果顯示量表總得分較高者為女性(P=0.017)、31-40歲(P=0.007)、自覺健康狀況不好(P<0.001)以及有氣喘者(P=0.001)。另外，超過92%的受訪者使用過西醫治療以及56.9%的患者至少使用一項輔助醫療治療鼻及鼻竇炎；包括中醫(34.3%)，飲食療法(15.9%)、芳香或藝術療法(6.7%)、心靈療法(11.7%)、民俗療法(7.8%)及物理療法(19.4%)等。以多因子線性複迴歸分析量表總得分較高者較易使用看中醫(P=0.010)、使用三伏貼或九伏貼(P=0.002)、畫畫(P=0.017)及唸佛經或讀聖經(P=0.032)等；但較不會使用算命(P=0.001)。 結論：本研究結果可作為醫療單位進行治療鼻及鼻竇炎及衛教預防之根據，亦可提供健康保險單位重視鼻及鼻竇炎患者之健康狀態及使用輔助醫療之的情況，並制定相關醫療政策以作為患者之參考。
Background: Little is known about the factors influencing patients’ choices of conventional treatments, and complementary and alternative medicine utilizations for management of rhinosinusitis symptoms. The purpose of this study was to investigate the factors associated with different utilizations of complementary and alternative medicine among patients with rhinosinusitis in Taiwan. Study design: A cross-sectional survey. Subjects and methods: Patients with physician-diagnosed rhinosinusitis were identified from the otolaryngology outpatient department of a medical center in central Taiwan. The diagnosis of rhinosinusitis was based on rhinoscopy examination and patients’ reports of typical symptoms persisting for 2 weeks or more. Patients under 17 years of age or had nasal malignancies were excluded from this study. Socio-demographic, lifestyle information, general health status, disease-specific quality of life (Chinese version of 31-item Rhinosinusitis Outcome measure, CRSOM-31), and previous choices of treatment modalities for rhinosinusitis of the participants were assessed by face-to-face interview. Descriptive statistics, one-way Analysis of Variance (ANOVA), and multiple linear regression analyses were used to evaluate the independent factors associated with the CRSOM-31 score and the different treatment modalities. Results: From July 2011 to September 2011, 283 subjects were successfully interviewed. A response rate of 98.3% was achieved by the participants. Among them, 41.3% were female and 58.7% were male. The mean age was 48.2 years. And the mean±S.D. of the CRSOM-31 score was 175.7±104.9. Results from multiple linear regression analysis showed higher CRSOM-31 score in females (P=0.017) those aged between 31 and 40 years (P=0.007), those with poor perceived health status (P<0.001), and had asthma (P=0.001). Additionally, over 92% of the participants had received conventional western medicine. A total of 56.9% of the patients had used at least one kind of complementary and alternative medicine for treatment of rhinosinusitis symptoms, which included traditional medicine (34.3%), diet-based therapy (15.9%), aromatherapy or art therapy (6.7%), mind-body therapy (11.7%), folk remedy (7.8%), and physiotherapy (19.4%). Results from multiple linear regression analysis indicated that participants with a high CRSOM-31 score was associated with the uses of Chinese medicine (P=0.010), San-fu-the or Dog-days paste treatments (P=0.002), spiritual beliefs (P=0.017), and the lesser use of fortune-telling (P=0.001). Conclusion: The results of this study could be used by health care professionals, health care providers, and public health units to provide more innovative and effective advice during the policy decision-making process for the uses of different treatment strategies for complementary and alternative medicine among patients with rhinosinusitis. |
