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研究生:鄭竹惠
研究生(外文):Chu-Huei Cheng
論文名稱:接受生殖科技懷孕婦女第一孕期身心症狀、因應行為與幸福安寧感之探討
論文名稱(外文):Evaluation of Psychosomatic and Coping Behaviors and Well-being During First Trimester for Infertile Women Receiving Assisted-Reproductive Techniques
指導教授:郭碧照郭碧照引用關係
指導教授(外文):Bih-Jaw Kuo
學位類別:碩士
校院名稱:中山醫學院
系所名稱:醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2001
畢業學年度:89
語文別:中文
論文頁數:88
中文關鍵詞:不孕症生殖科技治療第一孕期身心症狀因應行為幸福安寧感
外文關鍵詞:infertilityassisted reproductive techniquesfirst trimesterpsychosomaticcoping behaviorswell-being
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  本研究旨在探討生殖科技懷孕婦女第一孕期身心症狀、因應行為與幸福安寧感,並探究其身心症狀、因應行為與幸福安寧感的相關性及預測因子。以立意取樣,生殖科技組取自中部某不孕研究中心及醫學中心接受生殖科技成功懷孕之第一孕期婦女共61位,自然懷孕組取中部某教學醫院及某地區醫院之婦產科門診共78位為對照。研究工具為懷孕之身心症狀量表、Jalowiec因應行為量表、幸福安寧感量表、家庭功能量表之結構式問卷。資料分析以SPSS PC(+)10.0版套裝軟體,以百分比、平均數、標準差、皮爾森相關、因素分析、t檢定、卡方檢定、共變數分析、單因子變異數分析、及逐步複迴歸進行分析。
  研究結果發現:兩組身心症狀之前十項症狀相似,生殖科技懷孕婦女對懷孕的接受度比自然懷孕組高但自然懷孕組比生殖科技懷孕組易主動尋求社會資源。身心症狀受「宗教信仰」、「教育程度」、「不孕經驗與治療造成的壓力」因素的影響。因應行為類型受與「年齡」、「就業與否」、「家庭功能」、「孕期合併症」「不孕經驗與治療造成的壓力」因素的影響。而孕期的幸福安寧感受「正向情緒」、「主動尋求社會資源」、「認知上接受」、「消極且情緒化的發洩」、「認知上接受」因素的影響。
  不孕經驗與治療引發的壓力可預測「身體症狀」﹔不孕經驗與治療引發的壓力、宗教信仰可預測「負向情緒」﹔家庭功能、孕期合併症可預測「主動尋求社會資源」行為﹔孕婦年齡、不孕經驗與治療引發的壓力可預測「消極且情緒化的發洩」行為﹔有無孕期合併症、不孕經驗與治療引發的壓力可預測「尋求心靈寄託及轉移注意」行為﹔正向情緒症狀、主動尋求社會資源可預測「總幸福安寧感」。
  本研究可增進醫護人員對接受生殖科技治療懷孕後婦女的第一孕期身心症狀因應行為及幸福安寧感的相關性更進一步的了解,以提供專業性、全面性的產前照護。
The purpose of this study was to explore the psychosomatic symptoms, the coping behavior and the well being of pregnant women in first trimester, and determinate the relation and predictive factor of the psychosomatic symptoms, the coping behaviors and the well-being. A purposive sampling method was used to collect 61 mothers in their first trimester conceived by assisted reproductive techniques (ART) at a infertility center and a medical center in the central Taiwan as ART group, 78 mothers with nature pregnancy at a teaching hospital and local hospital as control group. There were four instruments used to collect data, including pregnant psychosomatic symptom scale, Jalowiec coping behaviors scale, well-being scale and family APGAR index. The data were analyzed by percentage, mean, standard deviation, Pearson’s correlation, Factor analysis, T-tests, Chi-square, NACOVA, one way ANOVA, and multiple stepwise regression with SPSS PC(+) 10.0 software.
The result indicated that the top 10 psychosomatic symptoms of the two group were similar. The degree of acceptation with pregnancy in the ART group were higher than that of the nature pregnancy group. But the nature pregnancy group tend to search more social resource than the ART group. Psychosomatic symptoms were influenced by “ religion”, “education level”, “stress from infertile experience and treatment”. The type of coping behavior were influenced by “age”, “working or not”, “complication of pregnancy”, “stress from infertile experience and treatment”. Well-being were influenced by “positive affection”, “active searching for social resource”, “acceptation of concepts”, “the liberation of pessimism and sentiment mentally release”.
The stress from infertile experience and treatment can predict “somatic symptoms”; stress from infertile experience and treatment, and religion can predict “negative affection”; family function and complication of pregnancy can predict “active searching for social resource”; age, and stress from infertile experience and treatment can predict “the liberation of pessimism and sentiment mentally release”; complication of pregnancy, and stress from infertile experience and treatment can predict “the search of repose soul and spirit and the transfer attention”; positive affective symptoms and can predict active searching for social resource can predict total well-being.
