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  1. NTU Theses and Dissertations Repository
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請用此 Handle URI 來引用此文件: http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/96308
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dc.contributor.advisor胡凱焜zh_TW
dc.contributor.advisorKae-Kuen Huen
dc.contributor.author劉彥伯zh_TW
dc.contributor.authorYEN-PO LIUen
dc.date.accessioned2024-12-24T16:16:43Z-
dc.date.available2024-12-25-
dc.date.copyright2024-12-24-
dc.date.issued2024-
dc.date.submitted2024-07-24-
dc.identifier.citation英文文獻
Ansell, R. C., Shuto, T., Busquets-Perez, N., Hensor, E. M., Marzo-Ortega, H., & McGonagle, D. (2015). The role of biomechanical factors in ankylosing spondylitis: the patient's perspective. Reumatismo, 67(3), 91-96. https://doi.org/10.4081/reumatismo.2015.853
Arturi, P., Schneeberger, E. E., Sommerfleck, F., Buschiazzo, E., Ledesma, C., Maldonado Cocco, J. A., & Citera, G. (2013). Adherence to treatment in patients with ankylosing spondylitis. Clin Rheumatol, 32(7), 1007-1015. https://doi.org/10.1007/s10067-013-2221-7
Baraliakos, X., Kiltz, U., Peters, S., Appel, H., Dybowski, F., Igelmann, M., Kalthoff, L., Krause, D., Menne, H. J., Saracbasi-Zender, E., Schmitz-Bortz, E., Vigneswaran, M., & Braun, J. (2017). Efficiency of treatment with non-steroidal anti-inflammatory drugs according to current recommendations in patients with radiographic and non-radiographic axial spondyloarthritis. Rheumatology (Oxford), 56(1), 95-102. https://doi.org/10.1093/rheumatology/kew367
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Capelusnik, D., Zhao, S. S., Boonen, A., Ziade, N., Medina, C. L., Dougados, M., Nikiphorou, E., & Ramiro, S. (2021). Individual-level and country-level socio-economic factors and health outcomes in spondyloarthritis: analysis of the ASAS-perSpA study. Rheumatology, 61(5), 2043-2053. https://doi.org/10.1093/rheumatology/keab638
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Kasapoglu Aksoy, M., Birtane, M., Tastekin, N., & Ekuklu, G. (2017). The Effectiveness of Structured Group Education on Ankylosing Spondylitis Patients. J Clin Rheumatol, 23(3), 138-143. https://doi.org/10.1097/RHU.0000000000000499
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Kuipers, J. G., Koller, M., Zeman, F., Muller, K., & Ruffer, J. U. (2019). Adherence and health literacy as related to outcome of patients treated for rheumatoid arthritis : Analyses of a large-scale observational study. Z Rheumatol, 78(1), 74-81. https://doi.org/10.1007/s00393-018-0449-y (Adharenz und Gesundheitskommunikationskompetenz in Bezug auf das Therapieergebnis bei Patienten mit rheumatoider Arthritis : Auswertungen einer grossen Beobachtungsstudie.)
Liang, L., Pan, Y., Wu, D., Pang, Y., Xie, Y., & Fang, H. (2019). Effects of Multidisciplinary Team-Based Nurse-led Transitional Care on Clinical Outcomes and Quality of Life in Patients With Ankylosing Spondylitis. Asian Nurs Res (Korean Soc Nurs Sci), 13(2), 107-114. https://doi.org/10.1016/j.anr.2019.02.004
Loke, Y. K., Hinz, I., Wang, X., Rowlands, G., Scott, D., & Salter, C. (2012). Impact of health literacy in patients with chronic musculoskeletal disease--systematic review. PLoS One, 7(7), e40210. https://doi.org/10.1371/journal.pone.0040210
Matrisch, L., Grasshoff, H., Muller, A., Schinke, S., & Riemekasten, G. (2023). Therapy satisfaction and health literacy are key factors to improve medication adherence in systemic sclerosis. Scand J Rheumatol, 52(4), 395-402. https://doi.org/10.1080/03009742.2022.2111771
Michielsens, C., Bolhuis, T. E., van Gaalen, F. A., van den Hoogen, F., Verhoef, L. M., den Broeder, N., & den Broeder, A. A. (2024). Construct validity of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS) treatment target cut-offs in a BASDAI treat-to-target axial spondyloarthritis cohort: a cross-sectional study. Scand J Rheumatol, 53(3), 180-187. https://doi.org/10.1080/03009742.2023.2213509
