ʻO J Behav Addict. 2018 Sep 11: 1-11. hoʻopiʻi: 10.1556 / 2006.7.2018.69.
Li JB1,2, Mo PKH2,3, Lau JTF2,3, Su XF2,3, Zhang X4, Wu AMS5, Mai JC6, A X YX6.
Hōʻuluʻulu Manaʻo
Ke kumu a me nā manaʻo
ʻO ka manaʻo o kēia noiʻi e hoʻohālikelike i ka hui o ka lōʻihi ma waena o ka addiction pūnaewele pūnaewele (OSNA) a me ke kaumaha, inā wīwī paha ʻo OSNA i ka hoʻomohala ʻana i ke kaumaha, a hoʻi i ka hewa, inā wīwī paha ke kaumaha i ke kūkulu ʻana o OSNA.
Nā Papahana
He nui o nā haumāna 5,365 mai ʻumi mau kula ma Guangzhou, ua ʻike ʻia ka Hema ma Kina ma ka papa ʻāina ma Malaki 2014, a ua hahai ʻia ma nā mahina o 9 ma hope mai. Ua anaʻi ka pae o OSNA a me ke kaumaha i ka hoʻohana ʻana i ka ʻōnaehana OSNA i hoʻopaʻa ʻia a me CES-D. Ua noi ʻia nā hiʻohiʻona Multilevel logistic regression e hoʻohālikelike i ka hui lōʻihi ma waena o OSNA a me ke kaumaha.
Results
ʻO nā ʻōpio i nā kaumaha a ma kahi o OSNA i ka baseline i loaʻa nā manawa 1.48 e ulu a hoʻoulu i ka OSNA ma ka hana huli ʻana a hoʻohālikelike ʻia me nā mea ʻole i ke kaumaha ma ka pae kahua. ]. Hoʻohui, ua hoʻohālikelike ʻia me ka poʻe i ʻole o ka poʻe kaumaha i ka wā e pili ana, a ʻo nā ʻōpio ʻoi aku ka luhi i ke kaumaha a i ʻole e hōʻeha ʻia i ka wā o ka wā e pau ai ka piʻi ʻana o ka hoʻoulu ʻana i ka OSNA ma hope (AOR: 1.48, 95% CI: ʻO 1.14-1.93 no ke kaumaha mau loa; AOR: 3.45, 95% CI: 2.51-4.75 no ka ulu ʻana o ke kaumaha). ʻO ka hewa, ma waena o ka poʻe i ʻole ke kaumaha ma ka papa, nā ʻōpio i hoʻokaʻawale ʻia ʻo OSNA a ʻoi paha i kū mai ana ka mana OSNA. 4.47; 95% CI: 3.33-5.99 no ka puka ʻana o OSNA).
Panina
Hōʻike nā mea i loaʻa i kahi hui bidirectional ma waena o OSNA a me ke kaumaha, i ka manaʻo e hoʻohui pū me ka ʻoihana pūnaewele pūnaewele me ka piʻi nui o nā hōʻailona kaumaha.
KEYWORDS: opio opio; nāʻauhaʻeha; hui pū lōʻihi; hoʻohui lāʻau pūnaewele pūnaewele
PMID: 30203664
Hoʻohui ʻenehana pūnaewele pūnaewele a me ke kaumaha: ʻO nā hualoaʻa mai ka loea cohort prospection nui me nā ʻōpio Kina.
ʻO J Behav Addict. 2018 Sep 11: 1-11. doi: 10.1556 / 2006.7.2018.69. [Epub ma mua o ka paʻi]
Li JB1,2, Mo PKH2,3, Lau JTF2,3, Su XF2,3, Zhang X4, Wu AMS5, Mai JC6, A X YX6.
Hōʻuluʻulu Manaʻo
Kahi a me ka pahuhopu ʻO ka pahuhopu o kēia noi ana e hoʻohālikelike i nā hui laulā ma waena o ka addiction pūnaewele pūnaewele (OSNA) a me ke kaumaha, ʻoiai ua wānana ʻo OSNA i ka hoʻomohala ʻana i ke kaumaha, a hoʻi i ka hewa, inā paha e wānana ka minamina i ka hoʻomohala ʻana o ka OSNA. Nā Palapala ʻAno o nā haumāna o 5,365 mai ʻumi mau kula kiʻekiʻe ma Guangzhou, ua ʻike ʻia ka Hema ma Kina ma ka papa ʻāina ma Malaki 2014, a ua hahai ʻia ma 9 mau mahina ma hope mai. Ua anaʻi ka pae o OSNA a me ke kaumaha i ka hoʻohana ʻana i ka ʻōnaehana OSNA i hoʻopaʻa ʻia a me CES-D. Ua noi ʻia nā hiʻohiʻona Multilevel logistic regression e hoʻohālikelike i ka hui lōʻihi ma waena o OSNA a me ke kaumaha. Nā hualoaʻa i nā ʻōpio i nā kaumaha ma waho o ka OSNA ma ka papa palena he 1.48 mau manawa i mea e ulu aʻe ai i ka OSNA ma ka ukali ʻana i hoʻohālikelike ʻia me nā mea ʻole ʻole i ke kaumaha ma ka pae palena [hoʻoponopono ʻia OR (AOR): 1.48, 95% hilinaʻi kikowaena (CI): 1.14- 1.93]. Hoʻohui, ua hoʻohālikelike ʻia me ka poʻe i ʻole o ka poʻe kaumaha i ka wā e pili ana, a ʻo nā ʻōpio ʻoi aku ka luhi i ke kaumaha a i ʻole e hōʻeha ʻia i ka wā o ka wā e pau ai ka piʻi ʻana o ka hoʻoulu ʻana i ka OSNA ma hope (AOR: 3.45, 95% CI: ʻO 2.51-4.75 no ke kaumaha mau loa; AOR: 4.47, 95% CI: 3.33-5.99 no ka ulu ʻana o ke kaumaha). ʻO ka hewa, ma waena o ka poʻe i ʻole ke kaumaha ma ka papa, nā ʻōpio i hoʻokaʻawale ʻia ʻo OSNA a ʻoi paha i kū mai ana ka mana OSNA. 1.65; 95% CI: 1.01-2.69 no ka puka ʻana o OSNA). Hoʻopili I hōʻike nā hōʻike i kahi hui bidirectional ma waena o OSNA a me ke kaumaha, i ka manaʻo e hoʻohana pū ʻia ka hoʻohana ʻana i ka ʻoihana pūnaewele me ka nui o nā hōʻailona kaumaha.
KEYWORDS: opio opio; nāʻauhaʻeha; hui pū lōʻihi; hoʻohui lāʻau pūnaewele pūnaewele
PMID: 30203664
Introduction
ʻO ke kaumaha, ka luhi i hōʻike pinepine ʻia e ka maʻi psychiatric (Knopf, Pāka, & Mulye, 2008; ʻO Thapar, Collishaw, Potter, & Thapar, 2010), he pilikia koʻikoʻi olakino ma waena o nā ʻōpio. ʻOi aku ma mua o 9% o nā wā ʻōpiopio i hōʻike ʻia i ke kiʻekiʻe o ka hina nui, a ua ʻike ʻia kona helu nui ʻana o 1 makahiki ma 3% i United States (ʻO Rushton, Forcier, & Schectman, 2002). Ma Kina Hema, ua hōʻike ʻia kā mākou aʻo mua ʻana i kahi hōʻeha o ka hopena ma mua o 1 i ka hopena o 23.5% ma waena o nā haumāna kula haʻahaʻa (Li et al., 2017).
