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研究生:林怡君
研究生(外文):Lin, Ye-Jane
論文名稱:疑陽性甲狀腺低能症患童母親之壓力源與調適行為
論文名稱(外文):Stressor and coping behaviors of mother having doubtful hypothyroidism children
指導教授:陳月枝陳月枝引用關係
指導教授(外文):Yueh-Chih Chen
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:護理學系
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:1997
畢業學年度:85
語文別:中文
論文頁數:140
中文關鍵詞:母親疑陽性甲狀腺低能症壓力源調適行為
外文關鍵詞:motherdoubtful hypothroidismstressorscoping behaviors
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中文摘要: 本研究主要是探討新生兒篩選後,疑陽性甲狀腺低能症患童母
親面對疾病確認診斷,醫療措施,及母親照護的壓力源及調適行為,並進而
探討可能影響的因素.方法採調查性研究法,依立意取樣,於台北市某一家
一級醫學中心的內分泌門診,利用結構式自擬問卷"母親壓力量表","母親
調適行為量表"進行資料的收集,再以SPSS軟體對資料進行描述性統計分
析,卡方檢定多變異數分析,因素分析,複回歸分析及皮爾森積差相關分析.
在研究51名患童母親中,平均年齡為29.14+-0.56歲,其中49%為職業婦
女,84.3%教育程度為高中職以上,50%信仰佛教,子女數僅一人者佔52.9%,
患童年齡平均5.30+-0.63月,男女各佔一半. 結果顯示:母親歷
經患童確認診斷期間,共面臨三大項壓力源,十三小項壓力源."來自患童方
面壓力源"包括:疾病典型特徵,疾病早期症狀,確認檢查過程,獲知不好訊
息等;"來自醫療措施壓力源"包括:接受醫療措施,醫護溝通方式,等待醫療
診斷確定疾病病情等;"來自母親方面壓力源"包括:人際關係互動,對疾病
的疑惑,對藥物的認知,擔心孩子未來,害怕憂心遺傳等.若以三大項壓力源
來看,依患童目前的醫療處置分為不服用藥物與服用藥物兩組,研究對象皆
以"來自母親方面壓力源"的感受最大,壓力感受最低的為"來自患童方面壓
力源".若以小項來看,則分別是"來自醫療措施壓力 源"中的"接
受醫療措施","確定疾病病情"及"來自母親方面壓力源"中的"人際關係互
動","對藥物的認知"等四項壓力源達統計上的差異. 患童目前
的醫療處置,母親教育程度及職業的不同是影響二組研究對象最重要的因
素.至於其它在母親的年齡,收入,子女數,宗教信仰,婚姻狀況,家族甲狀腺
疾病史,社會支持,患童年齡及其甲狀腺位置等變項並無統計上的顯著差
異. 先生是母親面對壓力源最好的支持者,其次是篩檢告知人員
的支持與幫助,再其次才是醫療團隊中的醫護人員. 在調適行為
方面,母親常採取的調適行為是"凡事往好的方面去想"其次是"害怕焦慮",
除此之外,母親還會主動積極的"尋找相關書籍報章雜誌"及"詢問專家"等
調適行為. 影響母親調適行為的因素依次為年齡,教育程度,收
入.年齡較大的比較會有情緒上的害怕焦慮;教育程度高的比較會尋找相關
書籍報章雜誌;收入尚可的比較會積極地尋找相關書籍報章雜誌及詢問專
家. 總而言之,希望研究結果可提供醫護人員瞭解母親的壓力
源,壓力感受,相關的影響因素及調適行為,如此可提供更適切的護理指導
給患童及家庭.
Abstract:The purpose of the study was to investigate the
maternal stressors in terms of taking care of their doubtful
hypothyroidism children after the newborn screen, the degree of
their stress, their coping behaviors and then discdss about the
relative factors associated with the medical diagnosis as well
as medical treatment of their sick children. The methods were
survey research and purposive sampling. Fifty-one mothers
participated and were divided into two groups in this study.
Group one including twenty-seven subjects was the "non-medical-
treatment", Group two including twenty-four subjects was the
"medical-treatment". Data were collected by interviewing with
these subjects and using questionnair in the outpatient clinics.
The instruments used in the research including:" Stressors
Scale" and "Coping Scale". Data were analyzed by using
Descriptive statistics, Chi-square, Factor analysis,Mutivariate
ANOVA, Mutiple regression and Pearson''s correlation. The results
showed that the stressors of the mother having doubtful
hypothyroidism children came:1)from the children''s typical
symptoms and their early signs, the process of the consultation,
and getting bad information;2)from the medical problems
including the medical treatment and the communicative way, the
acceptance of the diagnosis and the ascertainment of the
disease;3)from maternal aspects including interpersonal
relationship, confusion of disease, cognition of medicine,
worrying future, and worrying eugenical heredity.Two group
subjects wereaffected by "stressors from the maternal aspects"
but not affected by "stressor from the children ". There were
statistical significance between these two groups:medical
treatment, ascertainment of the disease, interpersonal
relationship and the cognition of medicine. The degree of the
stress affecting by the stressors of the mothers varied
significantly in treatment protocol of children level of
education of mother , and mother''s occupation. Anyhow, the
degree of the mothers''stress showed no statistiacl significane
with the mother''s age , income of family, number of children,
belief of religion, marital status, whether mother suffer from
thyroid disease, whether the family member had the disease,
social support, the age of the sick children, site of thyroid of
sick children in the study.However,the husbands, assisant of
screen center and nurses were reported to be the major
supporters of the mothers. Coping behaviors were used as
"thinking wonderful","fear-anxiety","seeking the relative
information from the medical references", and"asking the
expertise". The factors affecting by the coping behaviors of the
mother were mothers'' age, level of eduation and income of
family. The mother with older age showed fear-anxiety; the
mother with high level education were actively seeking
information ;the mother from the moderate income family were
seeking information and asking the expertise, too. In
conclusion, this result of this study could help the medical
staff realize the degree of the mothers'' stressand understand
the relative factors causing mothers'' stress. Therefore, the
medical professionals can provide the appropriate care to the
sick children and their family.
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