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系統識別號 U0026-0812200911413265
論文名稱(中文) 停經狀態、心血管舒縮症狀、神經質、外向性對婦女憂鬱症狀與生活品質之關聯性探討
論文名稱(英文) Impacts of Menopausal Status, Vasomotor Symptoms, Neuroticism, Extraversion on Depressive Symptoms, and Quality of Life among Women
校院名稱 成功大學
系所名稱(中) 行為醫學研究所
系所名稱(英) Institute of Behavioral Medicine
學年度 93
學期 2
出版年 94
研究生(中文) 林美芳
研究生(英文) Mei-Fang Lin
學號 s8691403
學位類別 碩士
語文別 中文
論文頁數 68頁
口試委員 口試委員-張峰銘
口試委員-毛家舲
指導教授-柯慧貞
中文關鍵字 神經質  外向性  憂鬱症狀  生活品質  心血管舒縮症狀  停經狀態 
英文關鍵字 menopausal status  vasomotor symptoms  neuroticism  extraversion  quality of life  depressive symptoms 
學科別分類
中文摘要   研究背景與目的:過去有關停經與憂鬱症狀與生活品質之相關研究仍意見分歧,有研究指出停經會導致婦女憂鬱與生活品質變差,然而亦有人主張停經並不會導致婦女憂鬱與生活品質變差。這些不一致的結論可能導因於未考量相關混淆變項,如賀爾蒙使用情形、經前心情惡劣疾患、過去憂鬱症病史及過去低落性情感疾患。又依據症狀假說(symptoms hypothesis)指出心血管舒縮症狀會中介停經對憂鬱症狀之影響。而近年來有研究指出心血管舒縮症狀會透過神經質中介影響婦女憂鬱症狀。再者Eysenck的人格理論指出高神經質與低外向性者較易罹患情感性疾患,而回顧過去有關神經質與憂鬱與生活品質之研究皆一致的指出神經質與憂鬱呈正相關,與生活品質呈負相關。然而外向性與憂鬱與生活品質之關係目前仍意見不一,大部分研究者認為外向性與憂鬱呈負相關或無關,與生活品質呈正相關或無關;此不一致性可能的解釋為,神經質能調節外向性與憂鬱與生活品質之關係,如同Eyscenk所說。基於上述,本研究以社區樣本、控制相關混淆變項並且排除手術停經進一步探討婦女停經狀態、心血管舒縮症狀、神經質、外向性與婦女憂鬱與生活品質之關係;研究目的包括1.心血管舒縮症狀、神經質,及外向性是否分別獨立影響婦女憂鬱症狀與各向度生活品質;2.神經質與外向性之交互作用是否影響婦女憂鬱症狀與各向度生活品質;3. 探討心血管舒縮症狀是否透過神經質中介影響婦女憂鬱症狀與各向度生活品質。

  研究方法:以叢集隨機抽樣出東區、西區,及北區之台南市40~60歲197位婦女,排除手術停經與不識字者後,依經期狀態將受試者分為停經前期、停經中期及停經後期三組。以半結構診斷性晤談SADS-L、柯氏憂鬱量表、生活品質量表、身心症狀量表及五大因素量表進行資料收集。並採用皮爾森與斯皮爾曼相關,t test, Mann-Whitney U test,多元階層回歸,及Sobel Test 進行資料分析。

  研究結果:在憂鬱症狀方面,多元階層回歸顯示神經質與外向性之交互作用達顯著,進一步將神經質分為高低兩組,結果顯示高神經質組,外向性與憂鬱症狀呈負相關; 低神經質組,外向性與憂鬱症狀無關。心血管舒縮症狀與憂鬱症狀有相關,然而在加入神經質、外向性及神經質與外向性之交互作用後,心血管舒縮症狀之主要效果消失。Sobel test也顯示神經質能中介心血管舒縮症狀與憂鬱症狀之關係。在生活品質方面,在環境生活品質上,多元階層回歸顯示神經質與外向性之交互作用達顯著,進一步將外向性分成高低兩組,結果發現高外向性組,神經質與環境生活品質呈負相關,而低外向性組神經質與環境生活品質無關;此外心血管舒縮症狀能獨立預測環境生活品質。在心理生活品質上,多元階層回歸顯示心血管舒縮症狀與心理生活品質有相關,然而在加入神經質、外向性及神經質與外向性之交互作用後,心血管舒縮症狀之主要效果消失。Sobel test也顯示神經質能中介心血管舒縮症狀與心理生活品質間關係;此外外向性能獨立預測心理生活品質。在生理生活品質上,心血管舒縮症狀、神經質及外向性皆能獨立預測生理生活品質。在社會生活品質上,神經質與外向性能獨立預測社會生活品質。

  結論:在控制與憂鬱症狀相關之混淆變項後,研究顯示神經質能調節外向性與憂鬱症狀之關係;外向性能調節神經質與環境生活品質之關係。神經質能中介心血管舒縮症狀與憂鬱症狀與心理生活品質之關係。神經質能獨立預測心理不健康面與各向度之心理健康面。外向性能獨立預測生理、心理及社會生活品質。心血管舒縮症狀能獨立預測生理與環境生活品質。
英文摘要 none
論文目次 摘要…………………………………………………………II
誌謝…………………………………………………………IV
主目錄……………………………………………………………V
表目錄……………………………………………………VII
圖目錄……………………………………………………VIII
第一章 導論………………………………………………1
第一節 停經的定義………………………………………2
第二節 停經與婦女憂鬱與生活品質之關係………………2
第三節 神經質、外向性與婦女憂鬱及生活品質之關係…7
第四節 其他停經與憂鬱相關之混淆變項………………13
第五節 研究目的…………………………………………14
第二章 研究方法…………………………………………17
第一節 研究程序與研究對象……………………………17
第二節 研究工具…………………………………………17
第三節 統計方法…………………………………………20
第三章 研究結果…………………………………………21
第一節 有反應與未反應婦女之基本資料與人口學變項21
第二節 研究變項之相關…………………………………21
第三節 以憂鬱分數為依變項之多元階層回歸…………22
第四節 以生活品質為依變項之多元階層回歸…………23
第四章 討論………………………………………………26
第一節 樣本特性…………………………………………26
第二節 心血管舒縮症狀、神經質、外向性與憂鬱症狀之關係………26
第三節 心血管舒縮症狀、神經質、外向性與生活品質之關係………27
第四節 停經狀態、心血管舒縮症與憂鬱症狀之關係…………………28
第五節 停經狀態、心血管舒縮症狀與生活品質之關係………………29
第六節 經前心情惡劣疾患、過去憂鬱症病史與憂鬱症狀之關係……29
第七節 研究貢獻…………………………………………30
第八節 研究限制與未來研究方向………………………30
第五章 參考文獻…………………………………………32
附錄………………………………………………………40
自述………………………………………………………68
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