簡易檢索 / 詳目顯示

回結果列表
研究生： 蔡宗益
Tsai, Tzung-Yi
論文名稱： 臺灣類風濕性關節炎患者之心理困擾及其心血管疾病風險，與後續個案管理模式成效評估
Psychological and cardiovascular disorders in patients with rheumatoid arthritis in Taiwan and the effects of case management
指導教授： 郭浩然
Guo, How-Ran
學位類別： 博士
Doctor
系所名稱： 醫學院 - 環境醫學研究所
Department of Environmental and Occupational Health
論文出版年： 2022
畢業學年度： 110
語文別： 英文
論文頁數： 74
中文關鍵詞： 類風濕性關節炎 、憂鬱 、中風 、關節炎自我效能量表 、個案管理 、廣義估計方程式
外文關鍵詞： rheumatoid arthritis, depression, stroke, Arthritis Self-Efficacy Scale, case management, generalized estimating equations
相關次數： 點閱：128  下載：11 
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報

    • 背景與目的　　
    　　類風濕性關節炎是一影響關節與周邊組織之慢性自體免疫疾病，其所伴隨的長期且慢性的全身性發炎狀態易使患者出現心血管疾病。此外，該疾患屬一不可逆狀態，健康狀態弱化下衍生之副作用，也常誘發憂鬱情緒。漫長病程中，除考驗著病患疾病自我照顧效能，亦挑戰醫療照護團隊的專業整合能力。回顧臺灣類風濕性關節炎相關文獻，發現聚焦該族群之憂鬱情緒或病人自我照護效能議題仍顯闕如，也少見有關憂鬱症對該族群個案心血管疾病之影響或是相關介入方案之成效評估。因此，本研究目的如下：(1) 探討臺灣類風濕性關節炎患者之憂鬱情緒對後續中風風險影響；(2) 評值個案管理模式之介入成效; (3) 將關節炎自我效能量表轉譯成中文並進行信效度驗證。
    方法
    　　首先透過世代研究設計，自全民健康保險研究資料庫擷取1997至2010年間之類風濕性關節炎患者和未罹此病之個案，將個案依有無憂鬱症進行分組，追蹤後比較中風之罹病風險。另外，採類實驗研究設計，於2017至2018年間在臺灣南部某醫院招募就醫之類風濕性關節炎病人，依是否參予個案管理分成兩組，再輔以廣義估計方程式比較兩組介入前測(T0)、後測一(T1)，與後測二(T2)的各項指標變化。最後，透過橫斷性研究設計，以曾至臺灣南部某醫院就醫之風濕性關節炎個案為對象，藉以評值關節炎自我效能量表中文版之信效度。
    結果
    　　研究發現，類風濕性關節炎患者較常人高出43%的中風風險；倘若出現憂鬱症，其罹患中風風險則攀升至常人的2.18倍 (95%信賴區間 = 1.87−2.54)。第二部分研究之結果顯示，個案管理模式介入可有效改善類風濕性關節炎個案之憂鬱情緒(T1 = -5.64, p = 0.04; T2 = -11.67, p < 0.01)、疾病活動度指數(T1 = -0.84, p < 0.01; T2 = -1.36, p < 0.01)、疼痛感(T1= -1.18, p = 0.01; T2 = -2.56, p < 0.01)、疲憊感(T1= -1.66, p =0.03; T2 = -2.41, p = 0.02)與C反應蛋白值(T1 = -0.67, p = 0.04; T2 = -1.06; p < 0.01)，並且提升自我照護能力(T1= 269.12, p = 0.02; T2 = 644.07, p < 0.01)。實施半年後上述指標之改善仍皆顯著。最後，經回譯翻譯程序與信校度評值過程，研究證實關節炎自我效能量表中文版具有良好的效度和信度。因素分析的結果指出各因素涵蓋的題目皆與原量表相同，累計解釋變異量為59.8%。信度方面，Cronbach’s α值為0.91。
    結論
    　　類風濕性關節炎患者有較高之中風風險，尤其療程中出現憂鬱症者，後續中風風險更顯攀升。個案管理模式介入可有效改善個案之憂鬱情緒、疼痛感、疲憊感、疾病活動度指數、C反應蛋白值與自我照護效能，且皆具延遞效應。本研究發展之關節炎自我效能量表中文版具有良好之信效度，可作為未來評量臺灣關節炎患者自我照護效能之工具。歸納以上結論，建議定期監測類風濕性關節炎患者之心理狀態和評估其自我照護能力，納入個案管理模式，以利建構契合病人需求的照護模式，提升治療效果。

    Background and aims
    Rheumatoid arthritis (RA) is a chronic debilitating inflammatory autoimmune disease that primarily targets joints and surrounding tissues. The systemic inflammation accompanied by RA may trigger several comorbidities such as cardiovascular diseases. Facing the irreversible nature of this disease, RA patients often develop depressive symptom due to the crippling conditions that only get worse with time. Not only does RA challenge the capability of mutlidisplinary integrated care of healthcare providers, but it also poses a major barrier to the patient's self-efficacy (SE). However, data on depression and SE among Taiwanese RA patients are scarce, let alone those on the impacts of depression or effects of intervention programs. So, this study has three aims:
    1. To explore if RA patients have a higher risk of stroke and further evaluate if onset of depression during the disease progress would lead to increase in the risk of stroke.
