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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 蕭妃秀(Fei-Hsiu Hsiao) | |
dc.contributor.author | Li-Ting Chen | en |
dc.contributor.author | 陳立庭 | zh_TW |
dc.date.accessioned | 2022-11-25T07:46:39Z | - |
dc.date.available | 2024-07-01 | |
dc.date.copyright | 2021-08-31 | |
dc.date.issued | 2021 | |
dc.date.submitted | 2021-07-21 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/82551 | - |
dc.description.abstract | 過去十年來,大腸直腸癌因早期診斷及對癌症治療方法的進步其存活率已逐漸增加,然而,大腸直腸癌的存活者們在完成癌症治療後仍會經歷身心壓力,特別是在完成癌症治療後、回到正常生活時的轉換時期,他們通常會對未來感到不確定,且在此存活階段中憂鬱症狀的發生率也顯著增加。因此我們在這項橫斷面研究中規劃了三個階段的研究,納入共90位於收案前3個月內完成主要癌症治療的大腸直腸癌存活者,以了解影響大腸直腸癌存活者憂鬱症狀的相關因素為何?並採用中介及調節分析方法,探討整體及大腸直腸癌相關的生理功能和症狀困擾、正念特質、癌症威脅評估和親密關係中的依附型態與憂鬱症狀之間的關係。 階段一:本研究的大腸直腸癌存活者的平均憂鬱分數為4.96分,當中有7.7%的存活者憂鬱分數大於13分,達到臨床上的顯著意義,而存活者的年齡、身心科病史為主要影響此時期憂鬱的人口學相關因素,大腸直腸相關生理功能及症狀困擾則是影響大腸直腸癌存活者憂鬱狀態的疾病相關因素,而在心理相關因素方面,正念特質、癌症威脅評估與親密關係中的依附型態三者則為影響大腸直腸癌存活者憂鬱的主要影響因子。 階段二:根據學者Garland所提出的正念意義理論為理論基礎提出研究架構,探討大腸直腸癌病人的正念特質是否會透過癌症威脅評估,進而影響其生理功能及症狀對憂鬱的影響,以PROCESS macro模組檢驗分析結果如下:1. 透過簡單中介模型的檢驗,癌症威脅評估為正念特質與大腸直腸癌存活者憂鬱狀態的部分中介因子。2. 透過多重中介模型的檢驗,正念特質可透過影響癌症威脅評估及大腸直腸症狀進而減少存活者的憂鬱症狀。3.透過中介-調節模型的檢驗,正念特質可透過影響大腸直腸功能及癌症威脅評估的交互作用效果來減少憂鬱症狀的產生。 階段三:在階段一中發現親密關係中的依附型態與癌症威脅評估無相關性,但和正念特質、大腸直腸功能及狀態則具有相關,故根據系統性回顧、近期文獻的結果及親密關係理論為基礎提出研究架構二,以PROCESS macro模組檢驗大腸直腸癌病人的親密關係中的依附型態、正念特質與大腸直腸癌症狀的因果關係,分析結果如下:1. 大腸直腸症狀對於焦慮依附對大腸直腸癌存活者的憂鬱症狀有著部分中介的效果,且正念特質對於焦慮依附影響憂鬱狀態的直接路徑具有調節效果,而正念次因子當中的行動察覺、不評價及不反應三個因素也對此路徑具有顯著的調節效果。2. 大腸直腸症狀對於逃避依附對大腸直腸癌存活者的憂鬱症狀有著完全中介的效果,但正念特質對於逃避依附影響憂鬱狀態的直接路徑不具有調節效果,而在檢驗正念次因子對此直接路徑的結果上,發現雖然正念總分不具有統計上的顯著差異,但正念中的行動察覺特質對於逃避依附影響憂鬱狀態的直接路徑仍具有顯著性的調節效果。 根據以上的研究結果顯示,正念特質對於大腸直腸癌存活者轉換期的憂鬱症狀具有影響效果,其可透過正向的癌症評估進而影響個體的生理症狀與功能來減少憂鬱症狀,其次也可透過調節對不安全依附型態的親密關係來減少存活者的憂鬱症狀,故未來建議可針對此族群提供正念與認知訓練,培養其正念技能將可增強早期的大腸直腸癌存活者重新評估疾病的能力,減少其面對癌症時產生的負向情緒或壓力。 | zh_TW |
dc.description.provenance | Made available in DSpace on 2022-11-25T07:46:39Z (GMT). No. of bitstreams: 1 U0001-2107202115231500.pdf: 2597233 bytes, checksum: 0862ec74a7505ecb3c88f71700ee6a6c (MD5) Previous issue date: 2021 | en |
dc.description.tableofcontents | 目錄 誌謝............................................................................... i 中文摘要......................................................................................................................... ii 英文摘要........................................................................................................................ iv 第一章 緒論 第一節 研究動機與背景......................................................................................1 第二節 研究問題與目的......................................................................................4 第三節 名詞定義..................................................................................................6 第二章 文獻探討 第一節 大腸直腸癌的分期、治療與存活...........................................................8 第二節 大腸直腸癌存活者的憂鬱現況..............................................................11 第三節 大腸直腸癌存活者轉換期......................................................................15 第四節 影響大腸直腸癌存活者憂鬱狀態的相關因素......................................19 第五節 正念特質與大腸直腸癌存活者憂鬱的相關性......................................24 第六節 親密關係中的依附型態與大腸直腸癌存活者憂鬱及正念的相關 性.............................................................................................................30 第三章 研究方法 第一節 研究架構................................................................................................35 第二節 