Ua hōʻike pū ʻia ka hui maikaʻi ma waena o ka loaʻa ʻana o ka Pūnaewele a me ke kaumaha i waena o nā ʻōpio i nā ʻāpana ʻāpana ʻelua (Moreno, Jelenchick, & Breland, 2015; ʻO Yoo, Cho, & Cha, 2014) a me ke aʻo ʻana i ka lōʻihi (Cho, Sung, Shin, Lim, & Shin, 2013; Ko, Yen, Chen, Yeh, & Yen, 2009; Lam, 2014). Eia naʻe, ua loiloi kēia mau noiʻi i ka pono o ka Pūnaewele ma mua he nui a ʻaʻole i nā ʻano kikoʻī o nā hana pūnaewele. Hiki i nā poʻe'ōpiopio ke hana i nā ʻano hana like ʻole ma ka Pūnaewele. Ua hōʻike nui ʻia kekahi mau noiʻi i ke koʻikoʻi a me ka pono no ka hoʻokaʻawale ʻana i nā mea pili i nā pūnaewele pili pūnaewele mai ka hoʻohui ʻana o ka pūnaewele i ka laulā nui (ʻO Davis, 2001; Laconi, Tricard, & Chabrol, 2015; ʻO Ponto, Szabo, & Griffiths, 2015). ʻO ka pūnaewele kaiāulu pūnaewele kahi kūlana hou, a ua nānā ʻia ka kiʻekiʻe o ke kaumaha i waena o ka poʻe i kū i ka ʻoihana pūnaewele ʻoihana pūnaewele (Lin et al., 2016; Tang & Koh, 2017). ʻO ka hoʻohālikelike ʻia i ka heluna ākea, ʻo nā ʻōpio a me nā haumāna nā mea hoʻohana maʻamau o ka pūnaewele pili pūnaewele.Griths, Kuss, & Demetrovics, 2014). He hana hoʻohaʻahaʻa pūnaewele hou ma ka ʻenehanaʻenehana (OSNA) i kahi ʻano hou i waena o ka poʻe ʻōpio a me ke komo ʻana i ka hana ma ka pūnaewele pili pūnaewele. Ma keʻano he ʻano kūikawā o ka pili pili pūnaewele e pili ana i ka pono, ua hoʻokomo ʻo OSNA i nā hōʻailona maʻamau o ka hoʻohui ʻana (Griffiths, 2013; ʻO Kuss & Griffiths, 2011), a ua ho'ākāka ʻia ʻo "no ka hopohopo nui e pili ana i ka hoʻohana pūnaewele pili pūnaewele, e uʻi ʻia e ka manaʻo ikaika e hoʻopaʻa ai i ka hoʻohana a hoʻohana i ka ʻoihana pūnaewele pūnaewele e hoʻopiʻi ana i nā hana ʻē aʻe, nā noiʻi / hana, ka pilina interpersonal, a me / a i ʻole olakino noʻonoʻo a me ka maikaʻi."(Andreassen, 2015). Ua ulu nui ʻo OSNA i ka wā ʻōpio. A puni 9.78% o nā haumāna kula US ʻAmelika i ʻike ʻia he mea hiki ke hoʻopili Facebook.Pempek, Yermolayeva, & Calvert, 2009), a me 29.5% o nā haumāna kula no Singaporean ua loaʻa iā OSNA (Tang & Koh, 2017). Ua hōʻike ʻia kahi haʻawina ma 2010 ka lōʻihi o ka OSNA prevalence ma mua o 30% i nā haumāna haumāna kula China.Zhou & Leung, 2010). Ua hōʻike aku nā hōʻike ʻike i ka nui o ka pūnaewele me ka hoʻopilikia pūnaewele ʻoi aku ka maikaʻi o ka maikaʻi o ka ʻōpio a me nā hopena e pili ana i ka olakino.Andreassen, 2015).
Ua hōʻike ʻia kekahi mau noiʻi i hōʻike ʻia i ka hui maikaʻi ma waena o OSNA a me ke kaumaha i waena o nā ʻōpio (Hong, Huang, Lin, & Chiu, 2014; Koc & Gulyagci, 2013). Eia nō naʻe, ma muli o ka palena o ka hoʻolālā ʻokoʻa ʻana o ka palapala noi, ʻike ʻia ke kumu he kumu a he kumu paha paha no ka OSNA. Hiki i ka ʻoihana pūnaewele pūnaewele hoʻolako i ka poʻe ʻōpio i ka launa pū ʻana o ka poʻe a me ke kapitalila, koho pilikino i koho ʻia a me ka kākoʻo kaiāulu (ʻO Ellison, Steinfield, & Lampe, 2007; Steinfield, Ellison, & Lampe, 2008). ʻO ka poʻe i ʻike i nā maʻi psychiatric (ʻo ia hoʻi, ke kaumaha a me ka hopohopo) e nānā paha i ka pūnaewele kaiaulu ma ke ʻano he kaiāulu ʻike pilikino koʻikoʻi a koʻikoʻi (Gámez-Guadix, 2014), kahi i hiki ai iā lākou ke pakele mai nā pilikia luhi i ʻike ʻia ma ka honua maoli (Andreassen, 2015; Griths et al., 2014), a alakaʻi hou i ka pili me ke komo i ka pili ʻana (ʻO Oberst, Wegmann, Stodt, Brand, & Chamarro, 2017). I ka manawa, nui ka hōʻike ʻana i ke kaiāulu kūloko e hopena i ka manaʻo maikaʻiʻole (McDougall et al., 2016). ʻO nā keiki'ōpiopio me ka halaʻole i kā lākou mau kaumaha kaumaha paha e ʻike i nā hopena hōʻino loa i ka ʻoihana pūnaewele ma ka pūnaewele.ʻO Selfhout, Branje, Delsing, Ter Bogt, & Meeus, 2009). No laila, kahi hui bidirectional ma waena o OSNA a me ke kaumaha he kūpono i loko o ka theoretically. Eia nō naʻe, ʻike iā mākou, ʻaʻohe ʻaiʻike like i ʻike ʻia i ka nānā ʻana i ka pilina pili lōʻihi ma waena o ka OSNA a me ke kaumaha i waena o nā ʻōpio a me nā ʻōiwi ʻē aʻe.
No laila, ua hoʻolālā mākou i kahi noiʻi prospective e koho pono i ka hui lōkahi ma waena o ke kaumaha a me ka OSNA ma kahi o ka manawa, e like paha me ka wānana ʻana o OSNA i ka ulu ʻana o ke kaumaha, a inā paha e wānana ke kaumaha i ka ulu ʻana o OSNA, e ka noʻonoʻo ʻana i nā loli i ke kūlana OSNA a me ke kaumaha (e like me ke kala ʻana mai maʻi) i ka manawa o 9 mau mahina o ka ukali.
Ka hoʻolālā aʻo
Ua mālama ʻia kēia haʻawina cohort pono ma Guangzhou, Hema China. Ua hoʻokele ʻia ka loiloi pae hana mai Malaki a ʻApelila 2014, a ma hope iho ka hana loiloi i hana ʻia ma kahi kikowaena 9 mahina, me ka hoʻohana ʻana i kēia kaʻina hana.
Nā mea komo a me ka ʻālana
Hoʻomohala ʻia nā mea e komo ana me ka hoʻohana ʻana i kahi hana hoʻohālikelike cluster stratified. Ua koho maʻalahi ʻia kahi ʻāpana / kalana mai kēlā me kēia o nā ʻāpana ʻekolu (ʻo ia hoʻi, ke kumu, ka suburb, a me nā wahi kaiāulu o waho) ma Guangzhou, (nā kiko ʻula i ke kiʻi 1). Ua koho pono ʻia nā kula kula ʻekahi ʻekolu no kēlā me kēia apana / i koho ʻia, a he ʻeiwa mau kula i koho ʻia a koho ʻia. Ua kono ʻia nā haumāna ʻehiku a me ka pae ʻewalu i loko o nā kula i koho ʻia e komo i ka hoʻopaʻa ʻana. He ʻano nīnau no ke ʻano he mea hoʻonaninani ʻia e nā poʻe komo i ka pae o ka lumi papa me kaʻole o kekahi kumu aʻo, ma lalo o ka mākaʻi o nā mea noiʻi hoʻomaʻamaʻa maikaʻi.
