臺灣博碩士論文加值系統

研究目的在探討乳癌婦女的病後婚姻調適及其影響因素，研究變項包括人口學特性、疾病特性、病前婚姻調適、憂鬱、性問題與病後婚姻調適。研究以抽樣調查法及便利取樣進行，對象選自臺北地區二所醫學中心及一所區域醫院，計有119位接受乳癌手術治療至少三個月的已婚婦女，在獨立隱密的空間接受研究者以結構式問卷訪談。所得資料以描述性統計、配對t、t-test、單因子變異數分析、Pearson積差相關及逐步迴歸進行分析，研究之重要發現如下：
一、 乳癌婦女病前、後之婚姻調適沒有差異，但病後生物面滿意下降，心理面滿意及社會面滿意感受上升。
二、 教育程度不同，病後婚姻調適及生物面、經濟面與哲學面滿意也不同。
三、 家庭收入不同，病後婚姻調適及心理面、社會面、經濟面與哲學面滿意也不同。
四、 罹病時間不同，病後婚姻調適及生物面、心理面、社會面與哲學面滿意也不同。
五、 目前接受之輔助治療不同，病後婚姻調適及心理面、社會面、哲學面滿意也不同。
六、 婦女憂鬱症狀越明顯，病後婚姻調適及各層面滿意度越差。
七、 婦女性問題越多，病後婚姻調適及各層面滿意度越差。
八、罹病時間、癌症期數、目前正接受化學或化學合併荷爾蒙治療、病前婚姻調適、家庭收入及憂鬱六變項，會影響乳癌婦女病後婚姻調適。其中，病前婚姻調適是最重要的預測變項。
依據研究結果，提出相關建議供臨床醫療、護理實務、教育及日後研究者參考。

The purpose of this study was to explore post-morbid marital adjustment and related factors in women with breast cancer. The variables include demographics, disease characteristics, pre-morbid marital adjustment, depression, sexual problems and post-morbid marital adjustment. The research method was based on a sampling survey. Subjects were recruited by convenience sampling from two medical centers and one local hospital in Taipei, A total of 119 married women who had received surgery for breast cancer for more than 3 months were interviewed with structured questionnaires at concealed space. Data were analyzed with descriptive statistics, paired t, t-test, one-way ANOVA, Pearson product correlation, and stepwise regression.
The major findings of this study are as follows：
（1） There was no difference between pre-morbid, post-morbid and marital adjustment in women with breast cancer, but there was a significant decrease in physical aspect of marriage satisfaction and a significant increase in both psychological and social aspect of marriage satisfaction of post-morbidity.
（2） A significant difference was found in post-morbid marital adjustment, physical, economic, and philosophical aspect of marriage satisfaction between patients different education degree.
（3） A significant difference was found in post-morbid marital adjustment, psychological, social, economic, and philosophical aspect of marriage satisfaction between patients different family income.
（4） A significant difference was found in post-morbid marital adjustment, physical, psychological, social, and philosophical aspect of marriage satisfaction between patients different duration of disease.
（5） A significant difference was found in post-morbid marital adjustment, psychological, social, and philosophical aspect of marriage satisfaction between different type of current adjuvant therapy.
（6） More depression possessed poorer post-morbid marital adjustment and marriage satisfaction in each aspect.
（7） More sexual problems possessed poorer post-morbid marital adjustment and marriage satisfaction in each aspect.
（8） The variables including duration of disease, stage of cancer, treatment with chemotherapy or combined chemohormonal therapy, pre-morbid marital adjustment, and family income could predict post-morbid marital adjustment. The strongest predictor was the pre-morbid marital adjustment.
Base on these findings, we have provided some suggestions to clinical medicine, nursing practice, education, and directions for further researches.

