論文摘要
本研究的目的是包括瞭解憂鬱症病患社會支持、互惠性、衝突、負向社會互動的現況，及與憂鬱程度之相關性，並找出憂鬱程度之重要預測因子。本研究採立意取樣的方式在台北市某醫學中心與某精神專科醫院門診的病患，選取100位憂鬱症病患為研究對象，使用結構式問卷收集資料，問卷內容包括（一）基本資料（二）憂鬱程度量表（三）社會支持（四）互惠性（五）負向社會互動（六）衝突量表六部分。資料分析以SPSS 10.0套裝軟體，統計分析方法包括百分比、平均值、標準差、t檢定、單因子變異數分析、皮爾森基差相關分析、逐步複回歸分析。研究結果發現：
（1）研究對象多為女性、已婚、大專以上、家庭近
一年來，平均每月收入為三萬零一至七萬。
（2）憂鬱症病患的社會支持、互惠性、衝突、負向社
會互動主要來源為配偶。
（3）憂鬱症病患的年齡、憂鬱症發病年齡、社會支持、
互惠性與憂鬱程度成負相關，年齡越輕、憂鬱症發
病年齡越輕、主觀感受到的社會支持、互惠性越
少，憂鬱程度越高。
（4）憂鬱症病患的衝突、負向社會互動與憂鬱程度成正相關，接收到越多的衝突、負向社會互動，憂鬱程度越高。
（5）本研究中憂鬱症病患的婚姻、衝突、互惠性、負
向社會支持這四項為憂鬱程度預測因子，總解釋量
為52.3﹪。
由以上結果提出幾點照顧上的建議：（1）評估病患
社會關係上的衝突與負向社會互動，對病患的憂鬱程度是有幫助的。（2）在評估社會支持系統時，應同時包含負向的社會互動及衝突。（3）在評估病患的社會關係時，可以先從配偶開始作初步的了解。

Abstract
The purposes of this study were twofold. First, this study was to understand the relationships among social support, reciprocity, unsupportive social interaction, and conflict with the level of depression of patients with depression. Secondly, this study was to determine the extent to which social support, reciprocity, unsupportive social interaction, and conflict might influence patients’ level of depression. A purposive sample of 100 patients came from the psychiatric outpatient departments of a medical center and a psychiatric hospital in northern Taiwan. Data were collected by structured questionnaires including:
(1) personal demographic questionnaire, (2) Center for Epidemiological Studies-Depression (CES-D), (3) social support scale, (4) reciprocity scale, (5) unsupportive social interaction inventory, (6) and conflict scale. Data were analyzed by using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation, and stepwise multiple regression.
The results of this study were:
(1) The characteristics of patients were mostly female, married, with college degree, their monthly family income were thirty to seventy thousands in the past year.
(2) Patient’s spouses were the primary source of their social support, reciprocity, unsupportive social interaction and conflict.
(3) Age of the patients, the age of onset of their depression, social support, reciprocity and the level of depression were negatively correlated, that is, patients who were younger, perceived less social support, less reciprocity experience more severe of depression.
(4) The perceived conflict, unsupportive social interaction and the level of depression were positively correlated, that is, patients who perceived more conflict, more unsupportive social interaction experienced more severe of depression.
(5) Statistically significant correlates of more severe of depression included not married, perceived higher conflict, less reciprocity and higher unsupportive social interaction. The R2 for the regression equation was .523.
The implications of the study results for nursing practice included:
(1) It is crucial for nurses to assess the perceived conflict and unsupportive social interaction of patients of depression.
(2) The perceived unsupportive social interaction and conflict need to be incorporated in the assessment of patients’ social support systems.
(3) Patients’ spouses are critical members in assessing patients’ social relationships.

