第五章 綜合討論
第六節 研究限制與對研究未來發展的建議
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第六節 研究限制與對研究未來發展的建議
首先，研究結果發現的用藥頻率軌跡預測模型，是以臨床門診情境為基礎平台，在 不清楚安眠藥使用者之前用藥軌跡的情況下，可以透過相關變項預測其未來18 個月的安 眠藥使用頻率狀況。而未來若要要探討更完整的安眠藥使用機制，可進一步以第一次使 用安眠藥開始追蹤（Ishigooka et al., 1998），以觀察更完整的行為機制。
接著，在設計此研究時，與其他研究不同，以時間密度相較高的電話追蹤研究為資 料收集模式，有利於確保安眠藥使用者經過醫療處方後具體的服用情形，但若要跟其他 研究所用的醫療處方資料庫相比，本研究設計會呈現明顯的追蹤的時間限制（Ishigooka et al., 1998; Cheung et al., 2019）。上述研究設計可能會限制研究看到更多的軌跡型態，舉 例來說，雖然追蹤一年半的時間已比臨床建議的時間長了（Siesta et al., 2017），但若與 其他研究的追蹤 3-5 年相比，就明顯顯得短了。因上述因素可能限制了本研究看到上升 或反彈軌跡型態的因素，建議未來研究可拉長追蹤的時間以利觀察更多的軌跡型態，跟 過去研究做呼應。
此外，本研究樣本數相當小，並未有機會將樣本折半，並將一部分進行模型建立與 相關變項的檢測，若想要驗證此軌跡模型是否能類化到大樣本，則可待後續收集更多的 安眠藥的使用者，再進行軌跡分類，以更確立研究結果之軌跡個別差異與相關變項的信、
效度。
在相關變項的選擇部分，雖然已盡量納入相當多的軌跡型態相關變項，然而，能夠 在統計上呈現預測力的變項卻相當少，或許未來研究可納入更多相關變項進行探索，包 含可能形成保護因子的變項，如社會支持量表、生活適應量表等，或許可提供更多對軌 跡發展個別差異的理解。
最後，因收案資源與統計技術的限制，除了睡眠嚴重程度量表，研究並未收集或追 蹤第一次面談以外的相關變項數據。然而，在所收集的變項中，不乏可能會隨著時間而 改變的變項，可能限制本研究結果對安眠藥使用機制的解釋。因此，若要更全面地了解 特定變項（如：安眠藥渴求程度）與軌跡變化的關係，未來研究可進一步在每個追蹤時 間點額外收集該變項的數據，並對其分析。
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