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系統識別號 U0026-0907201312011600
論文名稱(中文) 探討執行功能、身體意象及因應策略對憂鬱情緒之影響-以類風濕性關節炎婦女患者為例
論文名稱(英文) Effects of Executive Function , Body Image and Coping Strategies on Depression in Women with Rheumatoid Arthritis.
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 101
學期 2
出版年 102
研究生(中文) 黃雅羚
研究生(英文) Yalin Huang
學號 s86991049
學位類別 碩士
語文別 中文
論文頁數 73頁
口試委員 指導教授-郭乃文
口試委員-劉明煇
召集委員-翁嘉英
中文關鍵字 類風濕性關節炎  因應策略  身體意象  執行功能  憂鬱情緒 
英文關鍵字 Rheumatoid arthritis  Coping strategy  Body image  Executive function  Depression 
學科別分類
中文摘要 目的: 過去文獻指出憂鬱常出現於類風濕性關節炎患者中,而身體失能、疼痛及關節變形可能使患者的身體意象產生變化而影響心理適應。因應策略可以緩衝各種壓力,執行功能在調控對於壓力的因應策略上扮演重要角色。故本研究旨在探討類風濕性關節炎中年婦女患者之因應策略、身體意象及執行功能對憂鬱情緒的預測效果。

方法: 研究對象為120位確診為類風濕性關節炎的女性患者。完成問卷訪談的資料收集後,以路徑分析探討人口學變項、疾病變項、類風濕性關節炎因應策略量表、類風濕性關節炎身體意象量表、執行功能量表及流行病學研究中心憂鬱量表中文版之間的關係。

結果: 各人口學變項、疾病變項皆與憂鬱無顯著相關。而執行功能、身體意象、正向因應及負向因應等心理學變項皆與憂鬱情緒達顯著中度至高度相關。路徑分析結果顯示,在整體預測模式中執行功能對憂鬱有最高的預測效果。而身體意象對於憂鬱情緒亦有顯著預測效果,高於正向因應對於憂鬱情緒的預測效果;負向因應對於憂鬱情緒的直接預測效果則未達顯著。

討論: 過去研究著重疾病變項和因應策略對類風濕性關節炎患者憂鬱情緒之影響。但本研究結果顯示執行功能、身體意象及因應策略等心理學變項對患者憂鬱情緒影響力之重要性顯著高於疾病變項。且在此憂鬱情緒的預測模式中,執行功能與身體意象為憂鬱情緒之主要預測因子,其中執行功能對憂鬱情緒有最高之影響力。未來在臨床上可設計以增進患者之執行功能與身體意象作為目標之治療策略,以降低其憂鬱情緒。
英文摘要 Objective: To explore the predictive effects of coping strategy, body image and executive function on depression in women with rheumatoid arthritis.
Methods: 120 subjects were female patients with RA. Researcher interviewed the participants based on standardized questionnaires. Correlational analyses and path analysis were used to assess the relationship among demographic variables (e.g., age, education), disease-related variables (e.g., disease duration, disease activity, and physical disability), RA coping strategy scale, RA body image scale, executive function scale and Center for Epidemiologic Studies Depression Scale (CES-D).

Results: Demographic variables and disease-related variables did not correlate with depression. However, psychological variables including executive function, body image, positive coping and negative coping all strongly correlated with depression.
The results of path analysis showed that executive function had the strongest direct effect on depression. The direct effect of body image on depression is higher than positive coping on depression. Negative coping didn’t have significant effect on depression.

Conclusion: Previous studies emphasized the effect of disease-related variables and coping strategy on depression in patients with RA. Our results showed that in the model of depression in patients with RA, executive function and body image were the strongest predictors. It means if we could try to develop intervention to enhance patients’ executive function and body image, we may reduce their depression.
論文目次 第壹章 緒論 1
第一節、 類風濕性關節炎之疾病特性與患者之憂鬱情緒 1
第二節、 類風濕性關節炎患者之調適機制與憂鬱情緒 4
第三節、 身體意象 11
第四節、 執行功能 16
第五節、 研究動機與問題假設 21
第貳章 研究方法 24
第一節、 研究對象 24
第二節、 研究工具 24
第三節、 研究設計 34
第四節、 統計分析 36
第參章 研究結果 37
第一節、 研究樣本的基本屬性分析 37
第二節、 疾病變項、身體意象、因應策略、執行功能 及憂鬱情緒之相關分析 39
第三節、 類風濕性關節炎患者憂鬱情緒之預測模式 41
第肆章 討論 49
第一節、 研究變項之關聯性 49
第二節、 研究架構所擬之預測模式 50
第三節、 類風濕性關節炎患者憂鬱情緒之最終預測模式 51
第四節、 研究限制與建議 55
第五節、 研究貢獻與未來展望 56
參考文獻 58
附錄 68
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