目 錄
頁數
論文摘要…………………………………………….. ……………. Ⅰ
英文摘要…………………………………………….. ……………. Ⅲ
目錄………………………………………………….. ……………. Ⅴ
圖表目錄…………………………………………….. …………… Ⅷ
第一章 緒論………………………………………… ……………. 1
第一節 研究動機與重要…………………………. ……………. 1
第二節 研究的…………………………………… ……………. 3
第二章 文獻證……………………………………… ……………. 4
憂鬱症的病因及診斷…………………………... ……………. 4
(一) 憂鬱症的因……………………………… ……………. 4
(二) 憂鬱症的症狀與斷……………………… ……………. 5
(三) 憂鬱程度的量…………………………… ……………. 6
第二節 社會交換理論的念……………………… ……………. 7
(一) 社會交換論……………………………… ……………. 7
(二) 社會支持、負向社會互動………………… ……………. 9
(三) 社會支持、負向社會互動的量…………. …………..... 11
(四) 社會支持、負向社會互動與憂鬱症的關係 ……………. 13
第三節 其他相關素……………………………… ……………. 14
第三章 研究假設、研究架構及名詞定義………… ……………. 19
第一節 研究假設………………………………… …………… 19
第二節 名詞解釋………………………………… ……………. 22
第四章 研究法……………………………………… ……………. 23
第一節研究對象…………………………………. …………… 23
第二節 研究工具………………………………… ……………. 24
第三節 資料收集過程…………………………… ……………. 27
第四節 研究工具之效度與信度檢定……………. ……………. 28
第五節 研究對象倫理考量……………………… ……………. 30
第六節 資料分析…………………………………. ……………. 30
第五章 研究結果…………………………………… ……………. 33
第一節 研究對象的基本資料分佈情形…………. ……………. 34
第二節 憂鬱症病患的健康狀況、疾病特質及憂 鬱程度情形 36
第三節 憂鬱症病患的社會支持、互惠性、負向社會互動、衝突情形……………………………………………………………..37
第四節 憂鬱症病患的基本屬性與憂鬱程度、社會支持、互惠性、負向社會互動的關係、衝突………………………………..47
第五節 憂鬱症病患的憂鬱程度與社會支持、互惠性、負向社會互動、衝突的關係…………………………………………..…55
第六節 憂鬱症病患憂鬱程度的預測因素…………………... ….. 57
第六章 討論……………………………………………………... ….. 61
第一節 憂鬱症病患基本屬性之分析………………………... ….. 61
第二節 憂鬱症病患基本屬性與憂鬱程度之探討…………... ….. 63
第三節 憂鬱症病患基本屬性與社會支持、互惠性之探討 ….. 65
第四節 憂鬱症病患基本屬性與負向社會互動、衝突之探討 ….. 68
第五節 憂鬱症病患的憂鬱程度與社會支持、互惠性、負向社會互動、衝突之探討………………………………………………69
第六節 憂鬱症病患憂鬱程度的預測因子…………………... ….. 69
第七章 結論與建議……………………………………………... ….. 71
第一節 結論…………………………………………………... ….. 71
第二節 研究的限制…………………………………………... ….. 73
第三節 建議…………………………………………………... ….. 75
參考資料…………………………………………………………. ….. 77
附錄一 研究問卷………………………………………………... ….. 86
附錄二 量表專家效度名單……………………………………... ….. 91
圖 表 目 錄
圖一 社會支持的測量…………………………………….…. …... 12
圖二 研究架構…………………………………………………. ….. 21
表1 社會支持、負向社會互動的相關性研究……………….. …... 16
表2 各量表的α值…………………………………………….. …... 30
表3 研究對象的基本資料…………………………………….. …... 35
表4 研究對象的健康情形、疾病特質及憂鬱程度情形…….. …... 41
表5 社會支持單題得分排列………………………………….. …... 42
表6 社會支持、互惠性、負向社會互動、衝突的來源…….. ….. 43
表7 互惠性單題得分排列…………………………………….. …... 44
表8 負向社會互動單題得分排列…………………………….. …... 45
表9 衝突單題得分排列……………………………………….. …... 46
表10 憂鬱症病患的基本屬性與憂鬱程度之差異性分析…… …... 49
表11 憂鬱症病患的基本屬性與社會支持之差異性分析….. … 50
表12 憂鬱症病患的基本屬性與互惠性之差異…………….. … 51
表13 憂鬱症病患的基本屬性與負向社會互動之差異性分析 … 52
表14 憂鬱症病患的基本屬性與衝突之差異性分析……….. … 53
表15 憂鬱症病患的基本屬性與憂鬱程度、社會支持、互惠性、負向社會互動、衝突之相關性………………………………………54
表16 憂鬱症病患的憂鬱程度與社會支持、互惠性、負向社會互動、衝突的相關分析…………………………………………………56
表17 納入複回歸個變項知皮爾森相關矩陣分析………….. … 59
表18 憂鬱程度之共線性診斷……………………………….. …. 59
表19 憂鬱程度之逐步複回歸分析結果（模式1）………… …. 59
表20 憂鬱程度之逐步複回歸分析結果（模式2）……….. … 60
表21 憂鬱程度之逐步複回歸分析結果（模式3）………… …. 60
表22 憂鬱程度之逐步複回歸分析結果（模式4）………… … 60

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