Muscat, D. M., Shepherd, H. L., Nutbeam, D., Trevena, L., & McCaffery, K. J. (2021). Health Literacy and Shared Decision-making: Exploring the Relationship to Enable Meaningful Patient Engagement in Healthcare. J Gen Intern Med, 36(2), 521-524. https://doi.org/10.1007/s11606-020-05912-0
Nowell, W. B., Gavigan, K., Hunter, T., Malatestinic, W. N., Bolce, R. J., Lisse, J. R., Himelein, C., Curtis, J. R., & Walsh, J. A. (2022). Treatment Satisfaction and Decision-making from the Patient Perspective in Axial Spondyloarthritis: Real-World Data from a Descriptive Cross-sectional Survey Study from the ArthritisPower Registry. ACR Open Rheumatol, 4(1), 85-94. https://doi.org/10.1002/acr2.11365
Ortolan, A., Webers, C., Sepriano, A., Falzon, L., Baraliakos, X., Landewe, R. B., Ramiro, S., van der Heijde, D., & Nikiphorou, E. (2023). Efficacy and safety of non-pharmacological and non-biological interventions: a systematic literature review informing the 2022 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis. Annals of the Rheumatic Diseases, 82(1), 142-152. https://doi.org/10.1136/ard-2022-223297
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Ramiro, S., Nikiphorou, E., Sepriano, A., Ortolan, A., Webers, C., Baraliakos, X., Landewe, R. B. M., Van den Bosch, F. E., Boteva, B., Bremander, A., Carron, P., Ciurea, A., van Gaalen, F. A., Geher, P., Gensler, L., Hermann, J., de Hooge, M., Husakova, M., Kiltz, U., . . . van der Heijde, D. (2023). ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Annals of the Rheumatic Diseases, 82(1), 19-34. https://doi.org/10.1136/ard-2022-223296
Ramiro, S., van der Heijde, D., van Tubergen, A., Stolwijk, C., Dougados, M., van den Bosch, F., & Landewe, R. (2014). Higher disease activity leads to more structural damage in the spine in ankylosing spondylitis: 12-year longitudinal data from the OASIS cohort. Annals of the Rheumatic Diseases, 73(8), 1455-1461. https://doi.org/10.1136/annrheumdis-2014-205178
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Regel, A., Sepriano, A., Baraliakos, X., van der Heijde, D., Braun, J., Landewe, R., Van den Bosch, F., Falzon, L., & Ramiro, S. (2017). Efficacy and safety of non-pharmacological and non-biological pharmacological treatment: a systematic literature review informing the 2016 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis. RMD Open, 3(1), e000397. https://doi.org/10.1136/rmdopen-2016-000397
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王政為, & 楊榮森. (2013). 僵直性脊椎炎之診斷、治療與併發症 [Diagnosis, Treatment and Complications of Ankylosing Spondylitis]. 台灣醫學, 17(6), 687-694. https://doi.org/10.6320/fjm.2013.17(6).13
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官方文書
最新版藥品給付規定內容-第八節 免疫製劑(113.03.25更新). (2024). https://www.nhi.gov.tw/ch/cp-7593-ad2a9-3397-1.html

網路資訊
行政院. (2024/03/29). 國情簡介-全民健康保險. https://www.ey.gov.tw/state/A01F61B9E9A9758D/fa06e0d2-413f-401e-b694-20c2db86f404
社團法人中華民國風濕病醫學會. (2020/12/14). 僵直性脊椎炎介紹. http://www.rheumatology.org.tw/health/health_info.asp?/169.html
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dc.identifier.urihttp://tdr.lib.ntu.edu.tw/jspui/handle/123456789/96308-
dc.description.abstract本研究旨在探討僵直性脊椎炎(Ankylosing Spondylitis, AS)患者在治療旅程中的決策過程及其影響因素。研究主要集中在四個核心構面:健康素養、治療決策積極度、遵醫囑性和治療滿意度。透過調查台灣地區AS患者的問卷數據,研究採用結構方程模型(SEM)來驗證這些構面之間的關係。
研究結果顯示,健康素養對治療決策積極度和遵醫囑性有顯著正向影響,進而提高患者的治療滿意度。具體而言,健康素養較高的患者更能理解醫療資訊,並積極參與治療決策。此外,健康素養較高的患者也顯著影響其遵醫囑行為,最終影響治療整體滿意度。
本研究強調了在AS患者治療過程中提升健康素養的重要性,建議應加強患者教育和支持,促進患者積極參與治療決策。這不僅有助於改善治療滿意度,進而提高患者的生活品質。研究發現也為未來臨床實踐和健康政策制定提供了實證支持。
本研究在理論上填補了健康素養、治療決策、遵醫囑性與治療滿意度之間關係的研究空白,並在實務上建議通過提高患者的健康素養和遵醫囑性來改善治療結果和患者滿意度。
論文標題中的「忒休斯的迷宮」象徵僵直性脊椎炎患者在治療過程中面臨的複雜且困難的決策旅程。本篇論文旨在幫助患者走出這個迷宮。
zh_TW
dc.description.abstractThis study aims to explore the decision-making process and influencing factors in the treatment journey of patients with Ankylosing Spondylitis (AS). The research focuses on four core dimensions: health literacy, treatment decision-making engagement, medication adherence, and treatment satisfaction. By surveying AS patients in Taiwan, the study employs Structural Equation Modeling (SEM) to validate the relationships among these dimensions.