    2. To set up a nurse-led case management (NLCM) model and assess its long-term effects.
    3. To translate the Arthritis Self-Efficacy Scale (ASES), a widely used arthritis-specific measure for SE, into Chinese and explore its psychometric characteristics in Taiwan.

    Methods
    Using a cohort study design, we recruited patients with RA, together with randomly sampled subjects without RA, from the National Health Insurance Research Database. All participants were further divided into four groups based on whether they were diagnosed with depression during the follow-up. They were followed up until the end of 2012 to assess the incidence rate of stroke, and the risk was evaluated using Cox proportional hazards regressions. Thereafter, a two-group pretest-and-posttest study design was used in the second part of the current project. All participants were recruited from a teaching hospital in Taiwan between 2017 and 2018, and they were assigned to either an NLCM program for six months or a standard care treatment during the same time period. The outcomes were compared between the NLCM and the non-NLCM groups at three measurement points using the generalized estimating equation (GEE) analysis. Lastly, a cross-sectional study design was used to recruit the patients with rheumatic diseases from the hospital to explore the psychometrics of the Chinese version of ASES, like its construct validity and internal consistency.

    Results
    RA patients who developed depression were found to have a higher risk of stroke, with an adjusted hazard ratio of 2.18 (95% confidence interval: 1.87, 2.54). Nonetheless, those with RA only and those with depression only still had elevated risks of stroke, by 43% and 57% respectively, when they were compared with those without either condition. Findings of the GEE regressions indicated that the integration of NLCM into conventional care was associated with decreased scores of Taiwanese Depression Questionnaire (TDQ) (T1= -5.64, p =0.04; T2 = -11.67, p < 0.01), Disease Activity Score in 28 joints (DAS28) (T1 = -0.84, p < 0.01; T2 = -1.36, p < 0.01), pain (T1= -1.18, p = 0.01; T2= -2.56, p < 0.01), fatigue (T1= -1.66, p = 0.03; T2 = -2.41, p = 0.02) and C-reactive protein (CRP) (T1 = -0.67, p = 0.04; T2 = -1.06; p < 0.01), as well as elevated ASES levels (T1 = 269.12, p = 0.02; T2 = 644.07, p < 0.01). Lastly, we found the Chinese version of ASES accounted for 59.8% of the variance. The item composition in each of the three components was consistent with the conceptual framework of original scale. The reliability assessed using Cronbach’s alpha was 0.91.

    Conclusion
    This study supported an association between RA and the subsequent stroke, and further highlighted that depression occurred within the treatment process would double the likelihood of stroke. In addition, our study noted the positive impacts of NLCM on the medical care for RA patients. Furthermore, it found that the Chinese version of ASES was a reliable and valid screening instrument to assess SE in Chinese-speaking patients with RA. Based on those findings, it is recommended to have all RA patients screened for psychological problems and SE level on a regular basis, which may be helpful to optimize the care of the RA patients.