第一章 緒 論1
第一節 研究動機1
第二節 研究問題的重要性3
第三節 研究目的4
第二章 文獻查證5
第一節 乳癌及其治療5
第二節 乳癌婦女的憂鬱10
第三節 乳癌婦女的性問題14
第四節 婚姻調適17
第五節 影響乳癌婦女病後婚姻調適之相關因素22
第三章 研究架構32
第一節 研究架構32
第二節 名詞界定33
第三節 研究問題與假設35
第四章 研究方法36
第一節 研究對象及場所36
第二節 研究工具37
第三節 研究工具的信效度檢定43
第四節 研究步驟47
第五節 研究倫理考量49
第六節 資料處理與統計分析50
第五章 研究結果52
第一節 乳癌婦女之人口學特性與疾病特性描述52
第二節 乳癌婦女的憂鬱描述57
第三節 乳癌婦女的性問題描述60
第四節 乳癌婦女病前、病後婚姻調適分析63
第五節 人口學特性、疾病特性與病後婚姻調適之差異分析69
第六節 憂鬱、性問題與病後婚姻調適之相關分析77
第七節 乳癌婦女病後婚姻調適之相關因素預測82
第六章 討 論92
第一節 乳癌婦女的憂鬱分佈情形92
第二節 乳癌婦女的性問題分佈情形94
第三節 乳癌婦女病前、病後婚姻調適97
第四節 乳癌婦女人口學特性與病後婚姻調適101
第五節 乳癌婦女的疾病特性與病後婚姻調適討論104
第六節 乳癌婦女的憂鬱、性問題與病後婚姻調適討論106
第七節 影響乳癌婦女婚姻調適的因素討論109
第七章 結論、建議與研究限制115
第一節 結 論115
第二節 建 議116
第三節 研究限制與未來研究建議120
參考資料123
英文部分123
中文部分135

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晏涵文、江漢聲、馮榕（民81）金賽性學報告：親密關係篇台北：張老師。
曹中瑋（民73） 自我狀態、夫妻間溝通型態與婚姻滿意度之相關研究  國立台灣師範大學輔導研究所碩士論文。
陳玟秀（民75） 癌症病患的性問題及其調適方法  護理雜誌，33（2），75-81。
陳明君（民80） 家庭決策、夫妻溝通之自我開放程度與婚姻滿意度之相關研究  私立中國文化大學家政研究所碩士論文。
陳啟明（民82）  早期乳癌病人之乳房保留手術  醫學繼續教育，3（4），逸仙治癌中心醫院外科。
陳海焦（民85） 乳癌婦女接受乳房切除手術後身體改變的經驗  國防醫學院護理研究所碩士論文。
陳惠美（民86） 乳癌術後婦女身心社會調適之探討：以羅式適應模式為基礎  國立陽明大學臨床護理研究所碩士論文。
莊訓當（民85） 國中已婚教師滿意度相關因素及其調適之研究  國立高雄師範大學輔導研究所。
莊雙恩、楊志新（民87） 癌症之生物製劑療法及基因療法  台灣醫學，2（3）321-327。
黃俊升（民84） 乳癌  醫學繼續教育，5（2），152-155。
黃翠媛、黃秀梨（民84） 人類性學概要 護理雜誌，42（3），92-97。
曾玉華、王令瑋（民87） 癌之放射治療 臨床醫學，41（4），278-281。
張金堅（民81）乳癌之診斷與外科治療醫學繼續教育，2（1），2-8。
張春興（民76） 心理學 台北：東華。
國家衛生研究院癌症研究組（民87）乳癌診斷與治療共識台灣癌症臨床研究合作組織。
葉坤輝、鄭安理（民87）癌症化學治療之適應症台灣醫學，2（3），305-311。
趙祖怡、張俊彥（民84） 轉移性乳癌之認知及治療 國防醫學，21（2），112-117。
蔡麗雲、顧乃平（民86） 癌症病患的心理困擾、疼痛因應策略及其相關因素之探討 護理研究，5（2），137-148.
鄭安理、陳耀昌（民81） 乳癌之化學治療  醫學繼續教育，2（1），25-36。
劉向援（民75） 接受乳房根除手術之乳癌婦女，於住院期間有關「身體心像」與「調適行為」之探討  國防醫學院護理研究所碩士論文。
劉自嘉（民81）乳癌之內分泌治療醫學繼續教育，2（1），37-41。
謝銀沙（民81） 已婚婦女病患特質、婚姻溝通與婚姻調適相關研究  國立台灣師範大學家政教育研究所碩士論文。
藍采風（民71）婚姻關係與調適台北：張老師月刊。
藍采風（民85）婚姻與家庭台北：幼獅。
闕清模（民71）內科疾患的憂鬱症狀 臨床醫學，9（4），346-356。