The results show that health literacy has a significant positive impact on treatment decision-making engagement and medication adherence, which in turn enhances treatment satisfaction. Specifically, patients with higher health literacy can better understand medical information and actively participate in treatment decisions. Additionally, higher health literacy significantly influences patients' adherence behaviors, ultimately affecting overall treatment satisfaction.
This study highlights the importance of improving health literacy in the treatment process of AS patients, recommending that patient education and support be strengthened to promote active participation in treatment decisions. This not only helps improve treatment satisfaction but also enhances the quality of life for patients. The findings provide empirical support for future clinical practice and health policy development.
The study theoretically fills the research gap regarding the relationships among health literacy, treatment decision-making, medication adherence, and treatment satisfaction. Practically, it suggests that improving patients' health literacy and adherence can enhance treatment outcomes and patient satisfaction.
The title of the thesis, "Theseus' Labyrinth," symbolizes the complex and challenging decision-making journey faced by AS patients during their treatment process. This thesis aims to help patients navigate and find effective treatment options, improving their health literacy and treatment satisfaction.
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dc.description.tableofcontents目 次
致 謝 i
中文摘要 ii
Abstract iii
圖 次 vii
表 次 viii
第一章 緒論 1
第一節 研究動機 1
第二節 研究目的 2
第三節 研究流程 4
第二章 文獻探討 6
第一節 僵直性脊椎炎的歷史 6
第二節 僵直性脊椎炎盛行率 7
第三節 僵直性脊椎炎的診斷 9
第四節 僵直性脊椎炎的治療 12
第五節 僵直性脊椎炎台灣治療現況 14
第六節 病患旅程地圖 16
第七節 影響僵直性脊椎炎患者治療的潛在因素 18
第三章 研究方法 21
第一節 研究架構 21
第二節 問卷設計、研究變數及問項 22
第三節 資料來源 29
第四節 資料分析方法 29
第四章 研究分析結果 32
第一節 描述統計分析結果 32
第二節 結構方程模式分析結果 35
第三節 單因子變異數分析結果 43
第五章 結論與討論 47
第一節 主要研究發現 47
第二節 理論貢獻與實務意涵 51
第三節 研究限制與未來研究方向 53
參考文獻 56
《附錄》 68
⟪附錄一⟫、衛福部健保署藥品給付規定第八章(8.2.4.2節) 68
⟪附錄二⟫、問卷內容 72
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dc.language.isozh_TW-
dc.subject健康素養zh_TW
dc.subject治療決策zh_TW
dc.subject遵醫囑性zh_TW
dc.subject治療滿意度zh_TW
dc.subject僵直性脊椎炎zh_TW
dc.subjecttreatment satisfactionen
dc.subjectAnkylosing Spondylitisen
dc.subjecthealth literacyen
dc.subjecttreatment decision-makingen
dc.subjectmedication adherenceen
dc.title忒休斯的迷宮: 僵直性脊椎炎患者的病患旅程與治療決策分析zh_TW
dc.titleTheseus' Labyrinth: Analyzing the Journey and Treatment Decisions of Patients with Ankylosing Spondylitisen
dc.typeThesis-
dc.date.schoolyear113-1-
dc.description.degree碩士-
dc.contributor.coadvisor潘令妍zh_TW
dc.contributor.coadvisorLing-Yen Panen
dc.contributor.oralexamcommittee謝政穎;李婉若zh_TW
dc.contributor.oralexamcommitteeCheng-Ying Hsieh;Woan-Ruoh Leeen
dc.subject.keyword僵直性脊椎炎,健康素養,治療決策,遵醫囑性,治療滿意度,zh_TW
dc.subject.keywordAnkylosing Spondylitis,health literacy,treatment decision-making,medication adherence,treatment satisfaction,en
dc.relation.page77-
dc.identifier.doi10.6342/NTU202402105-
dc.rights.note未授權-
dc.date.accepted2024-07-24-
dc.contributor.author-college進修推廣學院-
dc.contributor.author-dept生物科技管理碩士在職學位學程-
顯示於系所單位:生物科技管理碩士在職學位學程

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