    中文摘要 i ABSTRACT iii BACKGROUND AND AIMS 1 LITERATURE REVIEW 4 2.1 The classification criteria and clinical features of rheumatoid arthritis 4 2.2 Review of cardiovascular diseases following rheumatoid arthritis 6 2.3 Review of case management model for rheumatoid arthritis 7 2.4 Summary of gaps from literature review 9 MATERIAL AND METHODS 11 3.1 Association of depression with stroke in rheumatoid arthritis 11 3.1.1 Data sources 11 3.1.2 Study subjects 11 3.1.3 Measurement of covariates 12 3.1.4 Statistical model 13 3.2 Effects of case management in rheumatoid arthritis 13 3.2.1 Study design and participants 14 3.2.2 Procedure 14 3.2.3 Sample size calculation 15 3.2.4 Intervention 15 3.2.5 Outcome measures 17 3.2.6 Covariates 18 3.2.7 Statistical analysis 19 3.3 Psychometric properties of ASES 19 3.3.1 Study design and enrollees 19 3.3.2 Ethics 20 3.3.3 Instruments 20 3.3.4 Data collection procedure 22 3.3.5 Data analysis 22 RESULTS 25 4.1 Association of depression with stroke in rheumatoid arthritis 25 4.2 Effects of case management in rheumatoid arthritis 26 4.2.1 Demographic and disease characteristics of study participants 26 4.2.2 Comparisons of covariates between two groups 26 4.2.3 Effects of NLCM for rheumatoid arthritis group 27 4.3 Psychometric properties of ASES 28 4.3.1 Study participants 28 4.3.2 Reliability estimate 29 4.3.3 Content Validity and face validity 29 4.3.4 Concurrent validity 30 4.3.5 Construct validity 30 DISCUSSION 32 5.1 Association of depression with stroke in rheumatoid arthritis 32 5.2 Effects of case management in rheumatoid arthritis 36 5.3 Psychometric properties of ASES 39 5.4 Conclusions 41 REFERENCES 43 Figure 1. Flowchart of the study 55 Figure 2. Difference in mean TDQ score between two groups 56 Figure 3. Difference in mean ASES score between two groups 57 Figure 4. Difference in mean DAS28 score between two groups 58 Figure 5. Difference in mean fatigue score between two groups 59 Figure 6. Difference in mean pain score between two groups 60 Figure 7. Difference in mean C-reactive protein level between two groups 61 Figure 8. Bland-Altman plot assessing agreement between two measuring points 62 Table 1. Demographic data and comorbidities of participants with and without rheumatoid arthritis 63 Table 2. Crude and adjusted hazard ratio (HR) of stroke across four groups 64 Table 3. Related factors with regard to the incidence of stroke among rheumatoid arthritis patients 65 Table 4. Demographic and clinical characteristics of the participants in the NLCM study 66 Table 5. Comparison of NLCM effects among RA patients by GEE model 67 Table 6. Demographic and clinical characteristics of participants in the ASES study 68 Table 7. Cronbach’s alpha coefficients of items of Chinese version of ASES 69 Table 8. Pearson correlation by comparing Chinese version of ASES and TDQ 70 Table 9. Results of factor analysis for Chinese version of ASES 71 ABBREVATIONS 73

    1. Cross M, Smith E, Hoy D, Carmona L, Wolf F, Vos T, et al. 2014. The global burden of rheumatoid arthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 73(7):1316-1322.
    2. Centers for Disease Control and Prevention. 2021. Disabilities and limitations. https://www.cdc.gov/arthritis/data_statistics/disabilities-limitations.htm [accessed 20 May 2022]
    3. Birnbaum H, Pike C, Kaufman R, Maynchenko M, Kidolezi Y, Cifaldi M. 2010. Societal cost of rheumatoid arthritis patients in the US. Curr Med Res Opin 26(1):77-90.
    4. Chen CI, Wang L, Wei W, Yuce H, Phillips K. 2018. Burden of rheumatoid arthritis among US medicare population: co-morbidities, health-care resource utilization and costs. Rheumatol Adv Pract 2(1):I1-I9.
