老年父母的孝道期待、落差與憂鬱反應

Abstract

背景與目的：老年憂鬱反應為老年人心理健康的重要指標之一，子女的孝道行為是讓老年父母感覺到身心健康及幸福的重要來源，但是何謂「子女孝道行為」則須考量到父母的主觀期望與知覺。本論文包含兩個研究：研究一藉由問卷調查量化分析來探討老年父母的孝道期待、知覺子女孝道行為、孝道期待切合度及其與自身憂鬱反應之間的關係；研究二則透過質化深度訪談以瞭解老年父母知覺到子女沒做到自己重視的孝道期待時（孝道期待落差），如何調適及其與自身憂鬱反應之間的發展歷程及心理運作機制。方法：研究一為自填式問卷法，研究樣本為100位大台北地區的老年父母，研究工具包含「TLSA短版CES-D量表」與筆者改編自「雙元孝道量表」之「孝道期待與知覺子女孝道行為量表」；研究二以半結構式訪談法，訪談11位高、低憂鬱組別之老年父母，並以主題分析法進行資料分析。結果：研究一的結果顯示（1）現今老年父母較重視子女實踐相互性孝道，較不重視權威性孝道；（2）老年父母自身的憂鬱反應與過度重視權威性孝道有正相關、與知覺到子女實踐了相互性孝道行為的程度、相互性孝道期待的切合度有負相關。研究二的結果顯示：老年父母面對孝道期待落差時，其可能經歷認知評估、產生負面情緒、對負面情緒的調節模式、負面情緒的調節結果，進而影響自身憂鬱反應之表現；當老年父母運用了較不具適應性的負面情緒調節模式，可能因此維持或增加了其原本產生的負面情緒，也可能新增額外的壓力來源或減少了原本可運用的資源；社會支持系統、個人的性格與特徵因素、調適的彈性等因素，也會影響老年父母親自身的憂鬱反應。討論：本論文研究有助於瞭解現今老年父母的孝道期待與需求，進而增進與子女孝道行為之間的切合性；雙元孝道信念於老年憂鬱反應、老年生活福祉的切入；孝道期待落差心理調適歷程模型有助於臨床實務工作者建立個案概念化與介入方案；多元的因素會影響老年父母的憂鬱反應，臨床實務上務必以生理－心理－社會的角度探究。

Background & Objective: Depressive reactions are an important indicator of mental health of the elderly. Children’s filial behaviors are important sources of parents’ health and well-being. But, what is meant by “children’s filial behaviors” shall consider parents’ subjective expectations and perceptions. This thesis consists of two studies: the Study one used quantitative analysis to explore the relationships among the elderly parents’ filial expectations, perceived children’s filial behaviors, the degree of fit between filial expectations and behaviors, and their own depressive reactions. The Study two used qualitative interviews to explore when the elderly parents confront a gap of filial expectation, what their regulating processes and adjustment mechanism are. Methods: The Study one adopted self-report scales, as “shot form of CES-D in the TLSA”, “filial expectation and perceived children’s filial behaviors scales” adapted from “dual filial piety scale”. And we collected one hundred elderly parents’ data in Taipei area and its immediate vicinity. The Study two adopted semi-structured interview and thematic analysis to analyze the data. And we totally interview eleven elderly parents, six in high-depression and five in low-depression groups. Results: The Study one showed that (1) elderly parents now more emphasis on the reciprocal filial expectations, less on the authoritarian filial expectations; (2) their own depressive reactions positively correlated with excessive emphasis on authoritarian filial expectations, negatively correlated with the degree of children’s reciprocal filial behaviors and with the degree of fitness between parent’s reciprocal filial expectations and children’s behaviors. The Study two showed that: when elderly parents confront filial expectation gap, which may experience cognitive appraisal, negative emotions, adjustment mode of negative emotions and the outcomes, thereby affecting the frequency of their depressive reactions; when elderly parents use the less adaptable adjustment mode of negative emotions, may therefore maintain or increase their original generated negative emotions, and may also add additional stressors or reduce the available resources; social support systems, personal character and personality, adjustment flexibility, may affect elderly parents’ depressive reactions as well. Discussion: This thesis helps us to understand elderly parents’ filial expectations and needs, and to enhance the fitness among filial expectations, needs and children’s filial behaviors; the dual filial piety model might seem a more promising starting point in understanding the depressive reactions and welfare of the elderly; psychological adjustment model of filial expectation gap helps clinical practitioners to establish case formulation and intervention programs; a variety of factors can affect depressive reactions of elderly parents, be sure to adopt biopsychosocial model in the clinical works.