Hōʻike 1. ʻO kahi o nā pūnaewele aʻo
Ka huina o nā haumāna 5,365 (pane pane = 98.04%) i hoʻopau i ka loiloi pae kumu. Ua hui ʻia nā nīnau nīnau ʻelua o nā haumāna like ʻole i ka helu ʻehā o ka helu kelepona hope, ʻehā mau helu helu kelepona o ka helu kelepona o nā mākua, ʻehā mau helu hope o ka helu helu helu helu, nā lā o ka poʻe hānau, nā leka hope o ka pono a me nā mākua 'pala inoa inoa. ʻO ka hope loa, hāʻawi ʻo 4,871 o nā hui 5,365 i nā nīnau nīnau i ka hahai ʻana (follow-up rate = 90.8%). Ma hope o ka hoʻokaʻa ʻole ʻana i ka poʻe i hoʻohana ʻole ʻole i ka ʻoihana pūnaewele pūnaewele.n = 643), he 4,237 poʻe i komo i loko o kā mākou noi lōʻihi.
kaumaha
ʻO ka pae nui o nā hōʻailona kaumaha e hoʻohuli ʻia me ka hoʻohana ʻana o 20-item kīnā o ka Center for Epidemiology Scale for Depression (CES-D). Ua hōʻoia ʻia kāna mau ʻekekema psychological ma waena o nā ʻōpio Kina.Chen, Yang, & Li, 2009; Cheng, Yen, Ko, & Yen, 2012; Lee et al., 2008; Wang et al., 2013). Loaʻa nā helu kiʻekiʻe i ka ʻehaʻeha o nā hōʻailona kaumaha, me ka huina holoʻokoʻa mai 0 a 60 (Radloff, 1977). ʻO nā mea pono a Cronbach α i kēia noiʻi ʻana .86 ma ka papa kuhikuhi a .87 i ka hana ʻana, e hōʻike ana i kahi hilinaʻi kūloko o ka maikaʻi. ʻO ka hōʻike pilikino ʻana i kahi helu CES-D ≥21 ka mea i wehewehe ʻia ma kahi hihia i hoʻopilikia ʻia (Stockings et al., 2015). Ma hope o nā haʻawina mua (Penninx, Deeg, van Eijk, Beekman, & Guralnik, 2000; Van Gool et al., 2003), ke hoʻololi ʻana i ke kūlana kaumaha i ka manawa a me kēia manawa e like me ka ʻole: ʻaʻohe kaumaha (nā poʻe komo me ke kaumaha ʻole ma ka palena a me ka hahai ʻana), he kala ʻia mai ke kaumaha (nā poʻe komo me ke kaumaha ma ka pae. -up) ke hoʻomau i nā kaumaha (i nā poʻe me ke kaumaha ma ka papa a me ka hahai ʻana), a me ka ulu kino ʻana (nā poʻe komo ʻole make kaumaha ma ke kumu akā nūnū ʻia me ka minamina i ka hana i kahuli).
Hoʻohui ʻikepili pūnaewele pūnaewele (OSNA)
Hoʻomaʻamaʻa ʻia nā pae hoʻohui i ka pūnaewele pūnaewele me ka kāʻei o OSNA, e loaʻa ana i ʻewalu mau mea e ʻike ana i nā hōʻailona addictive hōʻailona o ka cognitive a me ke ʻano salience, kue me nā hana ʻē aʻe, euphoria, ka nalowale o ka pale, hoʻihoʻi, hoʻihoʻi, a hoʻi hou. Loaʻa nā helu kiʻekiʻe o nā ʻāpana OSNA i nā kiʻekiʻe kiʻekiʻe o nā addictive i ka ʻoihana pūnaewele, me ka nui o ka helu 40. ʻO ka waiwai psychometric ua loiloi maikaʻi ʻia i kā mākou noi mua (Li et al., 2016). ʻAʻohe waiwai i hōʻoki ʻia no ka pālākiō OSNA e ʻike ai i nā hihia OSNA: ʻo nā mea i loaʻa i ka helu 10 o nā helu (ʻo ia hoʻi, ka helu OSNA ≥24) i hoʻokaʻawale ʻia ma ke ʻano he mau hihia OSNA ma ka laina mua, a ʻo ka waiwai like i hōʻoki ʻia hoʻohana ʻia e hoʻokaʻawale i nā hihia ma ka ukali. Ua hoʻohana ʻia ka hoʻolālā hoʻohālikelike like i ka noi mua (Verkuijl et al., 2014). ʻO nā koina Cronbach α o ke kao o ka OSNA i kēia noiʻi ʻana .86 ma ka pae kahua a .89 ma ke kāʻei ʻana. Pēlā nō, hoʻololi ʻia ke kūlana OSNA mai ka palena o ka hana i kahakaha ʻia e like me kēia: ʻaʻohe OSNA (nā poʻe komo ʻole OSNA ʻelua ma ka pae kahua a me ka hahai ʻana), kahi kinai mai OSNA (nā poʻe komo me OSNA ma ka pae kahua akā hele i ka ʻole OSNA ma ka huli ʻana ), e hoʻomau ka OSNA (nā mea komo me OSNA ma ka palena a me ka hahai ʻana), a me nā OSNA e kū mai ana (nā poʻe komo ʻole OSNA ma ka pae palena akā ua holo ʻia me OSNA ma ka hana hahai).
Nā Covariates
Hoʻokomo ʻia nā Covariates i ka moe, ka helu, ka pae hoʻonaʻauao makua, ʻike i ke kūlana kālā, ka noho ʻana (a me nā mākua ʻole a ʻole), ka hana hoʻonaʻauao pilikino, a ʻike ʻia i ke kaomi haʻawina ma ka pae ʻāina.
NānāʻIke Heluhelu
Hōʻike i nā helu helu wehewehe (e laʻa me ke ʻano o ka hoʻoliʻiliʻi maʻamau, a me nā pākēneka) ke kūpono. ʻO nā coefficients hoʻohui pilina no ka hoʻopili ʻana ma nā kula he 1.56% (p = .002) no ke kaumaha loa a me 1.42% (p = .042) no ka hanana OSNA, e hōʻike ana i nā ʻano nui ma waena o nā kula (Wang, Xie, & Fisher, 2009). Nā ʻōnaehana Multilevel logistic regression (Papa 1: haumāna; Papa 2: kula) no laila ua noi ʻia e loiloi i nā pilina lōʻihi ma waena o OSNA a me ke kaumaha i ka manawa, a kau i ka hopena o ka cluster sampling hopena mai ke kula. He poina e pili ana i ka launa pū me nā pilikia hōʻeha / OSNA me p <.05 i ka univariate analysis a i hōʻike ākea paha i nā puke (ie, ke kāne a me ka papa) i hoʻoponopono ʻia no nā ana hoʻohālikelike logistic multivariable.
No ka wānana o OSNA ma ka ulu hou o ke kaumaha i waena o nā poʻe i komo ʻole i ke kaumaha i ka pae.n = 3,196), ua koho mua mākou i ka lakio kaulike (OR) o ka OSNA baseline, ʻelua mau hoʻololi binary (ie, OSNA ʻaʻole paha) a me nā loli mau (nā pālākiō OSNA), ma nā hanana hou o ke kaumaha ma hope o ka hoʻoponopono ʻana i nā covariates nui, a laila ʻoi aku. ke hoʻoponopono nei i ka helu pālākiō CES-D kaha kiʻi (Hinkley et al., 2014). A laila ua manaʻo mākou i ka wānana o ka hoʻololi i ke kūlana OSNA ma luna o ka manawa i ka wā hou o ke kaumaha, me ka mea hoʻohālike i hoʻoponopono ʻia o nā covariates koʻikoʻi a me kahi hoʻohālikelike hou aʻe i nā helu pākuʻu CES-D.
ʻO ka manaʻo, ʻo ka wīwī i ke kaumaha i ka hou ʻana o ka OSNA i waena o nā mea komo me ka ʻole OSNA ma ka pae kahua (n = 3,657) i kuhi ʻia i kahi ʻano like me ka mea i hōʻike ʻia aʻe nei me nā hanana hou o OSNA e like me ka hopena a me ke kaumaha ma ke ʻano he hōʻike. ʻO ka wānana o ke kaumaha kaumaha (ka hoʻomau mau a me ka mana mahele) no nā hanana hou o OSNA a me ka wānana o ka loli i ke kūlana kaumaha i ka manawa o nā hanana hou o OSNA i koho ʻia.