    5. Gabriel S, Michaud K. 2009. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther 11(3):229.
    6. Innala L, Sjöberg C, Möller B, Ljung L, Smedby T, Sodergren A, et al. 2016. Co-morbidity in patients with early rheumatoid arthritis - inflammation matters. Arthritis Res Ther 18:33.
    7. Lassere MN, Rappo J, Portek IJ, Sturgess A, Edmonds JP. 2013. How many life years are lost in patients with rheumatoid arthritis? Secular cause-specific and all-cause mortality in rheumatoid arthritis, and their predictors in a long-term Australian cohort study. Intern Med J 43(1):66-72.
    8. Lévy L, Fautrel B, Barnetche T, Schaeverbeke T. 2008. Incidence and risk of fatal myocardial infarction and stroke events in rheumatoid arthritis patients. A systematic review of the literature. Clin Exp Rheumatol 26(4):673-679.
    9. Meune C, Touzé E, Trinquart L, Allanore Y. 2010. High risk of clinical cardiovascular events in rheumatoid arthritis: levels of associations of myocardial infarction and stroke through a systematic review and meta-analysis. Arch Cardiovasc Dis 103(4):253-261.
    10. Matcham F, Rayner L, Steer S, Hotopf M. 2013. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford) 52(12):2136-2148.
    11. Lee HC, Lin HC, Tsai SY. 2008. Severely depressed young patients have over five times increased risk for stroke: a 5-year follow-up study. Biol Psychiatry 64(10):912-915.
    12. Behrouz R. 2014. The risk of ischemic stroke in major rheumatic disorders. J Neuroimmunol 277(1-2):1-5.
    13. Irwin MR, Davis M, Zautra A. 2008. Behavioral comorbidities in rheumatoid arthritis: a psychoneuroimmunological perspective. Psychiatr Times 25(9):1.
    14. van den Oever IAM, van Sijl AM, Nurmohamed MT. 2013. Management of cardiovascular risk in patients with rheumatoid arthritis: evidence and expert opinion. Ther Adv Musculoskelet Dis 5(4):166-181.
    15. van Eijk-Hustings Y, van Tubergen A, Boström C, Braychenko E, Buss B, Felix J, et al. 2012. EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis. Ann Rheum Dis 71(1):13-19.
    16. Sezgin MG, Bektas H. 2022. The effect of nurse-led care on fatigue in patients with rheumatoid arthritis: a systematic review and meta-analysis of randomised controlled studies. J Clin Nurs 31(7-8):832-842.
    17. Primdahl J, Wagner L, Hørslev-Petersen K. 2011. Self-efficacy as an outcome measure and its association with physical disease-related variables in persons with rheumatoid arthritis: a literature review. Musculoskeletal Care 9(3):125-140.
    18. Ndosi M, Lewis M, Hale C, Quinn H, Ryan S, Emery P, et al. 2014. The outcome and cost-effectiveness of nurse-led care in people with rheumatoid arthritis: a multicentre randomised controlled trial. Ann Rheum Dis 73(11):1975-1982.
    19. de Thurah A, Esbensen BA, Roelsgaard IK, Frandsen TF, Primdahl J. 2017. Efficacy of embedded nurse-led versus conventional physician-led follow-up in rheumatoid arthritis: a systematic review and meta-analysis. RMD Open 3(2):e000481.
    20. Tsai TY, Chen SY, Tsai MH, Su YL, Ho CM, Su HF. 2011. Prevalence and associated factors of sexual dysfunction in cervical cancer patients. J Sex Med 8(6):1789-1796.
    21. Lin YC, Lin KC, Lee SS, Lin HY. 2005. The difference between rheumatoid arthritis and gout in epidemiology and health promotion strategies. J Intern Med Taiwan. 16(2):71-78.
    22. Lai NS, Tsai TY, Li CY, Koo M, Yu CL, Lu MC. 2014. Increased frequency and costs of ambulatory medical care utilization prior to the diagnosis of rheumatoid arthritis: a national population-based study. Arthritis Care Res 66(3):371-378.
    23. Kuo CF, Luo SF, See LC, Chou IJ, Chang HC, Yu KH. 2013. Rheumatoid arthritis prevalence, incidence, and mortality rates: a nationwide population study in Taiwan. Rheumatol Int 33(2):355-360.