研究設計................................................................................................37 第三節 研究對象................................................................................................38 第四節 研究假設................................................................................................39 第五節 研究工具................................................................................................40 第六節 研究步驟................................................................................................45 第七節 研究分析方法........................................................................................46 第八節 倫理考量................................................................................................49 第四章 研究結果 第一節 研究對象之人口學及疾病治療資料分析...........................................51 第二節 大腸直腸癌存活者的憂鬱狀態現況分析...........................................56 第三節 影響大腸直腸癌存活者憂鬱狀態的相關性分析...............................58 第四節 正念及癌症威脅評估影響大腸直腸癌存活者憂鬱狀態的中介 調節效果分析.......................................................................................62 第五節 正念特質及親密關係中的依附型態影響大腸直腸癌存活者憂鬱 狀態的調節中介調節效果分析...........................................................70 第五章 討論 第一節 大腸直腸癌存活者於轉換期的憂鬱狀態及其相關因素討論..........79 第二節 正念特質、癌症威脅評估與及生活品質對大腸直腸癌存活者轉 換期憂鬱的中介與調節效果探討......................................................81 第三節 正念特質、親密關係中的依附型態及生活品質對大腸直腸癌存 活者轉換期憂鬱的中介及調節效果探討..........................................85 第六章 結論與建議 第一節 結論......................................................................................................89 第二節 臨床應用及貢獻..................................................................................90 第三節 研究限制及未來研究建議..................................................................92 參考文獻.....................................................................................................................93 附錄 受試者基本資料問卷.......................................................................................109 貝氏憂鬱量表第二版中文版...........................................................................111 歐洲癌症治療與研究組織生活品質核心問卷第三版台灣中文版...............114 歐洲癌症治療與研究組織生活品質核心問卷-腸道症狀台灣中文版..........116 建構意義量表...................................................................................................119 簡短版親密關係量表.......................................................................................120 台灣版五因素正念量表...................................................................................121 表目錄 表2-1-1 大腸直腸癌分期系統...................................................................................10 表3-7-1 研究假設與統計分析方法表.......................................................................48 表4-1-1 大腸直腸癌存活者人口學資料...................................................................52 表4-1-2 大腸直腸癌存活者疾病相關資料...............................................................53 表4-1-3 大腸直腸癌存活者身體功能與症狀困擾資料...........................................55 表4-2-1 大腸直腸存活者的平均憂鬱分數...............................................................56 表4-2-2 大腸直腸癌存活者的憂鬱程度分佈...........................................................57 表4-3-1 影響大腸直腸癌存活者轉換期憂鬱症狀的因素.......................................60 表4-3-2 影響大腸直腸癌存活者轉換期憂鬱症狀的相關因素分析表...................61 表4-4-1大腸直腸癌存活者轉換期憂鬱症狀的迴歸預測分析(研究架構一)….....63 表4-5-1 大腸直腸癌存活者轉換期憂鬱症狀的迴歸預測分析(研究架構二)........71 圖 目 錄 圖2-1-1 大腸直腸癌分期系統....................................................................................11 圖2-2-1 轉換理論模式................................................................................................17 