臺灣博碩士論文加值系統

本研究為縱貫性研究，主要研究目的有二：1.多重角色婦女的健康促進生活、社會支持、角色壓力、身心健康的變化；2.多重角色婦女健康促進生活、社會支持對其角色壓力與身心健康關係的影響機制。研究對象為95學年度護理、教育、社工、諮商與輔導所的碩、博士班新生，該女研究生需同時為職業婦女、研究生，且與先生同住。本研究有兩次資料收集時間點，第一次為入學的第1-2週，第二次為期中考期間1-2週，資料的收集是以問卷的方式進行，問卷包含基本資料、角色壓力、健康促進生活、社會支持、身心健康等五部分。
得到資料後，個人屬性主要以平均值、標準差、中位數、百分比等描述性統計分析資料，使用t-test比較流失/未流失在入學期間變項的平均值的差異情形；以t-test與皮爾森積差相關檢測雙變項間的關係；以paired t-test檢測入學期間與期中考期間變項平均值的比較；兩波資料的結果顯示：期中考期間的角色壓力高於入學期間的角色壓力，而入學與期中考期間的家庭支持沒有顯著變化，期中考期間的機構支持明顯下降，而期中考期間的學校支持則顯著增加；期中考期間的健康促進生活顯著變差；身心健康方面，憂鬱症狀與焦慮症狀則是於期中考期間顯著變差。最後以階層式複廻歸分析健康促進生活、社會支持於角色壓力對身心健康的影響機制，結果是：1.「健康促進生活」、「社會支持」具有直接效應：「健康促進生活」、「社會支持」、「角色壓力」都能直接影響「身心健康」；2.「健康促進生活」具有前導效應：(1)「健康促進生活」中的「自我實現」於入學期間能影響期中考期間「角色壓力」對「憂鬱症狀」的影響；(2)「健康促進生活」中的「壓力管理」於入學期間能影響期中考期間「角色壓力」對「身體化症狀」、「焦慮症狀」的影響；(3)「健康促進生活」中的「營養」於入學期間能影響期中考期間「角色壓力」對「焦慮症狀」的影響，但是入學時越注重營養，則期中考期間的焦慮症狀越多；3.「健康促進生活」具有中間效應：(1)期中考期間的「自我實現」能減弱開學期間「角色壓力」對期中考期間「憂鬱症狀」、「焦慮症狀」的影響；(2)期中考期間的「營養」會減弱開學期間「角色壓力」對期中考期間「身體化症狀」的影響；4.「健康促進生活」、「社會支持」均未具有調節效應。本研究可作為未來有關健康促進方案介入時間點以及方向的參考。

This research is a longitudinal study. The main research purpose is to discuss: 1. The change of multiple role women’s health promotion lifestyles, social support, role strain and mental health; 2. The influence mechanism of multiple role women’s health promotion lifestyles and social support on role strain and mental health.
The research subjects are the new master or PhD students of school year 2006 in nursing, education, social work, and counseling. Our female subjects must be working women and students at the same time who live with their husbands. There are two data collection time: one is the first and second week of the new semester. The other one is the first and second week of mid-term exam period. The method of data collection is survey, including five measurements, demographic data, role strain, health promotion lifestyles, social support and mental health.