Ua hana ʻia ka noiʻi helu helu me ka hoʻohana ʻana i ka SAS version 9.4 (SAS Institute, Cary, NC, USA). Na kowa elua p waiwai <.05 i manaʻo ʻia he helu koʻikoʻi.
nā mea pono
ʻO nā kaʻina loiloi i hana ʻia e like me ka Hōʻikeʻike ʻo Helsinki. Ua loaʻa ka ʻae kula a me ka ʻae no ka hoʻokolokolo kula kula mai nā kumu kula ma mua o ka hoʻokolokolo ʻana. Loaʻa ʻia ka ʻae Verbal i nā haumāna ma mua o ko lākou komo ʻana i ka ʻōlelo. Ua apono ʻia kēia noiʻi a me ke kaʻina ʻae ʻana e ka Survey and Behanceal Research Ethics Committee o ke Kino University of Hong Kong.
Results
Nā hiʻohiʻona a me nā hōʻike hoʻonaninani
Ua hōʻike ʻia ka loiloi ʻana ʻaʻohe ʻano ʻokoʻa loa e pili ana i ka pae hoʻonaʻauao mau mākua a me ka hana ʻana o ka haʻawina ponoʻī ma waena o nā ʻōpio i komo i ka loiloi lōʻihi (n = 4,237) a me ka poʻe i kāpae ʻia mai ka loiloi lōʻihi.n = 1,128). ʻO nā ʻōpio, nā mea i pili i ka laʻana lōʻihi, ʻoi aku ka wahine, mai ka papa ʻewalu, he kūlana kālā ʻohana maikaʻi, noho pū me nā mākua ʻelua, a ʻike i ke kaomi aʻo māmā / māmā (Papa. 1).
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1 Pūnaewele. Hōʻalo ʻia o ka helu ʻana a me nā hiʻohiʻona o nā mea komo i ka hoʻohālike ka lōʻihi
ʻO Baseline | ʻO nā poʻe komo i ka hōʻike longitudinal | ʻO nā poʻe komo me ka make ʻole o ka papa hana | ʻO nā mea komo ʻole OSNA ma ka papa hana | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
ʻAe | ʻAʻole | p* | Non-OSNA | OSNA | p* | Ke ʻole makemake ʻole | Ua pilikia | p* | ||
| Ka huina | 5,365 | 4,237 | 1,128 | - | 2,922 | 274 | - | 2,922 | 735 | - |
| Sex | ||||||||||
| Male | 2,533 (47.2) | 2,105 (49.7) | 727 (64.4) | <.001 | 1,464 (50.1) | 164 (59.8) | .002 | 1,464 (50.1) | 309 (42.0) | <.001 |
| Female | 2,832 (52.8) | 2,132 (50.3) | 401 (35.6) | 1,458 (49.9) | 110 (40.2) | 1,458 (49.9) | 426 (58.0) | |||
| Papa | ||||||||||
| ʻehiku | 2,592 (48.3) | 2,011 (47.5) | 581 (51.5) | .016 | 1,418 (48.5) | 131 (47.8) | .820 | 1,418 (48.5) | 337 (45.9) | .194 |
| ʻewalu | 2,773 (51.7) | 2,226 (52.5) | 547 (48.5) | 1,504 (51.5) | 143 (52.2) | 1,504 (51.5) | 398 (54.2) | |||
| Papa pae kula papa | ||||||||||
| Kula mua a ma lalo paha | 356 (6.6) | 273 (6.4) | 83 (7.4) | .376 | 165 (5.7) | 21 (7.7) | .049 | 165 (5.7) | 61 (8.3) | .010 |
| Kula kiʻekiʻe ʻo Junior | 1,816 (33.9) | 1,425 (33.6) | 391 (34.7) | 958 (32.8) | 108 (39.4) | 958 (32.8) | 259 (35.2) | |||
| Kula puka kula kiʻekiʻe | 1,646 (30.7) | 1,312 (31.0) | 334 (29.6) | 911 (31.2) | 79 (28.8) | 911 (31.2) | 230 (31.3) | |||
| Kulanui a ʻoi paha | 1,317 (24.5) | 1,053 (24.9) | 264 (23.4) | 763 (26.1) | 54 (6.6) | 763 (26.1) | 159 (21.6) | |||
| ʻIke ʻole | 230 (4.3) | 174 (4.1) | 56 (5.0) | 125 (4.3) | 12 (4.4) | 125 (4.3) | 26 (3.5) | |||
| Papa pae hoʻonaʻauao makuahine | ||||||||||
| Kula mua a ma lalo paha | 588 (11.0) | 445 (10.5) | 143 (12.7) | .144 | 267 (9.1) | 35 (12.8) | .108 | 267 (9.1) | 103 (14.0) | <.001 |
| Kula kiʻekiʻe ʻo Junior | 1,909 (35.6) | 1,507 (35.6) | 402 (35.6) | 1,030 (35.3) | 108 (39.4) | 1,030 (35.3) | 274 (37.3) | |||
| Kula puka kula kiʻekiʻe | 1,497 (27.9) | 1,199 (28.3) | 298 (26.4) | 860 (29.4) | 71 (25.9) | 860 (29.4) | 180 (24.5) | |||
| Kulanui a ʻoi paha | 1,143 (21.3) | 913 (21.6) | 230 (20.4) | 634 (21.7) | 50 (18.3) | 634 (21.7) | 156 (21.2) | |||
| ʻIke ʻole | 228 (4.3) | 173 (4.1) | 55 (4.9) | 131 (4.5) | 10 (3.6) | 131 (4.5) | 22 (3.0) | |||
| ʻO ke kūlana kālā | ||||||||||
| Maikaʻi loa / maikaʻi | 2,519 (47.0) | 2,047 (48.3) | 472 (41.8) | <.001 | 1,495 (51.2) | 123 (44.9) | .115 | 1,495 (51.2) | 300 (40.8) | <.001 |
| ʻawelike | 2,664 (49.6) | 2,072 (48.9) | 592 (52.5) | 1,366 (46.7) | 143 (52.2) | 1,366 (46.8) | 405 (55.1) | |||
| ʻIlihune / ʻilihuna loa | 182 (3.4) | 118 (2.8) | 64 (5.7) | 61 (2.1) | 8 (8.6) | 61 (2.1) | 30 (4.1) | |||
| Noho me nā mākua ʻelua | ||||||||||
| ʻAʻole | 4,712 (87.8) | 490 (11.6) | 163 (14.4) | .008 | 312 (10.7) | 30 (11.0) | .890 | 312 (10.7) | 107 (14.6) | .003 |
| ʻAe | 653 (12.2) | 3,747 (88.4) | 965 (85.6) | 2,610 (89.3) | 244 (89.0) | 2,610 (89.3) | 628 (85.4) | |||
| Ka hana aʻo | ||||||||||
| luna | 1,817 (33.9) | 1,465 (34.6) | 223 (19.8) | .276 | 1,142 (39.1) | 51 (18.6) | <.001 | 1,142 (39.1) | 205 (27.9) | <.001 |
| Medium | 2,396 (44.6) | 1,920 (45.3) | 619 (54.9) | 1,306 (44.7) | 134 (48.9) | 1,306 (44.7) | 347 (47.2) | |||
| Pau | 1,152 (21.5) | 490 (20.1) | 286 (25.4) | 474 (16.2) | 89 (32.5) | 474 (16.2) | 183 (24.9) | |||
| Ke kaomi haʻawina hoʻonaʻauao ʻana | ||||||||||
| Nil / kukui | 1,034 (19.3) | 811 (19.1) | 352 (31.2) | <.001 | 667 (22.8) | 31 (11.3) | <.001 | 667 (22.8) | 78 (10.6) | <.001 |
| Nui | 3,052 (56.9) | 2,433 (57.4) | 476 (42.2) | 1,769 (60.5) | 172 (62.8) | 1,769 (60.5) | 359 (48.8) | |||
| Kaumaha / kaumaha loa | 1,279 (23.8) | 993 (23.4) | 300 (26.6) | 486 (16.6) | 71 (25.9) | 486 (16.6) | 298 (40.5) | |||
'Ōlelo Aʻo. Hōʻike ʻia nā ʻikepili e n (%). OSNA: ka hoʻohui inoa pūnaewele pūnaewele; CES-D: kikowaena no ka scidemiology Scale no ke kaumaha; -: pili 'ole.
*p loaʻa nā waiwai i ka hoʻohana χ2 hōʻike.