圖2-5-1 正念(Mindfulness)內涵及機轉概念圖.........................................................24 圖2-5-2 正念意義理論過程模型圖............................................................................27 圖2-5-3 正念意義理論在癌症存活者中的多元路徑模型........................................28 圖2-6-1 正念特質、親密關係中的依附型態及外在環境的關係層次圖................34 圖3-1-1 研究架構一.....................................................................................................35 圖3-1-2 研究架構二....................................................................................................36 圖4-5-1 簡單中介模型 (模型1) ................................................................................65 圖4-5-2 多重中介模型 (模型2) ................................................................................66 圖4-5-3 多重中介模型 (模型3) ................................................................................67 圖4-5-4 中介-調節模型 (模型4) ..............................................................................68 圖4-5-5 大腸直腸功能與癌症威脅評估的交互作用對憂鬱的調節效果...............68 圖4-5-6 正念特質與癌症威脅評估的交互作用對憂鬱的調節效果.......................69 圖4-5-1 焦慮依附型態對憂鬱的中介及調節模型 (模型5) ...................................73 圖4-5-2 正念特質與親密關係中的焦慮依附型態的交互作用對憂鬱的調節 效果...............................................................................................................73 圖4-5-3 行動察覺對親密關係中的焦慮依附型態之中介調節模型 (模型6)........74 圖4-5-4 不評價對親密關係中的焦慮依附型態之中介調節模型 (模型7) ...........74 圖4-5-5 不反應對親密關係中的焦慮依附型態之簡單調節模型 (模型8) ...........75 圖4-5-6 行動察覺與親密關係中的焦慮依附型態的交互作用對憂鬱的調 節效...............................................................................................................75 圖4-5-7 不評價與親密關係中的焦慮依附型態的交互作用對憂鬱的調節 效果...............................................................................................................76 圖4-5-8 不反應與親密關係中的焦慮依附型態的交互作用對憂鬱的調節 效果...............................................................................................................76 圖4-5-9 正念特質對親密關係中的逃避依附型態之中介調節模型 (模型 10) ................................................................................................................77 圖4-5-10 行動覺察對親密關係中的逃避依附型態之中介調節模型 (模型 11) ................................................................................................................77 圖4-5-11 行動覺察與親密關係中的逃避依附型態的交互作用對憂鬱的調 節效果..........................................................................................................78 | |
dc.language.iso | zh-TW | |
dc.title | 大腸直腸癌病人於轉換期的憂鬱程度與生活品質、正念及親密關係中的依附型態關係之探討 | zh_TW |
dc.title | "Exploration the relationship of depressive levels, quality of life, dispositional mindfulness, and attachment style in the transition period among colorectal cancer patients" | en |
dc.date.schoolyear | 109-2 | |
dc.description.degree | 博士 | |
dc.contributor.author-orcid | 0000-0001-6167-3039 | |
dc.contributor.advisor-orcid | 蕭妃秀(0000-0003-3295-5373) | |
dc.contributor.oralexamcommittee | 鄭致道(Hsin-Tsai Liu),黃一平(Chih-Yang Tseng),張仁和,張念慈 | |
dc.subject.keyword | 憂鬱,大腸直腸癌存活者,正念特質,癌症威脅評估,生活品質,親密關係中的依附型態, | zh_TW |
dc.subject.keyword | Depression,Colorectal survivor,Dispositional mindfulness,Cancer threat appraisal,Quality of life,Attachment style, | en |
dc.relation.page | 123 | |
dc.identifier.doi | 10.6342/NTU202101630 | |
dc.rights.note | 同意授權(限校園內公開) | |
dc.date.accepted | 2021-07-22 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 護理學研究所 | zh_TW |
dc.date.embargo-lift | 2024-07-01 | - |
顯示於系所單位: | 護理學系所 |
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