After getting the data, t-test is used to compare mean difference between attrition and non-attrition subjects for demographic data and key variables in the beginning of the semester. For demographic data employed descriptive statistic data analysis, such as, mean, standard deviation, median, frequency and percentage. Using t-test and Pearson correlation to test the relations of two variables and using paired t-test to compare the means of variables between the beginning of the semester and mid-term exam, this two data shows: the role strain of mid-term exam is higher than the role strain in the beginning of the semester but there is no significant change in family support between the beginning of the semester and mid-term exam. Institution support decreases significantly during mid-term exam while school support increases significantly during mid-term exam. However, health promotion lifestyles during mid-term exam become worse. As for mental health, depressive and anxious symptoms become worse significantly during mid-term exam. Finally, hierarchical multiple regression was used to analyze the influence mechanism of health promotion life styles and social support on role strain and mental health. The results are: 1. Health promotion lifestyles and social support have direct effect: Health promotion life styles, and social support can directly affect mental health with role strain. 2. Health promotion lifestyles have antecedent effect. (1) The self-actualization in health promotion lifestyles can affect the influence of role strain on depressive symptoms during mid-term exam period in the semester. (2) The stress management in health promotion lifestyles can affect the influence of role strain on somatic symptoms and anxiety symptom during mid-term exam period in the semester. 3. Health promotion lifestyles have mediator effect. (1) Self-actualization during mid-term exam period can minimize the influence of role strain on depressive symptoms and anxiety symptom in the semester. (2) Nutrition in the semester can increase the influence of role strain during mid-term exam period on anxiety symptom. (3) Nutrition in mid-term exam period can minimize the influence of role strain in the semester on somatic symptoms during mid-term exam period. (4) Considering the six dimensions of health promotion life styles and the three sources of social support, school support in the semester can increase the influence of role strain on anxiety symptom during mid-term exam period. 4. Health promotion life styles and social support both do not have moderator effect. This research can be the reference for the intervention time in the future health promotion life styles projects.

口試委員會審定書………………………………………………….. I
誌謝………………………………………………………..………… II
中文摘要……………………………………………………..……… Ⅲ
英文摘要……………………………………………………..……… V
第一章 緒論………………………………………………….....…………….. 1
第一節 研究背景與研究目的……………….……………………………….. 1
第二章 文獻查證……………………………………………….…...………... 5
第一節 角色壓力…………………………………………………….……….. 5
一• 壓力理論………………………………………………….………….. 5
