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題名:以自我決定理論觀點探討耳穴貼壓對於體重控制之影響
作者:葉慶輝
作者(外文):Ching-Hui Yeh
校院名稱:國立中山大學
系所名稱:企業管理學系研究所
指導教授:葉淑娟
學位類別:博士
出版日期:2011
主題關鍵詞:肥胖耳穴貼壓隨機對照實驗自我決定理論結構方程模式obesityear points pressingRCTSDTSEM
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目標:本研究之主要目的在探討成年人耳穴貼壓及自我決定理論與體重控制相關因子間之關係,並分析其相互關係,以了解耳穴貼壓及自我決定理論對於體脂肪、腰圍、臀圍、腰臀圍比、體重及身體質量指數在治療後是否有意義之減少,進而推廣較無副作用之耳穴貼壓於體重控制,並思考未來如何提昇或維持自我動機,以達到良好之體重控制成效。方法:本研究為一交叉式隨機對照實驗,研究對象為自願參與的189位成人。隨機分成兩組,兩組之基本特性一致;在前8週,93位耳穴貼壓加基本飲食衛教之個案為實驗(先治療)組,只有基本飲食衛教之96位研究對象為對照(後治療)組,8週後兩組交換治療;並於此32週之研究期間測量其自我決定理論相關問卷量表及肥胖相關參數指標。結果:經32週之研究,兩組在治療前後其腰圍、臀圍、體重及身體質量指數皆有進步,並達統計顯著差異,但兩組之間比較,並無法顯示耳穴貼壓治療對體重控制有不一樣的療效,不過若同一組人之前8週與後8週比較,則發現耳穴貼壓治療時有顯著的成效。而自我決定理論應用於體重改善成效的預測,當感受較佳醫療人員支持、連繫感佳者或原始個人動機較偏向自主傾向者,會有較佳的勝任能力,進而能有較佳的體重控制成效;另外本研究架構模式經結構方程模式測試,模式適合度尚可接受。結論:由結果顯示,雖然兩組之間比較,並無法顯示耳穴貼壓治療對體重控制有不一樣的療效,但兩組在治療前後其腰圍、臀圍、體重及身體質量指數皆有進步,且同一組人之前8週與後8週比較,也發現耳穴貼壓治療時有顯著的成效。由於其安全無副作用,並可引導病患的自我決定動機的提昇與維持,應可當成減重的輔助方法。未來也許可延長研究時間及增加樣本數以進一步了解耳穴貼壓治療的成效及提昇自我決定理論應用模式的適合度。
Objectives: To evaluate the effects of ear points pressing at ear meridian points on obesity-related parameters( body weight, body fat, body mass index, waist, hip circumferences, and WC/HC ratio) between treatment and control groups, and we also apply the Self-Determination Theory to discuss the relationship between motivation and performance of body weight control.
Methods: The study was an cross over open-parallel randomized control trial and the sample consisted of 189 volunteers who were randomly divided into two groups and the baseline characteristics were similar. In the experimental (immediate treatment) group (n=93), ear points pressing at five ear meridian points and lifestyle education were applied, while volunteers in the control (delay treatment) group (n=96) just receive lifestyle education in the first 8 weeks. At baseline, 24th, 32nd and each week of the sixteen weeks study, the outcomes mentioned above were examined in all volunteers, and related SDT questionnaires were checked during the period of 32 weeks study.
Results: The result showed a statistically significant drop in BW, BMI, Waist circumference and Hip circumference during the 32 weeks in experimental (immediate treatment) and control (delay treatment) group, and better effect while using ear points pressing in the same group. But, no significant differences were found between the two groups. A SEM analysis showed that autonomous support, relatedness and original autonomy can get better competence and was related to positive consequences in BW control. And it was relative an adequate model to test the self determination theory.
Conclusion: Even though the result showed a statistically significant drop in BW, BMI, WC, HC during the 32 weeks treatment in experimental (immediate treatment) and control (delay treatment) groups, and better effect while using ear points pressing in the same group. But, no statistical significance change in BW related parameters were found between the two groups. Further studies are needed to detect the effect of ear points pressing and model fit of SDT application by increasing research time, and sample sizes.
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