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系統識別號 U0026-0812200910433023
論文名稱(中文) 更年期婦女的生活事件壓力、更年期態度、更年期症狀、自我概念與憂鬱之關係
論文名稱(英文) The relationship among life event stress, perimenopause attitude, climacteric symptoms, self-concept, and depression in women during perimenopause
校院名稱 成功大學
系所名稱(中) 護理學系碩博士班
系所名稱(英) Department of Nursing
學年度 91
學期 2
出版年 92
研究生(中文) 盧欣怡
研究生(英文) Shin-Yi Lu
電子信箱 lsy1124@sinamail.com.tw
學號 t2690403
學位類別 碩士
語文別 中文
論文頁數 150頁
口試委員 口試委員-陸偉明
口試委員-楊明仁
指導教授-徐畢卿
中文關鍵字 更年期態度  生活事件壓力  更年期  更年期症狀  憂鬱  自我概念 
英文關鍵字 life-event stress  perimenopause  climacteric symptom  perimenopause attitude  self-concept  depression 
學科別分類
中文摘要 本研究的目的為瞭解台南市更年期婦女的憂鬱情形,並探討更年期婦女的人口學變項、生活事件壓力、更年期態度、更年期症狀、自我概念與憂鬱之關係;採用橫斷式相關研究設計,以隨機集束抽樣(Cluster Random Sampling)的方式選取台南市北區大山里、實踐里、文元里之四十五歲至五十五歲更年期婦女。於民國92年2月3日至4月11日,以「成人生活事件壓力量表」、「更年期態度量表」、「更年期症狀量表」、「田納西自我概念量表」、「流行病學中心憂鬱量表」進行資料收集,共發出問卷280份,回收有效問卷266份,回收率95%。以多元迴歸分析找出預測更年期婦女憂鬱之重要變項。
研究結果顯示:一、更年期婦女出現憂鬱症狀者之比例佔31.2%,約三成的更年期婦女有憂鬱。二、有無工作、有無疾病、有無使用荷爾蒙之更年期婦女在憂鬱上有差異。無工作之更年期婦女其憂鬱顯著高於有工作者;無疾病之更年期婦女其憂鬱顯著高低於有疾病者;無使用荷爾蒙之更年期婦女其憂鬱顯著低於有使用荷爾蒙者。顯示無工作、有疾病、有使用荷爾蒙之更年期婦女其憂鬱值得重視。而不同婚姻狀態、教育程度、停經階段的更年期婦女在憂鬱無顯著差異。三、91.8%更年期婦女視更年期為自然現象。不同教育程度、有無使用荷爾蒙之更年期婦女在更年期態度有差異,教育程度在小學以下之更年期婦女,其更年期態度較高中職、大專以上學歷者為負向。有使用荷爾蒙之更年期婦女其更年期態度較無使用荷爾蒙者為負向。四、約有92.5%的更年期婦女其自我概念介於一般正常者之間。更年期婦女在生理自我、道德倫理自我、心理自我、家庭自我、社會自我、工作自我之得分與常模相較,有較多人次集中於低分。無工作的更年期婦女其自我概念較有工作者為負向,有使用荷爾蒙的更年期婦女其自我概念較無使用荷爾蒙者為負向。五、更年期婦女之生活事件壓力、更年期症狀與憂鬱有顯著正相關,更年期婦女所經歷的生活事件壓力越大,更年期症狀越多,其憂鬱越嚴重;更年期婦女之更年期態度、自我概念與憂鬱有顯著負相關,顯示更年期態度越負向,自我概念越負向之更年期婦女,其憂鬱越嚴重。六、自我概念越負向、更年期症狀越多、生活事件壓力越大、越不是國小教育程度比上專科以上教育程度,是影響更年期婦女憂鬱之重要預測變項。而自我概念的分量尺中,以家庭自我、生理自我、社會自我最能夠預測憂鬱。
期望本研究結果可提供國內對於更年期婦女憂鬱現況之瞭解,與對影響更年期婦女憂鬱之相關因素有更多探索,以作為健康從業人員推動更年期婦女憂鬱防治工作之重要依據,並及早介入處理高危險罹患憂鬱族群,促進更年期婦女之精神衛生。

英文摘要 The purpose of this study was to explore the relationship among demographic data, life-event stress, perimenopause attitude, climacteric symptoms, self-concepts and depression of women during perimenopause. A cross-sectional design used self-administered questionnaires or interview was applied in this study. The subjects aged between 45 and 55 were selected by cluster random sampling of Tainan city in southern Taiwan. There were 43 district areas and Da Shan, Shjian and Wen Yuan district areas were selected. Total of 266 valid subjects were in this study.
Data were collected from February to April 2003. The following 5 instruments were used: the Adult Life-Event Scale, the Perimenopause Attitude Scale, the Greene Climacteric Symptom Scale, the Tennessee Self-Concept Scale Chinese Version and the Center of Epidemiological Study Depression Scale. Multiple regression analysis was used to analyze the data.
The results show that: (1) women who have depression symptoms are about 31.2%, that is about one-third women have depression; (2) women who are currently unemployed, with physical disease, have used hormone replacement therapy (HRT) frequently have more depression symptoms; there are no significant difference of depression symptoms between different marriage status, educational level, menopause stages of perimenopause women, (3) 91.8% women view that perimenopause as a natural phenomenon, women whose education level below elementary or who have used hormone replacement therapy have more negative attitude toward perimenopause; (4) about 92.5% women whose self-concept are at norm range as general adult, compare to the norm more women get lower score on self-concept subscale: Physical Self-concept, Moral Self-concept, Psychological Self- concept, Family Self-concept, Social Self-concept and Work Self-concept, women who are currently unemployed, who have used HRT have more negative attitude toward perimenopause; (5) the correlation between life event stress and depression, climacteric symptoms and depression are positive; the correlation between perimenopause attitude and depression, self-concept and depression are negative; and (6) negative self-concept, more climacteric symptoms, more life event stress and higher educational level are the most important variables to predict depression of women during perimenopause. The self-concept subscales: Family Self-concept, Physical Self-concept and Social Self-concept also predict depression.
The results of this study will help us to know more about the depression during perimenopause and we may apply these findings to develop interventions for preventing depression and promoting women’s mental health.