    24. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. 1988. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31(3):315-324.
    25. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham 3rd CO, et al. 2010. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62(9):2569-2581.
    26. Kasturi S, Goldstein BL, Malspeis S, Karlson EW, Costenbader KH. 2014. Comparison of the 1987 American College of Rheumatology and the 2010 American College of Rheumatology/European League against rheumatism criteria for classification of rheumatoid arthritis in the nurses' health study cohorts. Rheumatol Int 34(3):407-411.
    27. Radner H, Neogi T, Smolen JS, Aletaha D. 2014. Performance of the 2010 ACR/EULAR classification criteria for rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 2014;73(1):114-123.
    28. Sakellariou G, Scirè CA, Zambon A, Caporali R, Montecucco C. 2013. Performance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis. PLoS One 8(2):e56528.
    29. Druce KL, Aikman L, Dilleen M, Burden A, Szczypa P, Basu N. 2018. Fatigue independently predicts different work disability dimensions in etanercept-treated rheumatoid arthritis and ankylosing spondylitis patients. Arthritis Res Ther 20(1):96.
    30. Druce KL, Basu N. 2019. Predictors of fatigue in rheumatoid arthritis. Rheumatology (Oxford) 58(Suppl 5):v29-v34.
    31. Pope JE. 2020. Management of fatigue in rheumatoid arthritis. RMD Open 6(1):e001084.
    32. Lu MC, Guo HR, Lin MC, Livneh H, Lai NS, Tsai TY. 2016. Bidirectional associations between rheumatoid arthritis and depression: a nationwide longitudinal study. Sc Rep 6:20647.
    33. Joyce AT, Smith P, Khandker R, Melin JM, Singh A. 2009. Hidden cost of rheumatoid arthritis (RA): estimating cost of comorbid cardiovascular disease and depression among patients with RA. J Rheumatol 36(4):743-752.
    34. Ang DC, Choi H, Kroenke K, Wolfe F. 2005. Comorbid depression is an independent risk factor for mortality in patients with rheumatoid arthritis. J Rheumatol 32(6):1013-1019.
    35. Provan SA, Lillegraven S, Sexton J, Angel K, Austad C, Haavardsholm E, et al. 2020. Trends in all-cause and cardiovascular mortality in patients with incident rheumatoid arthritis: a 20-year follow-up matched case-cohort study. Rheumatology (Oxford). 59(3):505-512.
    36. Ohira T, Iso H. 2013. Cardiovascular disease epidemiology in Asia: an overview. Circ J 77(7):1646-1652.
    37. World Health Organization. 2020. The top 10 causes of death. https://www.who.int/en/news-room/fact-sheets/detail/the-top-10-causes-of-death [accessed 15 June 2021].
    38. Avina-Zubieta JA, Thomas J, Sadatsafavi M, Lehman AJ, Lacaille D. 2012. Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis 71(9):1524-1529.
    39. Sokka T, Abelson B, Pincus T. 2008. Mortality in rheumatoid arthritis: 2008 update. Clin Exp Rheumatol 26(5 Suppl 51):S35-S61.
    40. Pan A, Sun Q, Okereke OI, Rexrode KM, Hu FB. 2011. Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA. 306(11):1241-1249.
    41. Otte C, Gold SM, Penninx BW, Pariante CM, Etkin A, Fava M, et al. 2016. Major depressive disorder. Nat Rev Dis Primers 2:16065.
    42. Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK, et al. 2010. A meta-analysis of cytokines in major depression. Biol Psychiatry 67(5):446-457.
    43. Ndosi M, Johnson D, Young T, Hardware B, Hill J, Hale C, et al. 2016. Effects of needs-based patient education on self-efficacy and health outcomes in people with rheumatoid arthritis: a multicentre, single blind, randomised controlled trial. Ann Rheum Dis 75(6):1126-1132.
    44. Dougados M, Soubrier M, Perrodeau E, Gossec L, Fayet F, Gilson M, et al. 2015. Impact of a nurse-led programme on comorbidity management and impact of a patient self-assessment of disease activity on the management of rheumatoid arthritis: results of a prospective, multicentre, randomised, controlled trial (COMEDRA). Ann Rheum Dis 74(9):1725-1733.