Ma waena o nā ʻōpio 4,237 (ʻo ke ʻano o ka makahiki: 13.9, ka hoʻowahāwahā maʻamau: 0.7) i ka hoʻohālike lōʻihi, ʻo 49.7% (2,105 o 4,237) he wahine a ʻo 47.5% (2,011 o 4,237) nā haumāna helu ʻehiku. ʻO ka hapa nui o nā ʻōpio (88.4%; 3,747 o 4,237) i noho pū me ko lākou mau mākua. I ka hōʻike lōʻihi, ua hoʻonui nui ʻia ka hoʻonui ʻana i ke kaumaha mai 24.6% (1,041 o 4,237) i ka baseline a 26.6% a ka hopena (test McNemar = 7.459, p = .006). ʻAʻohe ʻokoʻa nui no ka prevalence o OSNA ma waena o ka laina palena manawa a me ka ukali ʻana (13.7% ma ka laina ma lalo o 13.6% ma ka ukali ʻana; hōʻike a McNemar = 0.053, p = .818). He 3,196 ka nui o nā haumāna i kaumaha ʻole i ka hoʻomaka, a ua noa nā haumāna 3,657 i ka OSNA ma ka laina hoʻomaka (Papa. 1).
Loaʻa nā mea e hoʻopili ʻia ai nā mea hou o ke kaumaha a me OSNA
papaʻaina 2 Hōʻike i ka ʻike ʻoi ʻole ka pilikia o ka ʻohana, ka hana hoʻonaʻauao haʻahaʻa ponoʻī, a ua ʻike ʻia ke ke aʻo ʻana o ka naʻau nui i pili i nā mea kiʻekiʻe o ke kaumaha (ma waena o ʻUwāwahine OR: 1.32-1.98) a me nā kūlana kiʻekiʻe o OSNA (ka ʻokoʻa o ka univariate OR: 1.61 – 2.76). ʻO ka noho me ko lākou mau mākua he kumu pale palekana nui no ka hōʻino ʻana o OSNA wale nō [univariate OR: 0.65, 95% hilinaʻi (CI): 0.48-0.89].
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2 Pūnaewele. Univariate hui ma waena o covariates a me nā pilikia o ke kaumaha / OSNA
ʻO ka hopena o ke kaumaha | ʻO nā manaʻo o OSNA | |||||
|---|---|---|---|---|---|---|
n (%) (n = 515) | ORu (95% CI) | p | n (%) (n = 335) | ORu (95% CI) | p | |
| Sex | ||||||
| Male | 249 (15.9) | 1 | 168 (8.9) | 1 | ||
| Female | 266 (16.3) | 0.96 (0.79, 1.16) | .641 | 167 (9.4) | 0.94 (0.75, 1.17) | .573 |
| Papa | ||||||
| ʻehiku | 250 (16.1) | 1 | 160 (9.1) | 1 | ||
| ʻewalu | 265 (16.1) | 1.00 (0.83, 1.21) | .977 | 175 (9.2) | 1.00 (0.80, 1.26) | .977 |
| Papa pae kula papa | ||||||
| Kula mua a ma lalo paha | 32 (17.2) | 1 | 26 (11.5) | 1 | ||
| Kula waena waena | 190 (17.8) | 1.04 (0.69, 1.59) | .827 | 116 (9.5) | 0.81 (0.52, 1.28) | .377 |
| Kula waena kiʻekiʻe | 139 (14.0) | 0.80 (0.52, 1.23) | .317 | 93 (8.2) | 0.67 (0.42, 1.07) | .090 |
| Kulanui a ʻoi paha | 129 (15.8) | 0.92 (0.60, 1.42) | .705 | 86 (9.3) | 0.78 (0.49, 1.26) | .310 |
| ʻIke ʻole | 25 (18.3) | 1.14 (0.63, 2.04) | .666 | 14 (9.3) | 0.79 (0.40, 1.59) | .516 |
| Papa pae hoʻonaʻauao makuahine | ||||||
| Kula mua a ma lalo paha | 47 (15.6) | 1 | 31 (8.4) | 1 | ||
| Kula waena waena | 196 (17.2) | 1.15 (0.81, 1.63) | .424 | 118 (9.1) | 1.11 (0.73, 1.69) | .621 |
| Kula waena kiʻekiʻe | 141 (15.2) | 1.01 (0.70, 1.46) | .939 | 109 (10.5) | 1.28 (0.84, 1.96) | .257 |
| Kulanui a ʻoi paha | 105 (15.4) | 1.03 (0.70, 1.52) | .861 | 64 (8.1) | 0.97 (0.61, 1.53) | .891 |
| ʻIke ʻole | 26 (18.4) | 1.32 (0.77, 2.25) | .310 | 13 (8.5) | 1.03 (0.52, 2.03) | .940 |
| ʻO ke kūlana kālā | ||||||
| Maikaʻi loa / maikaʻi | 229 (14.2) | 1 | 145 (8.1) | 1 | ||
| ʻawelike | 269 (17.8) | 1.32 (1.08, 1.60) | .006 | 172 (9.7) | 1.21 (0.96, 1.53) | .105 |
| ʻIlihune / ʻilihuna loa | 17 (24.6) | 1.98 (1.12, 3.49) | .019 | 18 (19.8) | 2.76 (1.60, 4.76) | <.001 |
| Noho me nā mākua ʻelua | ||||||
| ʻAʻole | 64 (18.7) | 1 | 54 (12.9) | 1 | ||
| ʻAe | 451 (15.8) | 0.80 (0.60, 1.07) | .135 | 281 (8.7) | 0.65 (0.48, 0.89) | .008 |
| Ka hana aʻo | ||||||
| luna | 169 (14.2) | 1 | 109 (8.1) | 1 | ||
| Medium | 226 (15.7) | 1.13 (0.91, 1.41) | .254 | 145 (8.8) | 1.10 (0.85, 1.42) | .488 |
| Pau | 120 (21.3) | 1.66 (1.28, 2.16) | <.001 | 81 (12.3) | 1.61 (1.19, 2.19) | .002 |
| Ke kaomi haʻawina hoʻonaʻauao ʻana | ||||||
| Nil / kukui | 96 (13.8) | 1 | 59 (7.9) | 1 | ||
| ʻawelike | 305 (15.7) | 1.16 (0.90, 1.48) | .253 | 178 (8.4) | 1.05 (0.77, 1.44) | .735 |
| Kaumaha / kaumaha loa | 114 (20.5) | 1.63 (1.20, 2.20) | .002 | 96 (12.5) | 1.65 (1.17, 2.32) | .004 |
'Ōlelo Aʻo. OSNA: ka hoʻohui inoa pūnaewele pūnaewele; ORu: univariate odds ratio; ʻO 95% CI: 95% hilinaʻi, loaʻa i nā hoʻohālikelike loea hoʻomāliʻikāwahine loea.
Hoʻomaopopo ka OSNA i ka ulu hou o ke kaumaha
Ma waena o nā ʻōpio 3,196 i nele ʻole i ka minamina, ka hoʻohālikelike hoʻohālikelike i hōʻike ʻia ʻo ka baseline OSNA pili nui me ke kiʻekiʻe o ke kaumaha i ka wā e pili ana i ka wā e hahai mai ana (univariate OR: 1.65, 95% CI: 1.22-2.22). Ma hope o ka hoʻoponopono ʻana i ka wahine, mākaʻi, kūlana kālā no ka ʻohana, ka hana hoʻonaʻauao, a me ke ʻano aʻo, ʻike ʻia ka nui o ke ahahui [hoʻoponopono ʻia OR (AOR): 1.48, 95% CI: 1.09-2.01]. Ke hoʻoponopono hou nei i ka helu CES-D pae, lilo ka ʻekekema i ka statistically i ʻole he nui (AOR: 1.16, 95% CI: 0.85-1.60). Loaʻa nā hopena like i ka wā e hoʻohana ana i ka helu OSNA (ka laulā maʻamau) e like me ka wānana o ka hōʻeha hou ʻana i ka manaʻo hou (Papa 3).