The study can promote the nursing staff to understand more about the psychosomatic symptoms of mothers conceived by ART and the relation of well-being, to provide professional and thorough antenatal care.
中文摘要……………………………………………………………Ⅱ
英文摘要……………………………………………………………Ⅲ
目錄…………………………………………………………………Ⅳ
圖表目錄……………………………………………………………Ⅵ
第一章緒論
 第一節研究動機…………………………………………………1
 第二節重要性……………………………………………………2
 第三節研究目的…………………………………………………3
第二章文獻查證
 第一節前言………………………………………………………4
 第二節接受生殖科技治療時婦女所經歷之痛苦………………5
 第三節不孕後懷孕婦女第一孕期之身心症狀…………………6
 第四節生殖科技懷孕婦女第一孕期常見之醫療處置及影響…9
 第五節懷孕婦女第一孕期之因應行為…………………………10
 第六節懷孕之幸福安寧感………………………………………12
第三章研究架構與研究假設
 第一節研究架構…………………………………………………14
 第二節研究問題與研究假設……………………………………15
 第三節名詞界定…………………………………………………17
第四章材料與方法
 第一節研究對象…………………………………………………18
 第二節研究場所…………………………………………………18
 第三節資料收集…………………………………………………18
 第四節研究工具…………………………………………………19
 第五節資料分析…………………………………………………34
第五章研究結果
 第一節接受生殖科技懷孕與
    自然懷孕婦女之基本資料………………………………36
 第二節接受生殖科技懷孕婦女其第一孕期
    身心症狀、因應行為與幸福安寧感得分與比較………41
 第三節接受生殖科技成功懷孕婦女第一孕期
    身心症狀、因應行為與基本屬性的關係………………44
 第四節接受生殖科技懷孕婦女第一孕期之
    身心症狀、因應行為與幸福安寧感的相關性分析……50
 第五節預測影響接受生殖科技懷孕婦女第一孕期其
    身心症狀、因應行為之相關因素………………………52
 第六節預測影響接受生殖科技懷孕婦女
    幸福安寧感的相關因素…………………………………55
第六章討論
 第一節第一孕期身心症狀及因應行為、
幸福安寧感得分情形……………………………………58
 第二節生殖科技懷孕婦女的基本屬性、治療因素與
    身心症狀、因應行為關係之分析………………………60
 第三節第一孕期身心症狀、因應行為與
幸福安寧感關係之分析…………………………………62
 第四節影響第一孕期身心症狀、因應行為、
    幸福安寧感的相關因素…………………………………63
第七章結論與建議
 第一節結論………………………………………………………64
 第二節護理上的應用……………………………………………66
 第三節研究限制與未來研究建議………………………………67
參考資料
 中文部分…………………………………………………………69
 英文部分…………………………………………………………72
附錄一 專家效度名單……………………………………………78
附錄二 研究工具…………………………………………………79
圖表目錄
頁數
圖3.1研究架構…………………………………………………………14
表4.1正試身心症狀量表之內在一致性及再測信度…………………20
表4.2正試不孕經驗及治療引發之壓力量表
之內在一致性及再測信度………………………………………22
表4.3正試因應行為量表之內在一致性及再測信度…………………23
表4.4因應行為量表項目分析結果……………………………………25
表4.5因應行為量表因素分析之正交轉軸結果………………………26
表4.6正試幸福安寧感量表之內在一致性及再測信度………………28
表4.7幸福安寧感量表項目分析結果…………………………………30
表4.8幸福安寧感量表因素分析之正交轉軸結果……………………31
表5.1研究樣本的基本屬性……………………………………………38
表5.2研究樣本的生殖科技治療因素…………………………………40
表5.3生殖科技懷孕婦女與自然懷孕婦女
其第一孕期身心症狀之前十項排名……………………………41
表5.4接受生殖科技與自然懷孕婦女第一孕期
身心症狀、因應行為與幸福安寧感量表之比較………………42
表5.5接受生殖科技與自然懷孕婦女第一孕期
身心症狀、因應行為與幸福安寧感量表之共變數分析比較…43
表5.6孕婦基本屬性不同與其身心症狀及因應行為次量表之比較…47
表5.7接受生殖科技懷孕婦女其第一孕期
身心症狀、因應行為與幸福安寧感之相關……………………51
表5.8預測影響接受生殖科技懷孕婦女其
第一孕期身心症狀、因應行為次量表之相關因子……………54
表5.9預測影響接受生殖科技懷孕婦女
第一孕期幸福安寧感次量表之相關因子………………………57
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