    45. Tokem Y, Argon G, Keser G. 2011. Case management in care of Turkish rheumatoid arthritis patients. Rehabil Nurs 36(5):205-213.
    46. Watts RA, Mooney J, Barton G, MacGregor AJ, Shepstone L, et al. 2015. The outcome and cost-effectiveness of nurse-led care in the community for people with rheumatoid arthritis: a non-randomised pragmatic study. BMJ Open 5(8):e007696.
    47. Sousa F, Santos E, Cunha M, Ferreira R, Marques A. 2017. Effectiveness of nursing consultations in people with rheumatoid arthritis: systematic review. Revista de Enfermagem Referência (4):147-156.
    48. Zeger SL, Liang KY. 1986. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 42(1):121-130.
    49. Bandura A. 1977. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84(2):191-215.
    50. Brus H, van de Laar M, Taal E, Rasker J, Wiegman O. 1999. Determinants of compliance with medication in patients with rheumatoid arthritis: the importance of self-efficacy expectations. Patient Educ Couns 36(1):57-64.
    51. Brady TJ. 2011. Measures of self-efficacy: Arthritis Self-Efficacy Scale (ASES), Arthritis Self-Efficacy Scale-8 Item (ASES-8), Children's Arthritis Self-Efficacy Scale (CASE), Chronic Disease Self-Efficacy Scale (CDSES), Parent's Arthritis Self-Efficacy Scale (PASE), and Rheumatoid Arthritis Self-Efficacy Scale (RASE). Arthritis Care Res 63(S11):S473-S485.
    52. Garratt AM, Smedslund G, Løchting I, Hagen KB. (2014). Measurement properties of instruments assessing self-efficacy in patients with rheumatic diseases. Rheumatology (Oxford) 53(7):1161-1171.
    53. Lorig K, Chastain RL, Ung E, Shoor S, Holman HR. 1989. Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum 32(1):37-44.
    54. Yang DH, Huang JY, Chiou JY, Wei CC. 2018. Analysis of socioeconomic status in the patients with rheumatoid arthritis. Int J Environ Res Public Health 15(6):1194.
    55. National Health Insurance Administration. National Health Insurance Database, 2016 http://nhird.nhri.org.tw/en/index.htm [accessed 29 Dec, 2021].
    56. Liu CY, Hung YT, Chuang YL, Chen YJ, Weng WS, Liu JS, et al. 2006. Incorporating development stratification of Taiwan townships into sampling design of large scale health interview survey. J Health Manag 4(1):1-22.
    57. Alani H, Henty JR, Thompson NL, Jury E, Ciurtin C. 2018. Systematic review and meta-analysis of the epidemiology of polyautoimmunity in Sjögren’s syndrome (secondary Sjögren’s syndrome) focusing on autoimmune rheumatic diseases. Scand J Rheumatol 47(2):141-154.
    58. Cohen J. 1992. Quantitative methods in psychology: a power primer. Psychol Bull 112(1):155-159.
    59. Lee Y, Yang MJ, Lai Daniel TJ, Chiu NM, Chau TT. 2000. Development of the Taiwanese depression questionnaire. Chang Gung Med J. 23:688-694.
    60. Chiang HH, Guo HR, Livneh H, Lu MC, Yen ML, Tsai TY. 2015. Increased risk of progression to dialysis or death in CKD patients with depressive symptoms: a prospective 3-year follow-up cohort study. J Psychosom Res 79(3):228-232.
    61. Santos EJF, Duarte C, da Silva JAP, Ferreira RJO. 2019. The impact of fatigue in rheumatoid arthritis and the challenges of its assessment. Rheumatology (Oxford) 58(Suppl 5):v3-v9.
    62. Hawker GA, Mian S, Kendzerska T, French M. 2011. Measures of adult pain: visual analog scale for pain (VAS Pain), numeric rating scale for pain (NRS Pain), mcgill pain questionnaire (MPQ), short-form mcgill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res 63(S11):S240-S252.