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3 Pūnaewele. ʻO nā hui lōʻihi ma waena o OSNA a me ke kaumaha: nā multilevel logistic regression models
n | ʻAʻole i nā hihia hou | Nā hiʻohiʻona hoʻohālikelike | Nā hiʻohiʻona multivariable | |||||
|---|---|---|---|---|---|---|---|---|
ORu (95% CI) | p | AOR (95% CI) | p | AOR (95% CI) | p | |||
| Weʻa ʻo OSNA i ka pōʻino hou hou i ke kaumaha (n = 3,196) | ||||||||
| Baseline OSNA helu (holo mau) | - | - | 1.05 (1.03, 1.07) | <.001 | 1.04 (1.02, 1.06)a | <.001 | 1.01 (0.99, 1.03)b | .242 |
| Baseline OSNA | ||||||||
| ʻAʻole | 2,922 | 451 | 1 | 1a | 1b | |||
| ʻAe | 274 | 64 | 1.65 (1.22, 2.22) | .001 | 1.48 (1.09, 2.01) | .012 | 1.16 (0.85, 1.60) | .342 |
| Hoʻololi i ka kūlana OSNA i ka lōʻihi o ka manawa | ||||||||
| ʻAʻohe OSNA | 2,694 | 354 | 1 | 1a | 1b | |||
| Ke kala ʻia mai OSNA | 179 | 38 | 1.77 (1.21, 2.58) | .003 | 1.61 (1.10, 2.37) | .015 | 1.29 (0.87, 1.91) | .202 |
| OSNA paʻa mau | 95 | 26 | 2.46 (1.54, 3.93) | <.001 | 2.23 (1.39, 3.58) | <.001 | 1.65 (1.01, 2.69) | .044 |
| ʻO OSNA e kū nei | 228 | 97 | 4.89 (3.67, 6.52) | <.001 | 4.67 (3.49, 6.24) | <.001 | 4.29 (3.17, 5.81) | <.001 |
| ʻO ka hopohopo e wānana hou i kahi hanana OSNA (n = 3,657) | ||||||||
| Koho helu CES-D (mau loa) | - | - | 1.05 (1.03, 1.06) | <.001 | 1.04 (1.03, 1.05)c | <.001 | 1.03 (1.01, 1.04)d | <.001 |
| Pākuʻi ʻāina | ||||||||
| ʻAʻole | 2,922 | 228 | 1 | 1c | 1d | |||
| ʻAe | 735 | 107 | 2.02 (1.58, 2.58) | <.001 | 1.78 (1.38, 2.31) | <.001 | 1.48 (1.14, 1.93) | .004 |
| Hoʻololi i ke kūlana kaumaha i ke ʻano o ka manawa | ||||||||
| ʻAʻohe puʻuwai | 2,471 | 131 | 1 | 1c | 1d | |||
| Ke kala mai ke kaumaha | 315 | 21 | 1.28 (0.80, 2.07) | .307 | 1.19 (0.73, 1.93) | .486 | 0.97 (0.60, 1.59) | .918 |
| Kaumaha kaumaha | 420 | 86 | 4.62 (3.43, 6.21) | <.001 | 4.17 (3.05, 5.69) | <.001 | 3.45 (2.51, 4.75) | <.001 |
| Kūkulu kaumaha | 451 | 97 | 4.88 (3.67, 6.50) | <.001 | 4.70 (3.53, 6.28) | <.001 | 4.47 (3.33, 5.99) | <.001 |
'Ōlelo Aʻo. OSNA: ka hoʻohui inoa pūnaewele pūnaewele; CES-D: kikowaena no ka scidemiology Scale no ke kaumaha; ORu: univariable odds ratio; AOR: i hoʻoponopono ʻia i ka pāʻina hōʻano; 95% CI: 95% kikowaena hilinaʻi.
aHoʻohui ʻia nā kumu hoʻohālikelike no ka wahine, mākaʻikaʻi, ke kūlana kālā no ka ʻohana, ka hana hoʻonaʻauao, a me ke ʻano noʻonoʻo. bHoʻoponopono nā ʻano hoʻohālikelike no ka moekolohe, mākaʻikaʻi, ke kūlana kālā no ka ʻohana, ka hana haʻawina, ke ʻano aʻo ʻana i ʻike ʻia, a me ka helu pākēnē CES-D (mau like ʻole). cHoʻohui ʻia nā kumu hoʻohālikelike no ka wahine, mākaʻikaʻi, ke kūlana kālā, pili ola me nā mākua, hana haʻawina, a me ke aʻo ʻana ʻike. dHoʻohui ʻia nā kumu hoʻohālikelike no ka wahine, mākaʻikaʻi, ke kūlana kālā no ka ʻohana, ke ola ʻana me nā mākua, ka hana hoʻonaʻauao, ʻike ʻia ka naʻau aʻo, a me ka pāpaʻina ʻaumea OSNA pae (maʻamau ākea).
ʻIke mākou i kahi hui nui ma waena o ka loli i ke kūlana OSNA a me nā mea kiʻekiʻe kiʻekiʻe o ke kaumaha. Hoʻohālikelike ʻia me nā ʻōpio i helu ʻia i ʻole OSNA, ʻo ka nui o ka hoʻoulu ʻana i ke kaumaha he 1.65 mau manawa (95% CI: 1.01-2.69) kiʻekiʻe i waena o ka poʻe me ka mau ʻana ʻo OSNA, a me nā manawa 4.29 (95% CI: 3.17-5.81) kiʻekiʻe i waena o ka poʻe me OSNA e puka mai ana, ma hope o ka hoʻoponopono ʻana o ka wahine, mākaʻikaʻi, ke kūlana kālā, nā hana haʻawina, ke ʻano aʻo ʻana i ʻike ʻia, a me nā helu CES-D (Papa Papa. 3).
ʻO ka hopohopo e wānana hou i kahi ulu hou o OSNA
Ma waena o nā ʻōpio 3,657 ka manuahi o OSNA i ka papa ʻāina, nā hopena hoʻohālikelike hōʻike i kahi hui maikaʻi nui ma waena o ke kumu baseline a me ka piʻi kiʻekiʻe o OSNA (univariate OR: 2.02, 95% CI: 1.58-2.58). Ma hope o ka hoʻoponopono ʻana i ka wahine, mākaʻi, kūlana kālā no ka ʻohana, ka noho ʻana me nā mākua, ka hana hoʻonaʻauao, a me ke aʻo ʻana ʻike, ʻike nui ʻia ka hui akā i noho nui (AOR: 1.78, 95% CI: 1.38 – 2.31). Ua pili nui ka pilina ma waena o ke kumu kīnā kaumaha a me ka ulu ʻana o OSNA i ka nui o ka hoʻoponopono ʻana i nā pae pākahi OSNA (AOR: 1.48, 95% CI: 1.14-1.93). Nui nā hopena i ka wā e hoʻohana ana i ka helu CES-D (ka loli mau) me ka wanana o ka hanana hou OSNA (Papa 3).
Ua ʻike ʻia kahi hui nui ma waena o ka hoʻololi ʻana i ke kūlana kaumaha a me ka ulu ʻana o OSNA i ka nānā ʻana multivariable. Ma hope o ka hoʻoponopono ʻana i ka wahine, mākaʻi, kūlana kālā no ka ʻohana, ka noho ʻana me nā mākua, ka hana hoʻonaʻauao, ʻike ʻia ke aʻo ʻana, a me ka pā o ka mana OSNA, e hoʻohālikelike ʻia me nā ʻōpiopio me ka minamina, nā pōʻino o ka hoʻolālā ʻana i ka OSNA ʻo 3.45 mau manawa (95% CI: 2.51– Ua ʻoi loa ka 4.75) i waena o ka poʻe e hoʻomanawanui nei, a me nā manawa 4.47 (95% CI: 3.33-5.99) kiʻekiʻe i waena o ka poʻe e kū mai nei i ke kaumaha 3).
kūkākūkā
I loko o kēia haʻawina loiloi lōʻihi lōʻihi, ua ʻike mākou i ka poʻe ʻōpio kaumaha a me ka manuahi o ka ONSA ma ka palena palena he 48% ʻoi aku ka makaʻu o ka hoʻomohala ʻana i ka OSNA ma loko o ka manawa o 9 mahina i ka hoʻohālikelike ʻia me ka poʻe me ka ʻole o ke kaumaha ma ka pae mua, akā ʻo ka wānana o ʻaʻole kākoʻo ʻia ʻo OSNA baseline no nā hanana hou o ke kaumaha i kēia noi ʻana. Eia kekahi, ke nānā ʻia nā hopena o nā loli i ke kūlana ma luna o ka manawa (ʻo ia hoʻi, ke kala ʻana mai ke kaumaha / OSNA ma ke kumu mua i ke kaumaha ʻole / ʻole OSNA ma hope) i nā hopena, ua hōʻike ʻia nā hopena i kahi hui ʻelua ma waena o OSNA a me ke kaumaha. . ʻO nā ʻōpio i kaumaha mau a kūpikipiki paha i ka pōpilikia i ʻoi aku ka kiʻekiʻe o ka hoʻomohala ʻana i ka OSNA ke hoʻohālikelike ʻia me ka poʻe i kaumaha ʻole i ka manawa o ka mālama ʻana o 9 mau mahina. Hoʻohuli ʻia, ʻo nā ʻōpio ʻōpio hoʻomau mau OSNA a i ʻole OSNA e kū aʻe nei ua hoʻonui ʻia ka makaʻu o ka hoʻomohala kaumaha ke hoʻohālikelike ʻia me ka poʻe ʻaʻole OSNA ma nā laina mua a me ka ukali.
