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研究生: 呂崟
研究生(外文): Yin Leu
論文名稱: 幽門桿菌感染及其對兒童注意力表現影響之探究
論文名稱(外文): The Exploration of Helicobacter pylori infection and Its Influence to Children's Attention Performance
指導教授: 顏世慧
指導教授(外文): Shih Hui Yen
學位類別: 碩士
校院名稱: 樹德科技大學
系所名稱: 幼兒保育學系
論文出版年: 2006
畢業學年度: 94
語文別: 中文
論文頁數: 166
中文關鍵詞: 幽門桿菌盛行率感染率消化性潰瘍預後注意力表現警覺力靈活性視覺搜尋
外文關鍵詞: Helicobacter pyloriprevalence ratespeptic ulcerprognosisAttention performanceAlertnessFlexibilityVisule search
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  • 被引用:2
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本研究旨在探討兒童受到幽門桿菌感染後,他們的注意力是否會產生什麼變化?感染兒童的生長發展是否會受到影響?其家族之間的感染率如何?接受抗生素治療後,其預後情形如何?
    參與本研究幽門桿菌簡易測試者,來自台南市濱海地區兩所小學之學童(共238人),以Hexagon H. pylori簡易檢測呈陽性反應者,再轉介到成大醫院進行尿素呼氣試驗及酵素結合免疫吸附法檢測,確認三種測試均呈現陽性反應者編為實驗組。控制組之選取則考量來自同一學區,社經背景不至於差異過大,同班級且年齡相近學童,發展之成熟度接近;本實驗分高年級實驗組、高年級控制組、中年級實驗組及中年級控制組,每組各8人,共32名受試者。以TAP軟體進行注意力的檢測,採其中警覺力測試、靈活性及視覺搜尋為測驗項目。治療前先做測試,並於療程結束一個月(short-term)及三個月(long-term)後分別測試其注意力表現。以t-test檢測藥物治療後對改變認知表現之效果差異,並做前後測之同質性比較。以單因子變異數分析(ANOVA)探討實驗組和控制組間之注意力表現及生長發展之差異。以重複量數相依樣本變異數分析分別探討不同階段注意力表現成對比較之差異。
    本研究發現幽門桿菌感染之兒童及其共居家族成員感染幽門桿菌的比率明顯高於學理之感染率。分析前後3個月不同階段的身體質量指數並未發現有顯著差異;但不同階段身高之成對比較則有顯著差異。警覺力測試並未發現有顯著差異,但一致呈現反應變慢之情形。靈活性測試分析發現,中年級實驗組只在前後測反應比較明顯變快,高年級實驗組則各階段反應均明顯變快。分析有目標蹤跡視覺搜尋反應發現高年級實驗組反應顯著變快,中年級實驗組則僅前後測階段比較有顯著變快。無目標蹤跡視覺搜尋反應分析發現高年級實驗組僅前測和追蹤的成對比較有顯著變快;中年級實驗組則沒有明顯差異。推測時間可能是影響預後效果的重要因素;至於,預後效果是否隨著年齡而變化?值得後續之研究探討。
    本研究經針對學校、教學、家庭、衛教保健行政及後續研究五個面向提出建議,學校重視衛生保健之推動及落實、教師在教學時藉由多元刺激來提升兒童學習成效、家長應留意兒童的生長及健康狀況並正視衛教及醫療對兒童健康維護之重要性、衛生醫療行政單位更加重視學校在衛教保健推動上所扮演的角色、後續研究可考量增加施測次數及作更長時間之研究以釐清警覺力在預後注意力表現之疑點。
Abstract
    This research aimed to investigate how children’s attention might change after Helicobacter pylori infection. Would the development of affected children be affected? What would the rate of transmission between family members be? What would the prognosis period be like after antibiotic treatment?