    63. Klimek L, Bergmann KC, Biedermann T, Bousquet J, Hellings P, Jung K, et al. 2017. Vsual analogue scales (VAS): measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care: position paper of the German society of allergology (AeDA) and the German society of allergy and clinical immunology (DGAKI), ENT section, in collaboration with the working group on clinical immunology, allergology and environmental medicine of the German society of otorhinolaryngology, head and neck surgery (DGHNOKHC). Allergo J Int 26(1):16-24.
    64. Hasson D, Arnetz BB. 2005. Validation and findings comparing VAS vs. likert scales for psychosocial measurements. Int Electron J Health Educ 8:178-192.
    65. D’Cruz LG, McEleney KG, Cochrane C, Tan KB, Shukla P, Gardiner PV, et al. 2020. Assessment of a dried blood spot C-reactive protein method to identify disease flares in rheumatoid arthritis patients. Sci Rep 10(1):21089.
    66. Overall JE, Tonidandel S. 2004. Robustness of generalized estimating equation (GEE) tests of significance against misspecification of the error structure model. Biom J. 46(2):203-213.
    67. Gorsuch RL. Factor Analysis Hillsdale, NJ: Lawrence Erlbaum Associates; 1983.
    68. Lomi C. 1992. Evaluation of a Swedish version of the arthritis self-efficacy scale. Scand J Caring Sci 6(3):131-138.
    69. Taal E, Riemsma RP, Brus HL, Seydel ER, Rasker JJ, Wiegman O. 1993. Group education for patients with rheumatoid arthritis. Patient Educ Couns 20(2-3):177-187.
    70. Mueller A, Hartmann M, Mueller K, Eich W. 2003. Validation of the arthritis self-efficacy short-form scale in German fibromyalgia patients. Eur J Pain 7(2):163-171.
    71. Brekke M, Hjortdahl P, Kvien TK. 2001. Self-efficacy and health status in rheumatoid arthritis: a two-year longitudinal observational study. Rheumatology (Oxford). 40(4):387-392.
    72. Lin MC, Lu MC, Livneh H, Lai NS, Guo HR, Tsai TY. 2017. Factors associated with sexual dysfunction in Taiwanese females with rheumatoid arthritis. BMC Womens Health 17(1):12.
    73. Sell KA, Amella EJ, Mueller M, Andrews J, Wachs J. 2016. Chronic disease self-management and behavior change attitudes in older adults: a mixed-method feasibility study. SAGE Open 6(3):2158244016665661.
    74. Marx RG, Menezes A, Horovitz L, Jones EC, Warren RF. 2003. A comparison of two time intervals for test-retest reliability of health status instruments. J Clin Epidemiol 56(8):730-735.
    75. Bland JM, Altman DG. 1999. Measuring agreement in method comparison studies. Stat Methods Med Res 8(2):135-160.
    76. Wu SF. 2006. A two-stage translation and test the validity and reliability of a foreign instrument. Hu Li Za Zhi 53(1):65-71.
    77. Kaiser HF. 1974. An index of factorial simplicity. Psychometrika 39(1):31-36.
    78. Lindhardsen J, Ahlehoff O, Gislason GH, Madsen OR, Olesen JB, Svendsen JH, et al. 2012. Risk of atrial fibrillation and stroke in rheumatoid arthritis: Danish nationwide cohort study. BMJ 344 :e1257.
    79. Liou TH, Huang SW, Lin JW, Chang YS, Wu CW, Lin HW. 2014. Risk of stroke in patients with rheumatism: a nationwide longitudinal population-based study. Sci Rep 4:5110.
    80 van den Bosch M, Meyer-Lindenberg A. 2019. Environmental exposures and depression: biological mechanisms and epidemiological evidence. Annu Rev Public Health 40:239-259.
    81. Rindfleisch JA, Muller D. 2005. Diagnosis and management of rheumatoid arthritis. Am Fam Physician 72(6):1037-1047.
    82. Zha AM, Napoli M, Behrouz R. 2015. Prevention of stroke in rheumatoid arthritis. Curr Neurol Neurosci Rep 15(12):77.
    83. Lakhan SE, Kirchgessner A, Tepper D, Aidan L. 2013. Matrix metalloproteinases and blood-brain barrier disruption in acute ischemic stroke. Front Neurol 4:32.
