女性經痛自我照護策略之發展

馬素華
國立臺東大學
這個二年的前瞻性控制性研究計畫擬檢測一個可以接受又實用的自我照護方案對於經痛婦女疼痛、身體自覺檢察與身體結構排列之成效。自我照護方案包括穴位按壓和身心動作教育。在研究的第一年，符合條件的研究對象將被分配至實驗組或控制組。實驗組100位個案除接受例行的經痛諮詢以外；並且接受身心動作教育每週一次，每次兩小時，為期12週以及從月經開始日實施自我穴位按壓，每日一次，每次12-24分鐘，計5天，為期12週。對照組200位個案僅接受例行的經痛諮詢。主要的結果變項為主觀的短式McGill疼痛量表，疼痛視覺類比量表，身體自覺檢察表，以及客觀的身體結構排列檢測表。本研究不僅將評估12週穴位按壓和身心動作教育後短期效果，更將評估自我照護方案實施後半年長期效果。本研究使用身心動作練習記錄表評估施行身心動作以監測實驗措施的遵循度，同時也將運用各種策略以增加研究對象在實驗措施的遵循度。經痛程度、疼痛藥物使用、以及身體結構排列檢測分數等共變項將透過研究設計或統計方法加以控制。實驗結果將採用兩種方式分析，一種為intent-to-treat，即按實驗開始前分配的情形，納入所有的個案資料，另一種則為on-treatment（per-protocol-all patients who complete the study without major protocol violation），即依實際完成措施的情形（不包括不遵循及中途退出之個案）。在研究的第二年，除了繼續評估自我照護方案實施後的長期效果，將自我照護方案製作成自我照護手冊和DVD。
關鍵字：女性、經痛、穴位按壓、身心學

Development of Self-Care Strategies for Dysmenorrhea

Suh-Hwa Maa
National Taitung University
This two-year prospective controlled study is to develop a well-conceived and feasible protocol of self-care on pain, body scan check and body alignment in females with dysmenorrhea. The intervention program is including both acupressure and somatic movement education. During the first year, eligible participants will be assigned to either the experimental group or the usual-care control group. One hundred subjects in the experimental group will accept not only routine dysmenorrheal consultation, but also somatic movement education 2 hours once a week for 12 weeks and perform self-administered acupressure 12~24 minutes once daily for five days during menstruation period for 10 weeks. Two hundred subjects in the control group will accept only routine dysmenorrheal consultation. The main outcome variables are subjective short form McGill pain questionnaire, pain visual analog scale, body scan check, and objective body alignment scale. Not only the immediate effect of the intervention will be tested at the end of the 10-week both acupressure and somatic movement education, the maintenance effects will be evaluated for up to a half year. Adherence to the study intervention will be monitored by assessing the actual somatic movement performed using somatic movement log. Strategies for enhancing adherence will be employed. Covariates that will be controlled through design or statistical approaches are dysmenorrhea stage, use of NSAID, and body alignment scale score. Data will be analyzed using both intent-to-treat and on-treatment approaches. In the second year, in addition to follow up the maintenance effects of the intervention program, the intervention program will be modified and implemented to become a self-care handbook and DVD.
關鍵字：Females, Dysmenorrheal, Acupressure, somatics