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研究生:吳瑞燕
研究生(外文):Jui-Yen Wu
論文名稱:探討思覺失調症患者希望感之相關研究
論文名稱(外文):The Study of Hope among Schizophrenic Patients
指導教授:顏 文 娟
指導教授(外文):Wen-Jiuan Yen
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:護理研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:96
中文關鍵詞:思覺失調症認知適應希望
外文關鍵詞:schizophreniacognitive adaptionhope
相關次數:
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本研究目的為探討影響思覺失調症患者希望感相關因素。本研究以中部某醫學中心精神科門診為研究地點,以立意方式取樣,研究對象須符合:(1)據DSM-Ⅳ或ICD-10診斷為思覺失調症患者(2)年齡介於20-65歲間(3)意識清楚能以國、台語溝通(4)精神症狀穩定,能持續專注約20-30分鐘者共收140位樣本數。本研究採橫斷式及描述性相關因子研究設計,採以Espie, Montgomery & Gilies(1988).所編制疾病症狀量、疾病意義量表(Constructed Meaning Scale )CMS(Fife1995, 2000)、自我控制量表Sense of control Scales(SCS) Lachman1 & Leaver1(1998)及韓、陳(2008)精神疾病自我污名感受量表(簡短版)、鄭伊真(2011)翻譯自尊量表與Snyder et al.(1991)The Hope Scale(THS)量表來測量與希望感分布與相關性及預測。
研究結果顯示思覺失調症患者:(1)疾病症狀越明顯,希望感越低其彼此呈現中度負相關。(2)疾病意義與希望呈現中度正相關。(3)自我控制中受限程度越高,希望感越低其彼此呈現低度負相關。(4)自尊與希望感呈現中度正相關。(5)疾病烙印感受與希望感呈現低度負相關。(6)疾病症狀及自尊可作為預測思覺失調症患者希望狀態。
研究應用與建議:針對研究結果,提升個案的希望感可藉由相關因子中的自我控制受限降低,自尊的提升以及症狀控制程度,臨床護理師可藉由提供疾病知識的正面訊息,以及與個案探討疾病的意義與降低負面疾病烙印感來協助個案提升自尊與希望感,增進照護品質。


The aim of the study was to explore the associated factors of hope in schizophrenia patients. The patients were recruited from psychiatric outpatient department in a medical center in Central Taiwan. In this cross sectional study, Judgmental sampling was used. The eligible inclusion criteria were:(1) DSM-Ⅳ or ICD-10 Diagnosis of schizophrenia (2) age between 20 and 65 years old (3) have clear consciousness and ability to communicate in Chinese and Taiwanese (4) have stable mental condition and maintain 20 to 30 minutes. 140 patients were recruited and descriptive comparative analysis of associated factors. This survey ues cross-sectional and descriptive related factors design. It includes six instruments, Psychological Behavior Scale (PBS), Constructed Meaning Scale(CMS),Sense of control Scales(SCS), Rosenberg Self-esteem Scale (RSES), perceived psychiatric stigma scale(PPSS) and The Hope Scale(THS). By these tests, investigate the sense of hope and related impacts.
The research consequence shows that schizophrenia patients (1) either positive or negative symptoms of disease is more obvious, the sense of hope would be less. It shows moderate negative correlation (2) the significance of disses and hope is moderate positive correlation (3) the higher the degree of self-control is limited, the lower sense of hope would be. It presents low negative correlation with each other (4) self-esteem and a sense of hope showing moderate positive correlation (5) Illness stigma feelings and a sense of hope showing low negative correlation (6) disease symptoms and self-esteem can be used to predict psychosis patients hope state.
Research applications and suggestion: For research results to enhance a sense of hope that the case may be related to factors in reducing self-control is limited, self-esteem enhancement and control the degree of symptoms, clinical nurse can provide a positive message by knowledge of the disease, as well as to investigate the significance of cases of the disease and reduce the negative stigma of the disease to help the case to enhance a sense of self-esteem and a sense of hope, enhance quality of care.

目錄
致謝 Ⅴ
中文摘要 Ⅵ
英文摘要 Ⅶ
第一章緒論
第一節 研究背景動機及重要性 1
第二節 研究目的 2
第三節 研究問題 2
第四節 名詞界定 3
第二章文獻查證
第一節 思覺失調症患者情緒適應狀況 5
第二節 希望感(Hope)概念 9
第三節 影響希望的因子 11
第四節 研究架構 19
第三章研究方法
第一節 研究設計 21
第二節 研究步驟 21
第三節 研究對象 22
第四節 研究對象權益及倫理考量 22
第五節 研究工具及信效度測試 23
第六節 資料處理與分析 30
第四章研究結果
第一節 思覺失調症人口學特性 32
第二節 思覺失調症認知適應與情緒感受分佈情形 33
第三節 思覺失調症患者希望感與變項間相關性 37
第四節 預測思覺失調症患者的希望感 42
第五章討論
第一節 人口學特徵與希望程度 45
第二節 希望之相關因子 45
第三節 思覺失調症患者希望感重要預測 52
第六章結論與建議
第一節 結論 54
第二節 研究限制 55
第三節 護理專業上之應用建議 56
參考資料 58
附錄一 人體試驗委員會通過同意書 72
附錄二 臨床研究受訪者問卷說明及同意書 73
附錄三 精神症狀量表 77
附錄四 基本人口學資料 78
附錄五 疾病意義量表 79
附錄六 自我控制量表 80
附錄七 自尊量表 81
附錄八 精神疾病污名感受量表 82
附錄九 希望量表 83
附錄十 問卷使用同意函(一)(二) 84
附錄十一專家名單 86
附錄十二專家檢測問卷內容 87




圖表目錄
表目錄
表3-1 希望量表原始問卷與修正後問卷對照表 28
表3-2 疾病意義量表原始問卷與修正後問卷對照表 28
表3-3 自我控制量表原始問卷與修正後問卷對照表 29
表3-4 希望量表及疾病意義量表和自我控制量表信度檢測 30
表3-5 研究問題與統計方法 31
表4-1 思覺失調症患者人口學特性分佈 33
表4-2 思覺失調症患者之疾病意義三項分量表分數 34
表4-3 思覺失調症患者之自我控制量表兩項分量表分數 35
表4-4 思覺失調症患者之自尊量表兩項分量表分數 35
表4-5 思覺失調症患者之精神疾病烙印感受量表三項分量表分數 36
表4-6 思覺失調症患者之希望量表兩項分量表分數 37
表4-7 思覺失調症患者之希望量表在人口學特性之分佈 38
表4-8 思覺失調症患者希望感與變項之相關性 39
表4-9思覺失調症患者希望感與疾病意義之相關性 40
表4-10思覺失調症患者希望感與自我控制之相關 41
表4-11思覺失調症患者希望感與自尊之相關 41
表4-12思覺失調症患者希望感與精神疾病烙印感受之相關 42
表4-13 以線性迴歸模式評估思覺失調症患者之希望量表的影響因子 43
表4-14 以逐步迴歸分析思覺失調症患者之希望量表的影響因子 44
圖目錄
圖 一、思覺失調症患者與希望感研究架構圖 20


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