（一）壓力的概念…………………………….……….…………….. 5
（二）壓力的歷程……………………….…………………………… 6
二• 角色壓力………………………………………….………………….. 7
（一）角色壓力的概念…………………………………...…………. 7
（二）女性角色壓力的測量…………………………...........………. 9
第二節 身心健康………………………………………….…………….. 11
一• 身心健康的概念………………………………...........……….…….. 11
二• 女性身心健康……………………………………………….. 11
三• 身心健康的測量……………………………………………………... 11
第三節 角色壓力與身心健康………………………………...……………. 14
第四節 健康促進生活………………………………........….………….. 15
一• 健康促進生活的概念……………………….......…………….... 15
二• 健康促進生活的測量…..…………………......…...………….. 16
三• 健康促進生活在角色壓力與身心健康所扮演的角色……... 16
第五節 社會支持…………………........................................……………….. 18
一• 社會支持的概念....…………….…………………………………….. 18
二• 社會支持的測量………….................................…………….......... 18
三• 社會支持在角色壓力與身心健康所扮演的角色………………... 20
第六節 基本屬性與角色壓力、女性身心健康的關係……………………… 24
第七節 理論架構…………………...............………………………………… 26
第三章 研究方法………………............................………………............... 27
第一節 研究設計………………….........................................…………….. 27
第二節 研究架構………………….......................................………………… 27
第三節 研究假設………………….......................................………………… 30
第四節 研究對象……………………………………………………………... 31
第五節 研究工具……………………………………………………………... 31
第六節 資料收集過程與研究倫理……………………………………….…. 33
第七節 資料分析方法………………………………………………………... 34
第四章 結果………….....................................................……………………. 40
第一節 研究樣本……..........................................................………………… 40
一• 研究樣本回收情形……...........................................………………... 40
二• 有效樣本個人屬性描述............................................………..……... 40
第二節 多重角色婦女角色壓力、身心健康、健康促進生活與社會支持之變化…………………………………………………………………... 42
一• 研究變項的分佈情形與兩次資料的比較……………………….…. 42
（一）多重角色婦女的角色壓力......................…………………….. 42
（二）多重角色婦女的的身心健康......................…………….… 44
（三）多重角色婦女的的健康促進生活.................…….………. 45
（四）多重角色婦女的的社會支持........................……………... 46
二• 不同時期之多重角色婦女角色壓力、身心健康、健康促進生活、社會支持的關係..……………………………………………………. 48
第三節 個人屬性與健康促進生活、社會支持、角色壓力、身心健康的關係................................................…………………………………….. 50
一• 個人屬性對入學期間「角色壓力」、「健康促進生活」、「社會支持」、「身心健康」的影響……………………………………………. 50
二• 個人屬性對期中考期間「角色壓力」、「健康促進生活」、「社會支持」、「身心健康」的影響……………………………………………. 55
第四節 健康促進生活、社會支持、角色壓力相關性……………………… 60
一• 健康促進生活與角色壓力的相關性.................……..…………….. 60
二• 社會支持與角色壓力的相關性.......................…………………….. 60
三• 社會支持與健康促進生活的相關性…………………………... 61
第五節 健康促進生活、社會支持對角色壓力與身心健康關係的影響機制 63
一• 「健康促進生活」、「社會支持」與「角色壓力」影響三個「身心健康」症狀－「健康促進生活」、「社會支持」直接效應的檢驗 63
二• 期中考期間的「健康促進生活」、「社會支持」影響入學期間「角色壓力」對期中考期間「身心健康」症狀的影響－期中考期間「健康促進生活」、「社會支持」中間效應的檢驗……………………… 77
三• 入學期間「角色壓力」對期中考期間「身心健康」的影響，隨著「健康促進生活」、「社會支持」而改變－期中考期間「健康促進生活」、「社會支持」調節效應的檢測………………………………. 82
四• 入學期間的「健康促進生活」、「社會支持」影響期中考期間「角色壓力」對「身心健康」的影響－入學期間「健康促進生活」、「社會支持」前導效應的檢驗……………………………………. 86
第五章 討論………………………………………………………………….. 94
第一節 多重角色女研究生角色壓力、健康促進生活、社會支持、身心健康現況.......................…..............………………………………. 95
一• 多重角色女研究生角色壓力現況...........….............……………….. 95
二• 多重角色女研究生身心健康現況………………………………... 95
三• 多重角色女研究生健康促進生活……………………………... 96
四• 多重角色女研究生社會支持現況………………………………... 97
五• 不同時期之多重角色婦女角色壓力、身心健康、健康促進生活與社會支持的關係……………………………………………………... 98
