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研究生:余靜雲
研究生(外文):Yu, Ching-Yun
論文名稱:門診精神分裂症患者之自我效能探討
論文名稱(外文):Exploring Self-efficacy of Schizophrenic Outpatients
指導教授:鍾信心鍾信心引用關係
指導教授(外文):Chung, Hsin-Hsin
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:護理學研究所
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:2000
畢業學年度:88
語文別:中文
論文頁數:86
中文關鍵詞:門診精神分裂症患者自我效能生活壓力事件
外文關鍵詞:schizophrenic outpatientsself-efficacystressful life events
相關次數:
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本研究之目的主要是探討門診精神分裂症患者之自我效能,及其與個人因素、疾病因素、生活壓力事件之相
關。以立意取樣自南部某一醫學中心之門診精神分裂症患者,共訪談135位個案,完成個人基本資料、精神症狀評估表、生活壓力事件量表及自我效能量表。問卷之信、效度良好,所得資料以描述性及推論性統計進行分析。
研究結果發現門診精神分裂症患者:(1)自我效能標準化得分69.41分,以「社交技巧」的自我效能得分較
低。(2)有宗教信仰者其自我效能較高。(3)生活壓力事件壓力感受愈大,其自我效能愈差。
(4)精神症狀愈嚴重者,自我效能愈差。(5)負性症狀、活性症狀、生活壓力事件及宗教信仰可以解釋自我效能之總變異量達45.7%,其中以負性症狀之預測力最佳,可以解釋35.4%變異量。
根據研究結果,建議護理人員將「自我效能」此概念運用於護理照顧中,並能進一步設計發展有效之治療方
案,以提升其自我效能;教導護理人員正確評估患者之精神症狀,尤其是負性症狀,並給予患者有效之護理措施,以減輕其精神症狀;且能將家屬納入治療計畫,教導家屬與個案之間恰當之互動方式,減少彼此間的生活壓力感受。
關鍵字:門診精神分裂症患者、自我效能、生活壓力事件
The purpose of this study is to investigate the self-efficacy of the schizophrenic outpatients and the relation between the personal demographic data, psychotic symptoms, stressful life events and self-efficacy. There were 135 subjects selected from a medical center in Kaohsiung city. Four assessment instruments were used including : Personal Demographic Data, Psychotic Symptoms Scale, Self-efficacy Scale and Stressful Life Events Scale. The validity and reliability of these instruments were tested and satisfied the requirement. The collected data were analyzed using the descriptive statistics, Pearson''s correlation, t-test, one way ANOVA, non-parametric analysis and stepwise multiple regression analysis.
The findings of this study were: (1) The standardized score of self-efficacy is 69.41, the score of social skills is the lowest. (2) The patients who have religious belief show higher self-efficacy. (3) The patients with more stress in life events have lower self-efficacy. (4) The patients who have more serious psychotic symptoms have lower self-efficacy. (5) The predictors of self-efficacy were negative symptoms, stress of life events, positive symptoms and religion, which accounted for 45.7% of variance. Among these variables, the negative symptoms show the best predict as 35.4% of variance.
According to these findings, we suggest that the nursing personnel utilize the concept of self-efficacy in caring the schizophrenic patients and develop more effective therapy design to promote the patients'' self-efficacy; namely to promote the nursing personnel to more accurately assess the psychotic symptoms, especially negative symptoms in order to effectively perform many interventions for releasing the patients'' psychotic symptoms. Also, involve the family to participate in the treatment plans to teach the family member communication skills to interact with patients so that mutual stress can be decreased to the minimum.
Key words: schizophrenic outpatients, self-efficacy, stressful life events
目 錄
第一章 緒論
第一節 研究動機及重要性………………………………………1
第二節 研究目的…………………………………………………3
第三節 名詞界定…………………………………………………4
第二章 文獻查證
第一節 精神分裂症之精神症狀…………………………………6
第二節 生活壓力事件……………………………………………9
第三節 自我效能……….…………………………………………11
第三章 研究架構與研究假設
第一節 研究架構…………………………………………………17
第二節 研究假設…………………………………………………18
第四章 研究方法
第一節 研究對象…………………………………………………19
第二節 研究工具…………………………………………………19
第三節 研究工具信度檢定………………………………………21
第四節 研究工具效度檢定………………………………………22
第五節 研究步驟…………………………………………………27
第六節 資料分析…………………………………………………28
第五章 研究結果
第一節 研究對象描述……………………………………………30
第二節 個人基本屬性、疾病因素、生活壓力事件及自我效能之關係44
第三節 疾病因素、生活壓力事件及自我效能之關係………53
第四節 自我效能的重要影響變項……………………………57
第六章 討論
第一節 個人基本屬性、疾病因素、生活壓力事件情形及自我效
能的情形……………………………………………………59
第二節 個人基本屬性、疾病因素、生活壓力事件情形及自我效能
之關係………………………………………………………67
第三節 影響自我效能之重要因素………………………………71
第七章 結論與建議
第一節 結論…………………………………………………………72
第二節 建議…………………………………………………………74
第三節 研究限制…………..………………….……………………77
參考資料…………………………………………………………………78
附錄一:內容效度鑑定專家名單………………………………………87
附錄二:研究工具…………………………………………………………88
附錄三:研究量表之同意使用函………………………………………98
圖 表 目 錄
圖2-1 效用期待與結果期待之區別……………………………………12
圖3-1 研究架構…………………………………………………………17
表4-1 自我效能量表之項目分析………………………………………23
表4-2 自我效能量表之因素分析………………………………………25
表5-1 個人基本屬性分佈情形…………………………………………31
表5-2 精神症狀得分情形………………………………………………33
表5-3 活性症狀之嚴重程度……………………………………………34
表5-4 負性症狀之嚴重程度……………………………………………35
表5-5 生活壓力事件分量表得分情形…………………………………36
表5-6 工作部分之壓力情形……………………………………………37
表5-7 學業部份之壓力情形……………………………………………38
表5-8 感情或婚姻生活部份之壓力情形………………………………38
表5-9 家人部份之壓力情形……………………………………………39
表5-10 個人部份之壓力情形……………………………………………40
表5-11 自我效能量表各因素得分情形…………………………………41
表5-12 自我效能量表單題得分情形……………………………………42
表5-13 個人基本資料與疾病之相關……………………………………45
表5-14 個人基本屬性與壓力感受之相關………………………………46
表5-15 個人基本屬性與壓力感受之相關………………………………47
表5-16 個人基本屬性與生活事件次量表之相關………………………48
表5-17 個人基本屬性與生活事件次量表之相關………………………49
表5-18 個人基本屬性與自我效能之相關………………………………50
表5-19 個人基本屬性與自我效能次量表之相關………………………51
表5-20 個人基本屬性與自我效能次量表之相關………………………52
表5-21 疾病因素與生活壓力事件之相關………………………………53
表5-22 疾病因素與自我效能之相關……………………………………54
表5-23 生活壓力事件與自我效能之相關………………………………56
表5-24 自變項之共線性分析……………………………………………57
表5-25 逐步多元迴歸分析摘要表………………………………………58
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