    84. Liao KP, Solomon DH. 2013. Traditional cardiovascular risk factors, inflammation and cardiovascular risk in rheumatoid arthritis. Rheumatology (Oxford) 52(1):45-52.
    85. Appelros P, Stegmayr B, Terént A. 2009. Sex differences in stroke epidemiology: a systematic review. Stroke 40(4):1082-1090.
    86. Stroebele N, Müller-Riemenschneider F, Nolte CH, Müller-Nordhorn J, Bockelbrink A, Willich SN. 2011. Knowledge of risk factors, and warning signs of stroke: a systematic review from a gender perspective. Int J Stroke 6(1):60-66.
    87. Shivers KY, Amador N, Abrams L, Hunter D, Jenab S, Quiñones-Jenab V. 2015. Estrogen alters baseline and inflammatory-induced cytokine levels independent from hypothalamic-pituitary-adrenal axis activity. Cytokine 72(2):121-129.
    88. Ai M, Otokozawa S, Asztalos BF, Ito Y, Nakajima K, White CC, et al. 2010. Small dense LDL cholesterol and coronary heart disease: results from the Framingham offspring study. Clin Chem 56(6):967-976.
    89. Garner S, Lopatina E, Rankin JA, Marshall DA. 2017. Nurse-led care for patients with rheumatoid arthritis: a systematic review of the effect on quality of care. J Rheumatol 44(6):757-765.
    90. Ndosi M, Vinall K, Hale C, Bird H, Hill J. 2011. The effectiveness of nurse-led care in people with rheumatoid arthritis: a systematic review. Int J Nurs Stud 48(5):642-654.
    91. Martínez-González NA, Berchtold P, Ullman K, Busato A, Egger M. 2014. Integrated care programmes for adults with chronic conditions: a meta-review. Int J Qual Health Care 26(5):561-570.
    92. Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA. 2011. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol 11(9):607-615.
    93. Tazawa R, Uchida K, Fujimaki H, Miyag M, Inoue G, Sekiguchi H, et al. 2019. Elevated leptin levels induce inflammation through IL-6 in skeletal muscle of aged female rats. BMC Musculoskelet Disord 20(1):199.
    94. Grygiel-Górniak B, Puszczewicz M. 2015. Fatigue and interleukin-6 - a multi-faceted relationship. Reumatologia 53(4):207-212.
    95. Bossola M, Di Stasio E, Giungi S, Rosa F, Tazza L. 2015. Fatigue is associated with serum interleukin-6 levels and symptoms of depression in patients on chronic hemodialysis. J Pain Symptom Manage 49(3):578-585.
    96. Larsson I, Fridlund B, Arvidsson B, Teleman A, Bergman S. 2014. Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. J Adv Nurs 70(1):164-175.
    97. Ishani A, Greer N, Taylor BC, Kubes L, Cole P, Atwood M, et al. 2011. Effect of nurse case management compared with usual care on controlling cardiovascular risk factors in patients with diabetes: a randomized controlled trial. Diabetes Care 34(8):1689-1694.
    98. Hladek M, Gill J, Lai C, Lorig K, Szanton S. 2020. High coping self-efficacy associated with lower sweat inflammatory cytokines in adults: a pilot study. Biol Res Nurs 22(1):75-81.
    99. Sproston NR, Ashworth JJ. 2018. Role of C-Reactive protein at sites of inflammation and infection. Front Immunol 9:754.
    100. Polit DF, Beck CT. 2006. The content validity index: are you sure you know what's being reported? Critique and recommendations. Res Nurs Health 29(5):489-497.
    101. Bland JM, Altman DG. 1997. Statistics notes: cronbach's alpha. BMJ. 314(7080):572.
    102. Vaz S, Falkmer T, Passmore AE, Parsons R, Andreou P. 2013. The case for using the repeatability coefficient when calculating test-retest reliability. PloS One 8(9):e73990

    下載圖示 校內：2023-06-30公開
    校外：2023-06-30公開
    QR CODE