論文目次 中文摘要 …………………………………………………………I-II
英文摘要 …………………………………………………………III-IV
目 錄 …………………………………………………………V-VII
附 錄 …………………………………………………………VIII
表 目 錄 …………………………………………………………IX-X
圖 目 錄 …………………………………………………………XI

第一章 緒 論
第一節 研究動機及重要性……………………………………1-3
第二節 研究目的………………………………………………3
第二章 文獻查證
第一節 更年期婦女之憂鬱……………………………………4-22
第二節 影響更年期婦女憂鬱之相關因素……………………23-34
第三章 研究方法
第一節 研究架構………………………………………………35
第二節 研究問題………………………………………………36
第三節 名詞界定………………………………………………37-40
第四節 研究設計………………………………………………41
第五節 研究對象………………………………………………41-43
第六節 研究工具………………………………………………44-48
第七節 資料收集過程…………………………………………49-51
第八節 分析方法………………………………………………52
第四章 研究結果
第一節 研究對象………………………………………………53-56
第二節 人口學變項與更年期婦女憂鬱、更年期態度、自我概念之關係…………………57-75
第三節 更年期婦女之憂鬱與生活事件壓力、更年期態度、更年期症狀、自我概念之間的相關…………………76-78
第四節 影響更年期婦女憂鬱之重要預測變項………………79-83
第五節 區辨更年期婦女憂鬱之重要預測因子………………84-86
第五章 討 論
第一節 更年期婦女之憂鬱………………………………………87-89
第二節 人口學變項與更年期婦女憂鬱、更年期態度、自我概念..90-94
第三節 影響更年期婦女憂鬱之相關因素探討………………95-100
第六章 結論與建議
第一節 結論…………………………………………………101-102
第二節 建議…………………………………………………103-104
第三節 研究限制……………………………………………105-108
參考文獻
一、中文部分……………………………………………………109-113
二、英文部分……………………………………………………113-125

附錄一 成人生活壓力事件量表使用同意書…………………126
附錄二 更年期態度量表使用同意書…………………………127
附錄三 更年期症狀量表使用同意書…………………………128
附錄四 田納西自我概念量表測驗申購單……………………129
附錄五 流行病學中心憂鬱量表使用同意書…………………130
附錄六 成人生活事件之壓力量化表………………………131-132
附錄七 國立成功大學函………………………………………133
附錄八 台南市北區戶政事務所函……………………………134
附錄九 台南市北區各里鄰數與45-55歲婦女人數分佈……135
附錄十 台南市文元里各鄰45-55歲婦女人數………………136
附錄十一 人體試驗委員會同意臨床試驗證明書………………137
附件十二 研究同意書與研究問卷……………………………138-150

表2-1-1 更年期婦女憂鬱之相關研究…………………………19-22
表4-1-1 人口學變項描述性分析………………………………55
表4-1-2 憂鬱、生活事件壓力、更年期態度、更年期症狀、自我概念之描述分析………………………………………56
表4-2-1 不同婚姻狀況、工作狀況、疾病狀況、使用荷爾蒙之更年期婦女在憂鬱之差異…………………………………61
表4-2-2 不同教育程度、停經階段之更年期婦女在憂鬱之差異…61
表4-2-3 更年期態度的次數分佈……………………………………66
表4-2-4 不同婚姻狀況、工作狀況、疾病狀況、使用荷爾蒙之更年期婦女在更年期態度之差異…………………………………67
表4-2-5 不同教育程度、停經階段之更年期婦女在更年期態度之差異…67
表4-2-6 教育程度在更年期態度之平均數差量表…………………68
表4-2-7 受試者在自我概念總分與六個分量尺之次數分佈………71
表4-2-8 不同婚姻狀況、工作狀況、疾病狀況、使用荷爾蒙之更年期婦女在自我概念之差異………………………………………74
表4-2-9 不同教育程度、停經階段之更年期婦女在自我概念之差異…75
表4-2-10 教育程度在自我概念之平均數差量表………………75
表4-3-1 憂鬱與生活事件壓力、更年期態度、更年期症狀、自我概念之相關摘要表……………………………………………77
表4-3-2 憂鬱與自我概念分量尺之相關摘要表………………78
表4-4-1a model (1) 共線性診斷表……………………83
表4-4-1b 影響更年期婦女憂鬱之重要預測變項model (1) …83
表4-4-2a model (2) 共線性診斷表……………………………83
表4-4-2b 影響更年期婦女憂鬱之重要預測變項model (2) …83
表4-5-1 區辨更年期婦女憂鬱之重要預測因子model (1) …86
表4-5-2 區辨更年期婦女憂鬱之重要預測因子model (2) …86

圖3-1-1 研究架構…………………………………………………35
圖4-4-1 殘差及預測值交叉散佈情形……………………………80
圖4-4-2 常態機率分佈情形………………………………………80
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