| 研究生: |
林美芳 Lin, Mei-Fang |
|---|---|
| 論文名稱: |
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 Impacts of Menopausal Status, Vasomotor Symptoms, Neuroticism, Extraversion on Depressive Symptoms, and Quality of Life among Women |
| 指導教授: |
柯慧貞
Ko, Huei-Chen |
| 學位類別: |
碩士 Master |
| 系所名稱: |
醫學院 - 行為醫學研究所 Institute of Behavioral Medicine |
| 論文出版年: | 2005 |
| 畢業學年度: | 93 |
| 語文別: | 中文 |
| 論文頁數: | 68 |
| 中文關鍵詞: | 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 |
| 外文關鍵詞: | menopausal status, vasomotor symptoms, neuroticism, extraversion, quality of life, depressive symptoms |
| 相關次數: | 點閱:82 下載:7 |
| 分享至: |
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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。
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