目的：育有先天性外觀缺陷孩童之家長會經驗到較高的親職照顧壓力與失落，孩子非預期且明顯的外觀異常會造成父母極大的心理壓力與衝擊。兩篇探討肌肉骨骼系統先天性畸形之孩童家長的心理調適策略架構，亦顯示出該類父母還要面對如社會文化、醫療處置及他人眼光等多重且特殊的壓力，這可能會造成其生理、心理及社會層面的影響，因此找出父母關鍵的心理特質，可協助其在壓力情境下取得較佳的調適，有助於安定心理狀態並形成正向改變，發展出創傷後成長(Posttraumatic growth)。研究指出，因應策略可調節家長所經驗到的壓力感受，且是形成創傷後成長的重要因素之一；另一方面，研究亦顯示執行功能可使個體彈性根據環境需求調整自身策略或行為，以減少對壓力事件的主觀感受。本研究除了再次檢驗因應策略與親職照顧壓力和創傷後成長的關係外，欲進一步了解罹病孩童家長的執行功能是否可緩解壓力感受，甚至與創傷後成長有關，故以多指症(Polydactyly)兒童之家長為研究對象，探討執行功能和因應策略與親職照顧壓力和創傷後成長的關聯。
方法：本研究通過人體試驗委員會審核，編號 B-BR-107-004，於南部某醫學中心資深小兒骨科專科醫師之門診立意取樣。門診共轉介29位多指症兒童的家長作為研究參與者。研究工具包含基本資料問卷、日常執行功能行為量表、心理調適因應策略量表、親職壓力量表簡式版、以及創傷後成長量表。以曼-惠特尼U檢定(Mann-Whitney U test)、Wilcoxon 符號等級檢定、Spearman等級相關以及簡單線性迴歸進行分析。
結果：參與者中男性比例為48.3%，平均年齡為36.28 ± 5.88歲，教育程度皆為高中職以上。人口學與疾病變項中，家長年齡與執行功能有顯著正相關、家中子女數與因應策略有顯著正相關，而其他變項皆與執行功能、因應策略、親職照顧壓力，以及創傷後成長無顯著相關，故排除了多數人口學與疾病變項的干擾因素。心理變項各因素中，執行功能中的動機與計畫、自我覺察力、低效能評價因素，皆與親職照顧壓力之因素呈顯著負相關；另執行功能所有因素皆與創傷後成長分數呈顯著正相關。因應策略各因素皆與親職照顧壓力之因素呈顯著負相關；另因應策略各因素皆與創傷後成長分數呈顯著正相關。以簡單線性迴歸分析發現，執行功能和因應策略與親職照顧壓力有顯著負向關係，並與創傷後成長有顯著正向關係，且皆具有大的效果量。
討論：執行功能和因應策略是個體重要的心理資源，並在緩解多指症孩童家長的親職照護壓力與促進正向心理改變上具重要角色，與過去結果相呼應。依據此基礎，臨床工作者在針對多指症孩童之家長進行心理照護時，除了針對心理壓力進行評估外，需考量個體心智功能與因應策略，有助於了解家庭優勢能力和潛在風險，並可透過強化正向心智功能、適應性因應策略技巧等個別化介入，促進家長之正向成長、緩解其親職照顧壓力。未來可進一步探討此結果是否適用於其他先天性外觀缺陷兒童之家長，並檢驗執行功能與因應策略共同預測創傷後成長或親職照顧壓力的效果。

Objective: Studies showed that better executive function will influence people’s choice of coping strategies and allows for better psychological adjustment. However, there has been little research on the role of executive function in post-traumatic growth among parents of children with congenital appearance defects. This study aimed to explore the role of executive function and coping strategies on parenting stress and post-traumatic growth in parents of children with polydactyly.
Method: This study included 29 parents of children with polydactyly completed self-reported questionnaires, including measures of executive function, parenting stress, coping strategies, and post-traumatic growth.
Result: The results showed that executive function and coping strategies were significantly negatively associated with parenting stress, but positively associated with post-traumatic growth.
Discussion: Better executive function and coping strategies may have an important role in parenting stress and post-traumatic growth with parents of children with polydactyly. It is recommended that apart from evaluating the stress level, clinicians also need to consider the executive function and coping strategies of an individual during psychological care. It helps in early screening or prediction of family strengths and potential risks and provides individualized interventions for executive function or adaptive coping strategies to enable parents to have a better disease adjustment process and mental health.

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