    Participants involving this research on simplified version of Helicobacter pylori  test were elementary school students from two schools in coastal area of Tainan city (238 people). Those showed positive response using Hexagon H. pylori test were then transferred to Cheng-Kung Hospital for urea breath test and enzyme linked immunoabsorbent assay. Children with positive effect in all three tests were assigned to the experimental group. Children in control group were selected from the same area with similar social and economic background, similar age and close developmental maturity. The experiment was thus divided into senior experimental group, senior control group, junior experimental group, and junior control group. There were eight participants in each group with a total of 32 participants. Softward TAP was used to examine the attention performance of participants. Alertness test, flexibility test and visual search task were selected as test items. The attention performance was tested at three time points: before treatment, one month after final treatment (short-term) and three months after final treatment (long-term). The effectiveness of drug treatment on attention performance was examined using t-test. The homogeneity of pre and post test was also compared. One way ANOVA was used to compare the relationship between attention performance and development differences in experimental and control group. Repeated measure dependent sample variance analysis was then used to compare the attention performance at different stages.
    This research discovered that family members of children affected with Helicobacter pylori had higher probability of being affected by Helicobacter pylori than previously reported. No significant difference in body mass index was found at different time points within three months. But significant difference was observed for heights at different stages. Although the results from alertness test did not reach significance, there was a tendency in responding slower as time progressed. Results from flexibility test showed that in junior experimental group was faster than junior control group only in the first and final testing stages but senior experimental group was faster than senior control group in all stages. Results from target present condition in visual search task revealed that senior experimental group was faster than senior control group at all stages but junior experimental group was only faster at first and final stages. Results from target absent condition in visual search task showed that senior experimental group was faster only at first and follow-up stages and no difference between junior experimental and junior control group was observed. It was hypothesize that time is a crucial factor in affecting prognosis performances. Further researches are needed to examine whether prognosis effect varied with age differences.
    This research proposed suggestions from five different perspectives: school, teaching, family, health policy and future research. Schools should highlight the importance of promoting healthy habit, teachers should use multi-dimension stimuli to increase the learning of children, parents should look after their child’s development and health condition and regard health education and medication treatment as important for children, health organizations should monitor the role of schools on health education promotion, future research can consider increasing number of testing and longer duration to understand the attention performance at prognosis stage.
中文封面  ------------------------------------  i
英文封面  ------------------------------------  ii
中文摘要  ------------------------------------  iii
英文摘要  ------------------------------------  v
誌    謝  ------------------------------------  viii
目    錄  ------------------------------------  ix
表 目 錄  ------------------------------------  xii
圖 目 錄  ------------------------------------  xix
第一章  緒論-------------------------------  1
第一節  研究動機與目的---------------------  1
第二節  研究假設---------------------------  6
第三節  研究的重要性-----------------------  7
第四節  名詞釋義---------------------------  9
第二章  文獻探討---------------------------  11
第一節  兒童認知特性與注意力---------------  11
第二節  疾病與認知表現---------------------  18
第三節  幽門桿菌與兒童健康-----------------  22
第三章  研究方法---------------------------  42
第一節  研究流程---------------------------  42
第二節  研究對象---------------------------  43
第三節  研究工具---------------------------  45
第四節  研究設計---------------------------  49
第五節  資料分析---------------------------  61
第四章  研究結果與分析---------------------  62
第一節  家族成員幽門桿菌感染率研究結果與分析--  62
第二節  身體質量指數及身高之差異分析-------  -      70
第三節  注意力表現的測試分析---------------  80
第五章  結論與建議-------------------------  136
第一節  結論-------------------------------  136
第二節  研究限制---------------------------  138
第三節  建議-------------------------------  139
參考文獻  ----------------------------------  141
中文文獻  ------------------------------------  141
西文文獻  ------------------------------------    144
附錄  ------------------------------------  163
附錄一 「幽門桿菌抗體含量分析」檢測同意書--------    163
附錄二 「幽門桿菌抗體含量分析」暨注意力表現施測同意書  164
附錄三 「幽門桿菌抗體含量分析」暨注意力測試及後續治療同意書
-------------------------------------------    165
附錄四 受試者不同階段身高體重及BMI表
-----------------------------------------  166
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