台灣中部地區某區域醫院健檢個案自覺疲勞症狀與相關因子之先導型研究

Self-Perceived Fatigue and Related Factors: A Preliminary Study in a Regional Hospital in Mid-Taiwan

疲勞在家醫科及基層醫療門診是相當常見的症狀之一，其可能會困擾患者的身心或生活品質，甚至引起失能而影響工作，因此是值得我們去探討的問題。本研究為了了解健檢個案之自覺疲勞症狀的相關因子，從2007年5月至10月間，以台中市某區域醫院自費全身健康檢查民眾為對象，選取年齡為20歲至82歲，平均為48.1 ±11.9歲，共收集有效樣本445人，其中男性佔有289人(64.9 %)。本研究使用之量表包括基本資料、最近一星期之身體症狀、精神症狀（採簡式症狀量表之憂鬱及焦慮症狀）及疲勞症狀有否之自陳式結構性問卷。結果顯示有自覺疲勞症狀者331 人( 74.4%)，年齡越小者(OR=0.96；95% CI 0.94-0.99)、憂鬱症狀分數越高(OR=2.3；95% CI 1.01-6.0)、疼痛症狀分數越高(OR=3.7；95% CI 2.0-6.6)、心肺症狀分數越高(OR=2.4；95% CI 1.2-4.7)、有睡眠障礙(OR=1.7；95% CI 1.0-2.9)、高三酸甘油酯(OR=2.4；95% CI 1.4-4.0)、總膽固醇較低(OR=0.6；95% CI 0.3-0.9)者皆較易有自覺疲勞症狀。因此對於有疲勞症狀者，在實驗室檢查前應先考量其年齡、是否有憂鬱症狀、疼痛症狀、心肺症狀及睡眠障礙。高三酸甘油酯及低總膽固醇血症與疲勞症狀之相關，則有待進一步研究證實。

Fatigue is a common symptom in family medicine and primary care outpatient departments. Fatigue may disturb the patient’s physical condition, mental condition or life-quality and eventually it maybe result in disability and being unable to work. Therefore, there is a need to inquire into the factors causing and the reasons for fatigue. The aim of this study was to investigate the relationship between self-perceived fatigue and various associated factors among those who underwent health examinations at a regional hospital in Taichung between May and October 2007. A constructive questionnaire was used and comprised basic data, somatic symptoms, psychiatric symptoms (brief symptom rating scale-depression and -anxiety) and fatigue symptom within the last week. A total of 445 participants, made up of 64.9% males and 35.1% females, were enrolled. Of these, 74.4% of the subjects reported self-perceived fatigue symptoms. The results of a stepwise multivariate logistic regression model revealed that the subjects who were of younger age (Odds Ratio [OR] =0.96; 95% Confidence Interval [CI] 0.94-0.99), showed more BSRS-depression symptoms (OR=2.3 ; 95% CI 1.01-6.0), showed more pain symptoms (OR=3.7 ; 95% CI 2.0-6.6), showed more cardiopulmonary symptoms (OR=2.4 ; 95% CI 1.2-4.7), had sleep disturbance (OR=1.7 ; 95% CI 1.0-2.9), suffered from hypertriglyceridemia (OR=2.4 ; 95% CI 1.4-4.0) and suffered from hypocholesterolemia (OR=0.6 ; 95% CI 0.3-0.9) were more likely to have self-perceived fatigue. In conclusion, physicians should carry out prompt evaluation of younger patients who suffer from more depressive, pain and cardiopulmonary symptoms and have sleep disturbance before prescribing a laboratory examination of subjects with fatigue symptoms. The relationship between the serum triglyceride level, cholesterol concentration and fatigue merits further investigation.