第二節 個人屬性與「角色壓力」、「健康促進生活現況」、「社會支持」、「身心健康」的關係……………………………………………………… 99
第三節 角色壓力、健康促進生活現況、社會支持的相關性……………… 102
第四節 健康促進生活、社會支持對角色壓力與身心健康關係的影響型態 103
一• 健康促進生活對角色壓力與身心健康關係的影響機制…………... 104
二• 社會支持對角色壓力與身心健康關係的影響機制………….……. 108
第六章 結論與建議…………………………………………….…………….. 112
第一節 結論…………………………………………………………………... 112
第二節 護理應用……………………………………………………………... 114
第三節 限制與建議…………………………………………….…………….. 115
參考文獻……………………………………………………………………...……. 117


圖表目錄
表2-1
Lengacher女性角色壓力量表引用概況………..………………….….. 10
表2-2 社會支持與其他因素在多重角色女性角色壓力與身心健康所扮演的角色……………….…………………………………………………….. 23
圖2-1 理論架構圖.…………….………………………………………………. 26
圖3-1 研究架構圖.……………….……………………………………………. 28
圖3-2 研究架構之四大影響機制…..…………….…………………………... 29
表4-1 多重角色女研究生的個人屬性……………….……………………….. 41
表4-2-1 多重角色婦女研究變項之描述性資料與兩個時期資料比較..……… 43
表4-2-2 入學期間與期中考期間相同變項的關係..…………………………… 49
表4-3-1-1 個人屬性對入學期間角色壓力的影響……………………………….. 50
表4-3-1-2 個人屬性對入學期間健康促進生活的影響………..………………… 52
表4-3-1-3 個人屬性對入學期間社會支持的影響……..………………………… 53
表4-3-1-4 個人屬性對入學期間身心健康的影響……………………...………… 54
表4-3-2-1 個人屬性對期中考期間角色壓力的影響……………..……………… 55
表4-3-2-2 個人屬性對期中考期間健康促進生活的影響……………..………… 57
表4-3-2-3 個人屬性對期中考期間社會支持的影響……..……………………… 58
表4-3-2-4 個人屬性對期中考期間健康促進生活的影響…..…………………… 59
表4-3-3 角色壓力、健康促進生活、社會支持相關性………………………… 62
表4-4-1 健康促進生活（t1）、社會支持（t1）與角色壓力（t1）對身心健康（t1）的直接效應………………………………………………………. 66
表4-4-2 健康促進生活（t2）、社會支持（t2）與角色壓力（t2）對身心健康（t2）的直接效應……………………………………………………………… 70
表4-4-3-1 健康促進生活（t1）、社會支持（t1）與角色壓力（t1）對身心健康－憂鬱症狀（t2）的直接效應…………………………………………………. 72
表4-4-3-2 健康促進生活（t1）、社會支持（t1）與角色壓力（t1）對身心健康－身體化症狀（t2）的直接效應………………………………………………. 74
表4-4-3-3 健康促進生活（t1）、社會支持（t1）與角色壓力（t1）對身心健康－焦慮症狀（t2）的直接效應………………………………………………….. 76
表4-5-1 表4-5-3健康促進生活(t2)、社會支持(t2)於角色壓力(t1)對身心健康－憂鬱症狀(t2)之中間與調節效應………………………………………………..
79
表4-5-2 表4-5-2健康促進生活(t2)、社會支持(t2)於角色壓力(t1)與身心健康－身體化症狀(t2)之中間與調節效應……………………………………………..
81
表4-5-3 表4-5-3健康促進生活(t2)、社會支持(t2)於角色壓力(t1)對身心健康－焦慮症狀(t2)之中間與調節效應………………………………………………..
84
表4-6-1 健康促進生活(t1)、社會支持(t1)對角色壓力(t2)與身心健康－憂鬱症狀(t2)的前導效應…………………………..…………………………… 88
表4-6-2 健康促進生活(t1)、社會支持(t1)對角色壓力(t2)與身心健康－身體化症狀(t2)的前導效應..…………………………………………………… 90
表4-6-3 健康促進生活(t1)、社會支持(t1)對角色壓力(t2)與身心健康－焦慮症狀(t2)的前導效應……………..………………………………………… 93
附錄表1 流失/未留失 開學期間變項平均值之比較…………………...…….. 132
附錄表2 樣本流失的風險因子………………………..……………….….…… 133
附錄表3 角色壓力各題項的平均值與標準差………………………………… 134
附錄表4 社會支持各題項的平均值與標準差…………………………..…….. 135
附錄表5 健康促進生活各題項的平均值與標準差…………………….……... 136
附錄表6 身心健康各題項的平均值與標準差…………………………..……. 138
附錄表7 開學期間與期中考期間變項的關係…………………………..…….. 139
附錄表8 多重角色女研究生個人屬性與身心健康的關係………..…….……. 140
附錄表9-1 健康促進生活(t1)與角色壓力(t1)對身心健康(t1)之影響…....…….. 141
附錄表9-2 健康促進生活(t2)與角色壓力(t2)對身心健康（t2）之影響………. 142
附錄表10 健康促進生活(t1)對角色壓力(t2)與身心健康(t2)之影響…………... 143
附錄表11-1 健康促進生活(t2)於角色壓力(t1)與身心健康(t2)－憂鬱症狀之影響型態…………………………………..……………………………. 144
附錄表11-2 健康促進生活(t2)於角色壓力(t1)與身心健康(t2)－身體化症狀之影響型態……………………………….………….…………………. 145
附錄表11-3 健康促進生活(t2)於角色壓力(t1)與身心健康(t2)－焦慮症狀之影響型態……………………………..…………………………………. 146
附錄表12-1 社會支持(t1)與角色壓力(t1)對身心健康(t1)之影響…………..…… 147
附錄表12-2 社會支持(t2與角色壓力(t2對身心健康(t2之影響………………… 148
附錄表13 社會支持(t1)與角色壓力(t2)對身心健康(t2)之影響……...………… 149
附錄表14 社會支持(t2)對角色壓力(t1)與身心健康(t2)之影響……..…………. 150

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