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Author: 黃泰郎
Tai-Lang Huang
Thesis Title: 使用者對陽壓呼吸器接受度之研究
A Study For User's Acceptance Of Continuous Positive Airway Pressure Ventilator
Advisor: 欒斌
Pin Luarn
Committee: 陳正剛
Cheng-Kang Chen
林鴻文
Hong-Wen-Lin
Degree: 碩士
Master
Department: 管理學院 - 管理研究所
Graduate Institute of Management
Thesis Publication Year: 2020
Graduation Academic Year: 108
Language: 中文
Pages: 62
Keywords (in Chinese): 使用者接受度病患接受度阻塞型睡眠呼吸中止睡眠呼吸暫停
Keywords (in other languages): Obstructive Sleep Apnea (OSA), Sleep Apnea Syndrome (SAS), Patient’s acceptance, User acceptance, Compliance
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  • 近來年阻塞型睡眠呼吸中止症(Obstructive Sleep Apnea)成為國人越來越關注的疾病議題,因為它不僅折磨著病患的生理及心理,也衍生出許多公共安全議題(例如:行車安全等)。
    「睡眠呼吸中止症」是指在睡眠的時候發生的呼吸中止或暫停的現象,這種現象是異常的表現。患有這種疾病障礙的人,進行睡眠活動時,很可能會發生重複性的呼吸中止。
    目前阻塞型睡眠呼吸中止症以連續性陽壓呼吸器(CPAP)為治療的黃金準則,但病患對於配戴機器的接受度(acceptance)與順從性(compliance)便是影響治療效果的決定性因子。
    本研究便是以呼吸器儀器供應商的角度切入,先以文獻了解何謂阻塞型睡眠呼吸中止症及提出臨床相關症狀、診斷方式,再以問卷的方式分析病患未能達成良好接受度及順從性的原因為何,並提出改善之要點。除了可替病患解決 CPAP使用上的問題,也可使病患更加願意使用 CPAP,進而提高業者對 CPAP 的銷售量。
    以管理實務角度來連結改善病患配戴儀器的接受度與品牌管理經營的長久之道。


    In recent years, Obstructive Sleep Apnea has become a disease issue of increasing
    concern to our country, because it not only tortures the patient's physiology and
    psychology, but also causes many public safety issues (such as driving safety, etc.).
    Sleep Apnea Syndrome (SAS) refers to the abnormal phenomenon of ceased or
    paused breathing during sleep. Patients with this disease are more likely to have
    repetitive apnea during sleep.
    At present, continuous positive airway pressure (CPAP) ventilator is the golden
    rule for the treatment of obstructive sleep apnea, but the acceptance and compliance of
    patients is the decisive factor affecting the treatment effect.
    This research is based on the perspective of the supplier of ventilator equipment.
    First to understand what obstructive sleep apnea from the literature is and propose
    clinically relevant symptoms and diagnostic methods, then to analyze the reasons why
    patients fail to achieve good acceptance and compliance by questionnaire, and put
    forward the key points for improvement. In addition to solving the problem of CPAP
    use for patients, it can also make patients more willing to use CPAP, thus improving the
    sales volume of CPAP. From the perspective of management practice, link the
    relationship between improving the patient's acceptance of equipment and brand
    management.

    摘要....................................................................................................................................I ABSTRACT..................................................................................................................... II 致謝.................................................................................................................................III 目 錄...............................................................................................................................IV 圖目錄.............................................................................................................................. V 表目錄.............................................................................................................................VI 第壹章 緒論..................................................................................................................... 1 第一節 研究背景..................................................................................................... 1 第二節 研究動機與目的......................................................................................... 4 第三節 論文架構..................................................................................................... 6 第貳章 文獻探討............................................................................................................. 8 第一節 睡眠呼吸中止症的定義與分類................................................................. 8 第二節 阻塞型睡眠呼吸中止症可能症狀與併發症........................................... 12 第三節 阻塞型睡眠呼吸中止症的診斷及治療方式........................................... 15 第四節 阻塞型睡眠呼吸中止症治療議題相關文獻........................................... 26 第參章 研究方法與步驟............................................................................................... 30 第一節 問卷問題蒐集方法................................................................................... 30 第二節 彙整問卷題目........................................................................................... 35 第肆章 研究結果與改善方案....................................................................................... 37 第一節 研究結果................................................................................................... 37 第二節 改善方案................................................................................................... 41 第伍章 結論與建議....................................................................................................... 44 第一節 研究結論................................................................................................... 44 第二節 研究限制與管理實務上之建議............................................................... 47 參考文獻......................................................................................................................... 49