ʻO ka ʻokoʻa o nā hopena i loaʻa me ka hoʻohana ʻana i nā ana laina (ie, basna OSNA) a me nā loli i ke kūlana (ʻo ia hoʻi, ka hoʻololi ʻana i ke kūlana OSNA) e wānana i kahi hopena i loaʻa (ʻo ia hoʻi, nā hanana hou o ke kaumaha) hiki ke wehewehe ʻia e nā helu remission kiʻekiʻe mai OSNA a kaumaha i loko o ka wā ukali. Ua ʻike ʻia ka nui o ke ʻano o ka remission o ka lawena ma ka Pūnaewele (49.5% –51.5%) i loko o ʻelua mau aʻo lōʻihi lōʻihi ma Taiwan (Ko, Yen, Yen, Lin, & Yang, 2007; Ko et al., 2015). Ua nānā mau ʻia nā hualoaʻa mai kā mākou noi mua ma Hong Kong i kahi hana nui o ke kala ʻana mai ka pili ʻana i ka Pūnaewele i ke ʻano he 12 a hoʻokahi mahina (59.29 i kēlā me kēia makahiki 100; Lau, Wu, loa, Cheng, & Lau, 2017). Pēlā nō hoʻi, i kēia noiʻi, kahi nui o nā hihia kala ʻana mai ke kaumaha (41.4%) a me OSNA (58.8%) i nānā ʻia i loko o ka wā aʻo. Ua hōʻike ʻia kēia mau hopena ua hiki i ka OSNA a me ke kūlana kaumaha i ka loiloi o ka pae ʻana i hiki ke mālama ʻia e like me ke ʻano he hoʻololi ʻole i ka lōʻihi o ka manawa a no laila ka nānā ʻole ʻana i ke kala ʻana i ka wā i ka wā hiki ke hoʻowahāwahā i ka hopena o OSNA i ke kaumaha. No laila, kuhi mākou i ke ala hoʻohālike e pili ana i nā loli kaulua i ka mana o OSNA a me ke kūlana kaumaha i ka manawa hiki ke hoʻolako i ka manaʻo kūʻiʻo hou a i hoʻopaʻa ʻia ma o ka hoʻoponopono ʻana i nā hopena e hiki mai ana i nā hihia kala ʻana.
Hōʻike nā mea i loaʻa i kēia noiʻi i kahi hui ʻelua ma waena o OSNA a me ke kaumaha i waena o nā ʻōpio, e hōʻike ana i ke kaumaha i kahi pilikino pilikino e hoʻomohala i ka OSNA, a ʻo ka hopena maikaʻi ʻole o ka OSNA e hoʻonui i nā ʻōuli o ke kaumaha. ʻO nā manaʻo maladaptive (ʻo ia hoʻi, rumination, kānalua iā ʻoe iho, haʻahaʻa haʻahaʻa, a me ka loiloi pono ʻole iā ʻoe iho) a me nā hana pono ʻole (ʻo ia hoʻi, ka hoʻohana ʻana i ka Pūnaewele e pakele ai i nā pilikia o ka naʻau) koʻikoʻi i ka hoʻomohala ʻana i nā lawena addict-e pili ana i ka Pūnaewele (ʻO Davis, 2001). Hōʻike pinepine nā poʻe kaumaha i nā ʻōuli ʻike a loaʻa nā manaʻolana maikaʻi no kā lākou hoʻohana pūnaewele e hiki i ka Pūnaewele ke hoʻoweliweli iā lākou mai nā ʻano maikaʻi ʻole a me nā pilikia pilikino (e laʻa, ke kaumaha a me ka mehameha; Brand, Laier, & Young, 2014; ʻO Wu, Cheung, Ku, & Hung, 2013). ʻO ka mea nui, ʻoluʻolu ka launa pūnaewele ʻana i ka poʻe me nā pilikia o ka naʻau no ka inoa ʻole a me ka ʻole o nā ʻike kaiāulu (ʻo ia hoʻi, ka helehelena o ka helehelena, ke kani ʻana o ka leo, a me ka maka maka) ke hoʻohālikelike ʻia i nā kamaʻilio maka-he alo (Young & Rogers, 1998). Makemake paha kekahi poʻe kaumaha i ka pūnaewele pūnaewele ma ke ʻano he ʻoi aku ka palekana a me ka hoʻoweliweli o ke kamaʻilio ʻana, a me nā ala no ka hoʻoponopono ʻana i ko lākou ʻano maikaʻi ʻole (ʻo ia hoʻi, ka hōʻemi ʻana i nā manaʻo maikaʻi ʻole, ka hopohopo, a me nā pilikia pilikino). ʻO kēia mau ʻike maladaptive a me ka pale ʻana i nā hoʻolālā kope e hōʻeleu i ka hoʻomohala ʻana o OSNA. Hoʻopili ke komo ʻana o ka pūnaewele nui i ka manawa i hala me ka ʻohana a me nā hoa i ka honua maoli, a kumu e haʻalele ai i nā hana ma waena o ka pūnaewele, e hoʻonui ai i nā ʻano maikaʻi ʻole (e laʻa me nā ʻōuli depressive a me ka mehameha; Kraut et al., 1998), ma ia hōʻike ʻana i kahi pilina pili.
Loaʻa nā mea i loaʻa i kēia noiʻi ʻana i kekahi mau hopena i ka hoʻolālā ʻana i nā polokalamu e pale ai a me nā polokalamu. ʻO ka mea mua, ʻo ka wānana kūpono o ka pōkole i lalo i ka hou o OSNA ka mea e hoʻopiʻi ai ka manaʻo o nā ʻōpio kaumaha i nā mea koʻikoʻi i ka hoʻouluʻana i ka OSNA ma hope aʻe. Hōʻalo ka hoʻoweliweli o ka hōʻemi ʻana i nā ʻōhua kaumaha, ʻo ia hoʻi, ke hōʻemi nei i ka manaʻoʻiʻo maladaptive no ka maikaʻi o nā mea e pono ai ka hoʻohana ʻana i ka Pūnaewele, hoʻomaʻamaʻa ana i nā loea kanaka, a me ka hoʻolālā ʻana i nā hana leʻaleʻa kūwaho (Chou et al., 2015), pale paha i ka hoʻomohala ʻana o OSNA. ʻO ka lua, he mea nui e nānā i nā pae o nā hōʻailona depressive ma ke ʻano he māka o ka nāwaliwali no OSNA. ʻO nā hana a me nā pale ʻana i ka poʻe ʻōpio i ka makaʻu nui me nā ʻōuli depressive e hoʻoliʻiliʻi paha i nā pilikia o ka ʻike ʻana i ka OSNA ma waena o nā ʻōpio kula. ʻO ke kolu, no ka wānana ikaika o ka loli i ke kūlana OSNA (ʻo ia hoʻi, ʻo OSNA mau a me OSNA e kū aʻe nei) ma ka hanana o ke kaumaha a me ka wānana o ka loli i ke kūlana kaumaha (ʻo ia hoʻi, ke kaumaha mau a me ke kaumaha e kū nei) ma nā hanana OSNA, hōʻike ia OSNA hoʻonui nui ʻia me ke kaumaha, e hōʻike ana i kahi ʻano hoʻoikaika ikaika.
