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系統識別號 U0026-0812200913562404
論文名稱(中文) 大學生家庭功能與壓力因應型態對憂鬱症狀之影響
論文名稱(英文) The Effects of Family Functioning and Coping Styles to Depressive Symptoms among College Students
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 95
學期 2
出版年 96
研究生(中文) 吳政航
研究生(英文) Cheng-hang Wu
學號 s8693404
學位類別 碩士
語文別 中文
論文頁數 77頁
口試委員 指導教授-柯慧貞
召集委員-葉光輝
口試委員-謝碧玲
中文關鍵字 壓力因應型態  家庭功能  憂鬱症狀 
英文關鍵字 depressive symptoms  coping style  family functioning 
學科別分類
中文摘要 研究背景 世界衛生組織認為憂鬱症是21世紀三大重要疾病之一。在台灣,大學生達到中度到重度憂鬱程度的有13.2% ~ 22.5%,且憂鬱也是自殺的重要預測因子,因此,對憂鬱症狀的病理機制的瞭解成為重要的議題。從憂鬱的心理社會模式來看,負向家庭功能為重要社會因子。過去文獻指出,家庭功能與憂鬱症狀有關,但是其影響歷程目前仍然未明,亦缺乏以縱貫性研究與具代表性之大樣本所從事的研究結果。近期研究發現,家庭功能與家庭成員所採用的因應方式或策略有關,通常具有較好的家庭功能的家庭,家庭成員所採用的因應方式也會較適當也較具結構性或主動性;家庭功能較差或僵化壓迫的家庭,其成員所採用的因應方式則較適應不良與較多的逃避型因應。然而,目前在家庭功能與壓力因應的研究所採用的參與者數目較小,亦多為橫斷性研究。另過去文獻指出壓力因應與憂鬱症狀有關;研究發現,越常使用「逃避因應」或「情緒取向因應」,就越容易會產生憂鬱症狀;而經常使用「問題解決取向因應」則於憂鬱症狀呈現負相關。然而,由於過去研究極少探討壓力因應型態在家庭功能與憂鬱之間所扮演之角色為何;最後,目前雖然有探討家庭功能、壓力因應型態與憂鬱症狀的研究,但是皆未探討三者的影響模式。而根據過去文獻,本研究將假設壓力因應型態是否中介家庭功能對憂鬱症狀之影響。

研究目的 本研究試圖驗證家庭功能、壓力因應型態與大學生憂鬱症狀的機制模式,並假設家庭功能會透過壓力因應型態的中介而影響大學生次年憂鬱症狀。

研究方法 本研究採縱貫性設計。參與者:本研究以南區大專學生為母群,採分層與叢集隨機抽樣方式,抽選出14所南區大專院校。第一年回收3,743份問卷,回收率為72.9%,其中可追蹤人數為3,246人,第二年回收1,532份問卷,其追蹤率為47.02%,其中在本研究所有研究工具上呈有效反應者共1,142份。研究工具:同意書、個人資本資料表、柯氏憂鬱量表、家庭功能量表簡版與壓力因應量表。研究程序:本研究為一年縱貫性研究,分別在2003年與2004年11月開始為期六週進行問卷施測。施測時先解釋施測目的以及保密原則,在獲得參與者的同意,才請參與者進行填寫問卷,並於填完問卷後贈送小禮物給參與者。參與者可獲得個人回饋報告、教育宣傳衛教單。資料分析:由描述性統計分析樣本特性,並以結構方程式模型(SEM)與Sobel test分析中介模式。

研究結果 結果顯示「追蹤且有效組」與「未追蹤或排除組」兩組在年齡、性別、第一年逃避-情緒壓力因應及家庭功能中的綜合負向向度上達顯著差異,但檢驗效果量後發現效果量均低。針對假設模式方面,發現透過逃避-情緒壓力因應型態的中介第一年所測量的家庭功能顯著的預測第二年憂鬱症狀的變化,而逃避-情緒模式符合大部分基本適配度與內在適配度之標準,並有理想之整體適配度,結果顯示此測量模式可解釋未來憂鬱症狀達44%。