    一、 中文部分
    1. 成人阻塞性睡眠呼吸中止症診斷與治療-高以信;江瑞坤;林彥璋 家庭醫學與基層醫療 34:1 2019.01[民 108.01]
    2. 馬偕紀念醫院網站,胸腔內科、家庭醫學科,衛教資訊
    3. 阻塞型呼吸中止症候群-鐘威昇;侯承伯 家庭醫學與基層醫療第 28 卷第 6 期 P.161
    4. 阻塞型睡眠呼吸中止病人使用連續氣道正壓呼吸器後其睡眠和生活品質之成效-邱靜文;黃瓊玉;陳志金 前瞻科技與管理 4:2 2014.11[民 103.11]
    5. 簡介阻塞型睡眠呼吸中止症-台北榮民總醫院 胸腔部 周昆達;陽明大學臨床醫學研究所 吳紹豪、蕭光明 2012 年第 56 卷第 10 期 台北市醫師公會會刊
    6. 睡眠呼吸生理與相關疾病介紹,台灣醫界,48 (3),25-30,葉世彬(民 94)
    7. 耳鼻喉專科/職業醫學專科/睡眠醫學專科 林政佑醫師之部落格--不必到醫院 在家即可檢測睡眠障礙 20090409
    8. 睡眠呼吸中止症患者長期規則使用單向正壓呼吸器對睡眠品質和血壓上的影響-楊美貞(第一), 黃奕智,藍胄進 ,吳燿光,黃國烽(通訊),2015

    50

    二、 英文部分
    1. Sleep Apnea: What Is Sleep Apnea?. NHLBI: Health Information for the Public. U.S.
    Department of Health and Human Services. July 10, 2012 [2016-08-18].
    2. Obstructive Sleep Apnea Syndrome (OSAS).Review of the literature
    -Eva Azagra-Calero, Eduardo Espinar-Escalona, José M. Barrera-Mora, José M.
    Llamas-Carreras, and Enrique Solano-Reina / doi:10.4317/medoral.17706
    3. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An
    American Academy of Sleep Medicine Clinical Practice Guideline- Susheel P. Patil, MD,
    PhD; Indu A. Ayappa, PhD; Sean M. Caples, DO; R. John Kimoff, MD; Sanjay R. Patel,
    MD; Christopher G. Harrod, MS
    4. Atul Malhotra and David P White, 2002, “Obstructive sleep apnoea”, Lancet Vol. 360, pp.
    237-245.
    5. Conrad I, Sonia A, Andrew LC, Stuart FQ, 2007, AASM manual for snoring sleep.
    6. Accuracy of Neck Actigraphy in the Assessment of Behavioral Sleep/Wake - Daniel
    Levendowski, Sean Seagraves, Kara Henninger, Bratislav Veljkovic, Philip Westbrook,
    Advanced Brain Monitoring, Inc., Carlsbad, CA, Complete Sleep Solutions, Murrieta,
    CA, Sleep 2014, 37:A372
    7. Assessment of a Neck-Based Treatment and Monitoring Device for Positional
    Obstructive Sleep Apnea - Daniel J. Levendowski, M.B.A.; Sean Seagraves, B.S;
    Djordje Popovic, M.D.; Philip R. Westbrook, M.D. Advanced Brain Monitoring, Inc.,
    Carlsbad, CA
    8. Dramatic improvement in OSA severity when oral appliance and positional therapies are
    combined – a case study by David P. Barr, DDS, 2016

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    9. A novel intermittent negative air pressure device ameliorates obstructive sleep apnea
    syndrome in adults-Tzu-Chun Hung & Tien-Jen Liu & Wen-Yeh Hsieh & Bo-Nien Chen
    & Wen-Ko Su & Kuang-Hui Sun & Christian Guilleminault, 2018
    10. Identifying poor compliance with CPAP in obstructive sleep apnoea: A simple prediction
    equation using data after a two week trial - Dipansu Ghosh , Victoria Allgar , Mark W.
    Elliott ,2012
    11. Influencing factors on CPAP adherence and anatomic characteristics of upper airway in
    OSA subjects - Pona Park, MD, Jinil Kim, MD, Yoon Jae Song, MD, Jae Hyun Lim, MD,
    Sung Woo Cho, MD, Tae-Bin Won, MD, PhD, Doo Hee Han, MD, PhD, Dong-Young
    Kim, MD, PhD, Chae Seo Rhee, MD, PhD, Hyun Jik Kim, MD, PhD , 2017
    12. A Systematic Review of CPAP Adherence Across Age Groups: Clinical and Empiric
    Insights for Developing CPAP Adherence Interventions - A.M. Sawyer, N. Gooneratne,
    C.L. Marcus, D. Ofer, K.C. Richards and T.E. Weaver , 2011
    13. Improving CPAP use by patients with the sleep apnoea/hypopnoea syndrome(SAHS) -
    Engleman, H.M., & Wild, M. R.,2003
    14. Dramatic improvement in OSA severity when oral appliance and positional therapies are
    combined – a case study- David P. Barr, DDS, 2016

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