Aia kekahi mau hopena no ka noiʻi o ka wā e hiki mai ana. ʻO ka mea mua, ʻo kā mākou mau hopena a me nā haʻawina mua i hōʻike ʻia he nui mau ka hoʻonaninani o ka OSNA a me nā hōʻailona kaumaha i ka manawa o ke aʻo ʻana ma kahi o ka fluctuation maʻamau i ka manawa (Lau et al., 2017). ʻ suggestedlelo ʻia nā noiʻi e hiki mai ana e pili ana i nā ana o ke kaumaha a i ʻole OSNA e ana pinepine i kēia mau maʻi ma mua o hoʻokahi wale nō manawa kiko e ka manaʻo ʻana ʻaʻole hiki ke hoʻololi ʻia i ka manawa. Eia hou, pono i ka metodology helu e noʻonoʻo i ka hoʻololi o ke kūlana i nā kikoʻī hoʻohālikelike, e like me ka hoʻohana ʻana i ka loli i ke kūlana pathological ma mua o ka manawa ma mua o ke kūlana kumu ma ke ʻano he wānana i nā hopena olakino noʻonoʻo. ʻO ka lua, ua hāpai ʻia kahi hopohopo inā he lōʻihi a lōʻihi paha kēia mau maʻi (ie, nā ʻōuli depressive a me nā ʻano e pili ana i ka Pūnaewele). ʻO nā loiloi lōʻihi hou aʻe e pili ana i ka papa hana papahele papa inoa latent he mea ʻokoʻa e koho i ka papa hoʻomohala kūlohelohe o kēia mau maʻi.
No ka ʻike iā mākou, ʻo kā mākou cohort study ka mea mua i koho i kahi hui bidirectional ma waena o OSNA a me ke kaumaha i waena o nā wā'ōpiopio. ʻO ka ikaika nui o kēia aʻo ʻana ka hoʻolālā hana hoʻomohala nui a me ka hana hou ʻana no ka OSNA a me ke kaumaha. ʻO kahi pōmaikaʻi hou, ʻo ia ka hui o kahi bidirectional, me ka wānana ka lōʻihi o ka OSNA i ka hoʻomohala ʻana i ke kaumaha a me ka wānana wīwī o ke kaumaha i ka ulu ʻana o OSNA, ua hoʻohālikelike i ka like.
Eia nō naʻe, pono e ʻike ʻia nā palena i ka wehewehe ʻana i nā mea i loaʻa. ʻO ka mea, ma muli o ke ʻano o ka hōʻiliʻili ʻana o ka ʻikepili ponoʻī, loaʻa ka hopena o ka hōʻike ʻana i ka bias. ʻO ka lua, ua nānā kēia noiʻi ʻana i ka heluna kanaka kikoʻī (ʻo ia hoʻi, nā haumāna ʻole kula, nā haumāna o ke kula), a me ka laulā ʻana o nā hopena i nā lehulehu ʻē aʻe e akahele. Pono nā haʻawina i nā heluna kanaka ʻē aʻe (ʻo ia hoʻi, ka heluna kanaka psychiatric clinical) e hōʻoia hou i kēlā mau hui longitudinal i loaʻa i kēia noi. ʻO ke kolu, hiki i ka misclassification no ke kaumaha ma ke ʻano he kumu o ke kuhi hewa ʻana e noʻonoʻo ana ua ana ʻia ke kaumaha e kahi pālāki kānana epidemiological i lawelawe ponoʻī ʻia ma mua o ka ʻike maʻi e nānā i ke kaumaha. ʻEhā, ua kapu kēia aʻo ʻana i nā helu manawa ʻelua me ka wā 9-mahina. E like me kā mākou e wehewehe ai i ka loli i ka OSNA / kaumaha (ʻo ia hoʻi, ONSA mau loa / kaumaha a me ke kala ʻia ʻana mai OSNA / kaumaha) ma ka hoʻohālikelike ʻana i nā hopena o nā ana o ka papa hana a me nā ukali i mālama ʻia i 9 mau mahina kaawale, ʻaʻole mākou i ʻike inā ua loli ke kūlana OSNA / kaumaha. fluctuated i loko o ka 9-malama au. ʻO nā aʻo lōʻihi me nā nānā ʻana he nui a me ka wā pōkole e pono ai e kiʻi i ke kiʻi hōʻeuʻeu o kēia mau kūlana maikaʻi ʻole. ʻO ka ʻelima, ke noʻonoʻo nei ʻaʻohe loaʻa pono o nā mea hana gula a me nā pae diagnostic no OSNA, ua hoʻohana mākou i ka 10 decile o nā māka OSNA ma ka laina e wehewehe i nā hihia OSNA ma hope o ka noi like i paʻi ʻia (Verkuijl et al., 2014). Maikaʻi ka ʻike a me ka kikoʻī o kēia ʻike no ka kūlana OSNA ʻaʻole i maopopo a pono ʻia ke loiloi ʻia i ka noiʻi ma hope. Eia nō naʻe, ua hōʻike ka ʻōpiopio o ka OSNA i nā waiwai psychometric i hoʻopaʻa ʻia i kēia kaua aʻo kā mākou noiʻi i mua. ʻEono, ua manaʻo ʻia nā hui ʻana ma waena o ka OSNA a me ke kaumaha i ka hoʻokaʻawale ʻana i ka hoʻohana ʻana he ʻelua mau minana. Ke manaʻoʻiʻo nei mākou ʻo ka hoʻohana ʻana i ke kūlana pathological e like me ka hopena ma mua o nā helu mau no ka hiki ke hāʻawi i ka wehewehe nui ʻana i ka ʻenekia epidemiological. ʻO ke kumu hoʻohālike kumu hoʻohālikelike papa kumu hiki i ke ala hou e huli ai i nā kumu kumu i nā noiʻi longitudinal me ʻekolu o ʻekolu mau ʻike. Eia kekahi, ʻike kā mākou ʻike i nā hōʻike ikaika o nā hui kino (hoʻokahi kikoʻī koʻikoʻi no ka inuga kumu) ma waena o OSNA a me ke kaumaha. Eia nō naʻe, ʻaʻole hiki iā mākou ke kāpae i ka hiki ʻole o kahi ʻano ʻekolu i komo i loko o kēia aʻo ʻana e pili ana i nā hui ʻana ma waena o ka OSNA a me ke kaumaha.
hopena a
Ua hōʻike ʻia kēia haʻawina ma kahi hui bidirectional ma waena o ka OSNA a me ke kaumaha i waena o nā wā'ōpiopio, ʻo ia hoʻi ka manaʻo nui i ke kaumaha i ka hoʻomohala ʻana o OSNA, a ma ka huli ʻana, ua ʻike ʻia nā mea e hopohopo nei i nā hopena maikaʻi ʻole mai ka hoʻohana ʻana i ka ʻoihana pūnaewele. Ua ʻike ʻia nā haʻawina lōʻihi lōʻihi me nā manawa ʻike lōʻihi a me ka manawa pōkole no ka hōʻoia hou o nā ʻike mai kēia ʻike.
ʻO ka hāʻawiʻana o nā mea hoʻohana
J-BL, JTFL, PKHM, a me X-FS hāpai a hoʻolālā i ka hoʻopaʻa ʻana. Ua loaʻa iā J-BL, J-CM, a me Y-XC ka ʻike. J-BL, JTFL, a me PKHM i hana i ka helu helu helu helu. J-BL, JTFL, PKHM, XZ, a me AMSW i hoʻolālā a hoʻoponopono hou ʻia ka palapala. Ua pili nā mea kākau a pau i ka ho'ākāka o nā hopena a me ka loiloi koʻikoʻi o ka kākau ʻōlelo no ka ʻike naʻau koʻikoʻi a apono i ka hopena hope loa o ka kākau.
Kōkua hihia
ʻAʻole i hōʻikeʻia e nā mea kākau i ka paʻi kālā.
'Ōlelo hōʻeia
Makemake nā mea kākau i ke mahalo i nā mea a pau a me ko lākou ʻohana a me nā kula no ke kākoʻo ʻana i kēia aʻo.
E hoʻomaopopo '
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