結論與建議 本研究採用縱貫性大樣本研究,驗證逃避-情緒壓力因應型態為整體家庭功能與憂鬱症狀間關係的中介因子,此模式亦適用於重鬱發作之大學生。在未來應用方面,可針對家庭功能進行衛教,並可針對家庭功能或壓力因應方式進行個別或家族的介入與治療,改善其壓力因應技巧以及不良之家庭功能,減少其對憂鬱症狀的惡化效果。
英文摘要 Through a one year follow-up with a large representative sample of participants, the present study aimed to examine the model of how coping styles mediated the relationship between family functioning and depressive symptoms by Structural Equation Model (SEM). After a stratified and random cluster sampling, 3,246 Southern Taiwan college students were recruited from 14 colleges in 2003 (T1) among which 1,142 students (63.6% female) completed the measurements both at T1 and one year later in 2004 (T2). The instruments comprised of the Ko Depression Inventory, Family Functioning Scale Short Form, and Stress Coping Checklist. SEM was employed through Amos to examine the model. Results found that the effect of family functioning (T1) on depressive symptoms (T2) was mediated through the avoidance/emotional coping style (T2). The measurement model accounted for 44% of the variance in depressive symptoms measured at T2. Our results provided support which emphasized that more attention should be given towards the development of preventive programs on diminishing avoidance/emotional coping styles and diminishing family dysfunction. Results suggested that Students would be able to benefit from the intervention programs from the incorporation of coping skills and family components.
論文目次 內文目錄
中文摘要……………………………………………………………………….I
Abstract………………………………………………………………III
致謝……………………………………………………………….....IV
內文目錄……………………………………………………………...V
表目錄………………………………………………………………….VI
圖目錄………………………………………………………………….VI
附錄目錄………………………………………………………………….…....VI
第一章 研究背景……………………………………………………1
第一節 大學生憂鬱問題的重要性………………………………..…………......1
一、 憂鬱症狀的定義………………………………………………1
二、 大學生憂鬱的盛行率及其影響………………………………2
第二節 家庭功能與憂鬱間關係的探討………………………………...…..….......4
一、 家庭系統理論……………………………………………………...….……4
二、 家庭功能的定義與相關理論…………………………………….….…......4
三、 家庭功能與憂鬱相關之研究………………………………………………8
四、 小結………………………………………………………….……..……...10
第三節 家庭功能、壓力因應與憂鬱間關係的探討………….………………......11
一、 壓力因應的定義………………………………………………..................11
二、 家庭功能與壓力因應間關係的探討……………………………………..12
三、 壓力因應與憂鬱間關係的探討…………………………………………..12
四、 家庭功能、壓力因應與憂鬱的關係….………………………………….13
第四節 研究目的與假設………………………………………………………......15
一、 研究目的……………………………………………………………….….15
二、 研究問題與假設…………………………………………………………..15
第二章 研究方法…. ………………………………………………………………..…..17
第一節 研究參與者…………………………………………………………….…...17
第二節 研究工具………………………………………………………………...….18
第三節 研究程序……………………………………………………………….…...20
第四節 統計分析與資料處理………………………………………………….…...20
第三章 研究結果………………………………………………………………………..22
第一節 參與者人口學變項與各變項之分析……………………………………..22
第二節 憂鬱症狀、家庭功能與壓力因應型態之相關分析……………………...22
第三節 家庭功能、壓力因應型態與憂鬱症狀之影響關係模型………………...23
一、 逃避-情緒模式之基本適配度…………………………………….....……23
二、 逃避-情緒模式之整體適配度………………..……………………….…..24
三、 逃避-情緒模式之內在適配度…………………………………………….25
四、 逃避-情緒模式之潛在變項間的效果…………………………………….25
五、 問題解決模式與尋求社會支持模式之整體適配度……………………..26
六、 問題解決模式與尋求社會支持模式之內在適配度…………………..…27
七、 模式潛在變項的中介效果分析…………………………………………..27
第四章 討論…………………………………………………………………………..…28
第一節 本研究之主要發現與解釋………………………………………………....28
一、 家庭功能、逃避-情緒因應型態與憂鬱症狀間的模式……………………28
二、 壓力因應型態與憂鬱症狀之間的關係………………………...…………30
第二節 研究限制…………………………………………………………..…...….31
第三節 結論與建議………………………………………………………………..32
第五章 參考文獻………………………………………………………………………..35


表目錄
表1. 「追蹤有效組」與「未追蹤或排除組」在基本人口學變項及各量表得分分…46
表2. 家庭功能、兩年壓力因應型態與兩年憂鬱症狀之相關矩陣…......…….......48
表3. 測量模式估計參數的顯著性考驗與標準化係數值………………………….49
表4. 模式中各觀察變項之信度及內生潛在變項之信度………………………….50
表5. 測量模式整體適配度考驗結果…………………………………...…………..51
表6. 模式潛在變項交互相關係數矩陣…………………………………………….52
表7. 模式觀察變項之標準化殘差共變數矩陣…………………………………….53
表8. 潛在變項間的直接、間接與整體效果之標準化效果值.………………….54

圖目錄
圖1. 環繞模式………………………………………………………………………55
圖2. 壓力因應中介整體家庭功能至憂鬱症狀間之研究假設模式………………56
圖3. 逃避-情緒中介家庭功能與未來憂鬱症狀之結構方程式模型………...……57
圖4. 逃避-情緒模式之標準化徑路係數圖………...……………………………....58
圖5. 問題解決模式之標準化徑路係數圖………...……………………………….59
圖6. 尋求社會支持模式之標準化徑路係數圖………...………………………….60

附錄目錄
附錄一、同意書…………………………………………………………………….61
附錄二、個人基本資料表………………………………………………………….62
附錄三、柯氏憂鬱量表…………………………………………………………….67
附錄四、家庭功能量表簡版……………………………………………………….72
附錄五、壓力因應量表…………………………………………………………….74
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