巴金森氏病為常見的神經退化性疾病，除了動作障礙之外，口語問題在巴金森氏病患者中也很常見，讓患者在日常生活中經歷許多不可言喻的困難。患者因口語問題感到尷尬、羞愧，進而避免與人互動的情況其實和烙印感的定義十分相似。此外，研究發現憂鬱和口語問題呈高度相關，而憂鬱和烙印感皆可能是決定患者生活品質的關鍵因素。但是回顧巴金森氏病患者的生活品質相關文獻，尚未能找到有關口語問題的探討。
因此本研究的主要目的為探討口語問題和生活品質的相關性，並採取中介模式分析，將憂鬱及烙印感定義為中介因子，以更進一步了解口語問題和生活品質的關係。
本研究共收錄了92位巴金森氏病患者的資料，結果顯示口語問題和生活品質有中等程度的相關，且平行中介模式分析顯示憂鬱及烙印感皆為口語問題和生活品質相關的中介因子。這代表巴金森氏病患者的口語問題可能是憂鬱情緒及烙印感的部份原因，而憂鬱及和烙印感又進而使患者自覺生活品質較差。
為提升巴金森氏病患者們的生活品質，相關醫學專業除了替巴金森氏病患者轉介適當的語言治療介入外，也應多注意患者的情緒問題並對此族群的烙印感議題有更多教育及認識。

Parkinson’s disease (PD) is one of the most common neurodegenerative disorders. The prevalence of PD is increasing worldwide. Maintaining their quality of life (QoL) and helping them live with dignity are crucial for every PD-related professional.
Despite of motor difficulties, speech problems are common in people with PD. Speech problems, such as dysphonia and stutter, may make people with PD feel embarrassed or shamed. Consequently, speech problems may be associated with stigma, defined as an attribute that is deeply discrediting. In addition, previous studies have shown that depression is significantly associated with speech problems, and that depression and stigma are associated with QoL in people with PD. Nevertheless, the relationship between speech problems and QoL has not been examined in quantitative research while there are some qualitative studies depicting the impact of speech problems in PD.
The purpose of this study was to investigate the relationship between speech problems and QoL. Mediation analyses were conducted to clarify the mechanism between speech problems and QoL. Based on previous studies, depression and stigma were entered as mediators. A total of 92 participants with PD were included. Correlational analyses showed that speech problems were moderately correlated with QoL. In addition, parallel mediation analyses indicated that both depression and stigma are mediators in the association between speech problems and QoL. The results suggest that healthcare practitioners should pay attention to stigma and depression associated with speech problems and QoL in people with PD.

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