目的：本研究主要目的有三：(一)探討酒精依賴患者飲酒行為變化與生活品質之關係；(二)探討家庭功能與酒精依賴患者飲酒行為之關係，分為早期家庭功能與日後酒精依賴的形成與預後之關係，以及酒精依賴患者最近三個月飲酒行為與近期家庭功能之關係；(三)探討酒精依賴患者家庭功能與生活品質之關係；(四)探討酒精依賴患者家庭功能、飲酒行為及生活品質之關係。

方法：取樣參與戒癮治療且經過終生診斷晤談確立診斷的77名男性酒精依賴患者為受試者，以飲酒行為測量表收集戒癮前三個月的飲酒行為，再將之區分為三組，其中尚未接受戒癮治療的患者為「尚未治療組」，共19名；其餘58位患者已經完成戒癮治療達三個月以上，依照下列條件予以分組：患者在參與治療後三個月以上的追蹤時，在追蹤點前三個月的每週平均飲酒量大於零者為「非戒斷組」，共39名；追蹤時每週平均飲酒量等於零者為「戒斷組」，共19名。另外由社區經廣告招募而取樣32名未符合DSM-III-R之精神疾病診斷、腦傷、以及身體重大疾病者做為「正常控制組」。每組受試者均接受診斷晤談與飲酒行為晤談，並填寫兒童期、近期家庭功能量表及生活品質量表。
結果：(一)四組在生活品質生理健康、心理、社會關係及環境四個範疇上皆達顯著差異。事後比較發現發現在生理健康範疇上，戒斷組與正常控制組高於尚未治療組與非戒斷組，而戒斷組與正常控制組無顯著差異，尚未治療組與非戒斷組無顯著差異。在心理範疇上，戒斷組高於尚未治療組，正常控制組高於非戒斷組與尚未治療組。在社會關係範疇上，戒斷組與正常控制組高於尚未治療組與非戒斷組，其餘任兩組間均無顯著差異。在環境範疇上，戒斷組高於非戒斷組，其餘任兩組間均無顯著差異。(二)在兒童期家庭功能的衝突、情感過度涉入、問題解決向度上達顯著差異。事後比較發現尚未治療組與非戒斷組的衝突高於戒斷組與正常控制組；非戒斷組的情感過度涉入高於戒斷組；非戒斷組的問題解決低於尚未治療組；但在兒童期家庭功能其餘五個向度上未達顯著差異。而在近期家庭功能的衝突與情感過度涉入向度上，四組亦達顯著差異。事後比較發現非戒斷組的情感過度涉入高於戒斷組；但在衝突向度上任兩組間並未達顯著差異；另在近期家庭功能其餘六個向度上則四組間未達顯著差異。(三)近期家庭功能八個向度與生活品質四個範疇皆達顯著相關，以逐步回歸分析探討酒精依賴患者近期家庭功能八個分向度對生活品質四個範疇的預測力發現對生理健康範疇而言，解釋變異量最大為衝突向度，其次為家庭責任向度；對心理範疇而言，解釋變異量最大為衝突向度，其次為問題解決、獨立性及溝通向度；對社會關係範疇而言，解釋變異量最大為凝聚力向度，其次為情感過度涉入向度；對環境範疇而言，解釋變異量最大為衝突，其次為獨立性向度。(四)採用階層回歸分析，探討兒童期家庭功能、近期家庭功能、飲酒行為改善程度對生活品質的解釋模式，結果發現近期凝聚力與近期情感表達向度影響飲酒行為改善程度，而飲酒行為改善程度為中介變項，影響生理健康範疇；而兒童期溝通與近期溝通向度直接影響心理範疇;兒童期情感過度涉入影響近期獨立性，再經由飲酒行為改善程度影響社會關係範疇；兒童期情感過度涉入影響飲酒行為改善程度，飲酒行為改善程度與兒童期情感表達再一起影響環境範疇。

結論：(1) 酒精依賴患者之生活品質與其飲酒行為密切相關；(2)兒童期的家庭衝突與酒精依賴有關；(3)兒童期家庭的衝突與情感過度涉入及近期家庭的情感過度涉入與酒精依賴患者接受戒癮治療後之預後不佳有關；(3)近期的家庭功能與酒精依賴患者之生活品質間有高相關；其中，家庭衝突高會影響生理健康、心理及環境範疇的生活品質；(4)酒精依賴患者的飲酒行為的改善程度將直接影響患者的生理健康、社會關係及環境範疇的生活品質。

摘要 …………………………………………………… 1

第一章 緒論…………………………………………………… 8
第一節 酒癮問題的嚴重性…………………………………… 8
壹 酒癮的定義…………………………………………… 8
貳 酒癮的盛行率與其影響……………………………… 9
参 酒癮的治療方法與療效指標………………………… 11
第二節 從家庭功能來探討酒癮患者之飲酒行為…………… 23
壹 從家庭功能探討飲酒行為之重要性………………… 23
貳 兒童期家庭功能與日後飲酒行為之關係…………… 25
參 飲酒行為與近期家庭功能之關係…………………… 27
第三節 家庭功能與生活品質之關係………………………… 28
第四節 研究目的……………………………………………… 42
壹 飲酒行為與生活品質之關係………………………… 42
貳 家庭功能與飲酒行為之關係………………………… 42
參 家庭功能與生活品質之關係………………………… 43

第二章 研究方法……………………………………………… 44
第一節 生活品質量表之修訂………………………………… 44
壹 生活品質的定義……………………………………… 44
貳 生活品質量表來源…………………………………… 44
參 生活品質量表修訂…………………………………… 49
第二節 正式研究方法………………………………………… 51
壹 研究樣本……………………………………………… 51
貳 研究工具……………………………………………… 52
參 研究流程……………………………………………… 56
肆 資料分析……………………………………………… 57
第三章 研究結果……………………………………………… 60
第一節 受試者的基本人口統計、臨床及家庭資料分析…… 60
第二節 飲酒行為變化與生活品質之關係…………………… 65
第三節 家庭功能與飲酒行為之關係………………………… 67
壹 兒童期家庭功能與酒精依賴之關係………………… 67
貳 近期家庭功能與飲酒行為變化之關係……………… 67
第四節 家庭功能與生活品質之相關分析…………………… 70

第四章 討論…………………………………………………… 80
第一節 本研究之主要發現與解釋…………………………… 80
壹 飲酒行為與生活品質之關係………………………… 80
貳 兒童期家庭功能與酒精依賴患者飲酒行為之關係… 82
參 非戒斷組兒童期與近期家庭功能之特性…………… 83
肆 近期家庭功能與飲酒行為變化之關係……………… 85
伍 家庭功能的整合與分類……………………………… 86
陸 家庭功能與生活品質之關係………………………… 88
柒 家庭功能、飲酒行為改善程度及生活品質之關係 88
第二節 本研究限制與未來研究方向………………………… 90
壹 樣本之限制…………………………………………… 90
貳 研究工具的限制……………………………………… 91
參 研究設計的限制……………………………………… 92
肆 其他的混淆變項……………………………………… 93
第三節 本研究之理論貢獻與應用價值……………………… 96

第五章 參考資料……………………………………………… 98
壹 中文部分……………………………………………… 98
貳 英文部分……………………………………………… 100

附錄 (1)生活品質量表 (2)兒童期家庭功能量表 (3)近期家庭功能量表

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