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系統識別號 U0026-0812200911413571
論文名稱(中文) 停經階段、負向生活事件及社會支持對婦女憂鬱症狀之影響
論文名稱(英文) The impact of menopause status, negative life events and social support on depressive symptoms in 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) 劉怡汝
研究生(英文) Yi-Ju Liu
電子信箱 s8690106@ccmail.ncku.edu.tw
學號 s8690106
學位類別 碩士
語文別 中文
論文頁數 88頁
口試委員 指導教授-柯慧貞
口試委員-張峰銘
口試委員-毛家舲
中文關鍵字 負向生活事件  社會支持  停經階段  憂鬱症狀 
英文關鍵字 negative life events  social support  menopausal status  depressive symptoms 
學科別分類
中文摘要 研究背景與目的
過去研究多指出婦女在停經時期會出現憂鬱症狀是因為其雌激素降低之故,然而也有其他研究指出生活事件與社會支持也是影響婦女出現憂鬱症狀的相關因素;此外,婦女的過去憂鬱病史(包括重鬱症、產後憂鬱、低落性情感疾患)、月經前心情惡劣疾患等也被認為與婦女停經時期的憂鬱症狀有關。本研究的主要目的為控制過去憂鬱病史、月經前心情惡劣疾患、荷爾蒙替代療法使用情形、血管舒縮症狀等混淆變項後,探討停經階段、負向生活事件與社會支持對婦女憂鬱症狀的影響。

研究方法
本研究取樣自台南市40-60歲社區婦女,以叢集抽樣取樣東區大學里與東門里、北區國興里、中西區民生里與永華里等五里。自戶政事務所取得婦女名單後,請里鄰長協助發放與回收問卷,進行第一階段之社會人口學資料、身心症狀評量表與柯氏憂鬱量表等的收集,此階段不納入不識字婦女。回收資料後將婦女依自陳之經期情形區分為停經前期、中期、後期,及手術停經組等四組,排除手術停經婦女後,再電邀婦女參與第二階段之生活事件量表與社會支援量表之填寫,並以「終生精神疾病診斷量表」(the Modified Schedule of Affective Disorders and Schizophrenia, Lifetime Version)進行半結構式診斷晤談以評估其終生精神病史。共有320位婦女參與第一階段問卷填答;188位婦女參與第二階段之研究,92位為停經前期,37位屬停經中期,59位為停經後期。

研究結果
研究發現如下:以柯氏憂鬱量表得分為效標變項,過去憂鬱病史、月經前心情惡劣疾患(階層一)、荷爾蒙替代療法使用情形、血管舒縮症狀、停經階段(階層二)、負向生活事件(階層三)、社會支持(階層四)、停經階段x負向生活事件、停經階段x社會支持、社會支持x負向生活事件、停經階段x負向生活事件x社會支持(階層五)為預測變項,進行階層多元迴歸分析。結果顯示控制過去憂鬱病史、月經前心情惡劣疾患、荷爾蒙替代療法使用情形與血管舒縮症狀等混淆變項的影響後,停經階段x負向生活事件x社會支持之三因子交互作用達顯著水準。進一步分析發現:對社會支持程度高之婦女而言,停經階段或負向生活事件無法預測憂鬱症狀,而社會支持程度低組,其停經階段與負向生活事件之交互作用達顯著水準;再針對此交互作用進行分析,結果顯示對社會支持程度低婦女而言,當其處於停經後期時,負向生活事件對憂鬱症狀的預測力達顯著水準。

結論
研究發現對社會支持度低,且處於停經後期的婦女而言,負向生活事件對於婦女的憂鬱症狀才具有顯著影響力;但對社會支持度高的婦女而言,停經階段與負向生活事件未與憂鬱症狀有所關聯。
英文摘要 none
論文目次 第一章、緒論‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧1
第一節、停經階段與婦女的憂鬱症狀‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧1
一、停經的定義‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧1
二、停經與憂鬱症狀之關係‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧2
三、停經階段與憂鬱症狀間關係的可能干擾變項‧‧‧‧‧‧‧‧‧‧‧‧4
第二節、停經階段、生活事件、憂鬱症狀‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧8
一、生活事件的定義‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧8
二、生活事件與停經階段的憂鬱症狀‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧8
第三節、停經階段、社會支持、憂鬱症狀‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧11
一、社會支持的定義‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧11
二、社會支持與停經階段的憂鬱症狀‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧12
第四節、社會支持、生活事件與停經階段的憂鬱症狀‧‧‧‧‧‧‧‧‧‧14
一、緩衝效果與直接效果‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧14
二、相關研究發現‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧14
三、未解決的問題‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧15
第五節、停經研究的相關方法學考量‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧16
一、方法學的考量‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧16
二、本研究的考量‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧17
第六節、研究目的‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧18
第二章、研究方法‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧19
第一節、研究對象‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧19
第二節、研究工具‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧20
第三節、研究程序‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧24
第四節、統計分析方法‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧25
第三章、研究結果‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧27
第一節、受試者的基本人口統計學與社會資料分析‧‧‧‧‧‧‧‧‧‧‧27
第二節、身心症狀評量表之因素結構‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧28
第三節、停經階段與憂鬱症狀之關係‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧29
第四節、停經階段與更年期症狀之關係‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧30
第五節、停經階段與生活事件數之關係‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧31
第六節、停經階段與社會支持之關係‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧32
第七節、憂鬱症狀、過去憂鬱病史、月經前心情惡劣疾患、荷爾蒙替代療法使用情形、血管舒縮症狀、停經階段、生活事件與社會支持等變項之間的相關‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧33
第八節、停經階段、負向生活事件及社會支持對憂鬱症狀的影響‧‧‧‧‧34
第四章、結論與討論‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧38
第一節、本研究的主要發現與解釋‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧38
一、停經婦女的憂鬱症狀‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧38
二、停經階段與憂鬱症狀‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧38
三、婦女憂鬱症狀的預測因素‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧39
第二節、本研究限制與未來研究方向‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧40
一、研究樣本的限制‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧40
二、研究工具的限制‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧40
三、研究設計的限制‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧41
四、其他研究變項的可能影響‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧41
第三節、本研究的理論貢獻與應用價值‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧42
參考文獻‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧43
附錄一、個人基本資料‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧69
附錄二、柯氏憂鬱量表‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧74
附錄三、身心症狀評量表‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧80
附錄四、生活事件量表‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧81
附錄五、社會支援量表‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧85
自述‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧‧88
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