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研究生:周幸玲
研究生(外文):Hsing-Ling Chou
論文名稱:重鬱症個案自殺企圖與生活型態防衛機轉相關性之探討
論文名稱(外文):A Study of the Relationship Between Suicide Attempt and Lifestyle Defense Mechanisms in Patients With Major Depressive Disorder
指導教授:蕭妃秀蕭妃秀引用關係
指導教授(外文):Fei - Hsiu Hsiao
學位類別:碩士
校院名稱:臺北醫學大學
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:2008
畢業學年度:96
語文別:中文
論文頁數:71
中文關鍵詞:重鬰生活型態防衛機轉憂鬱狀態
外文關鍵詞:Major depressive disorderLifestyle Defense Mechanisms(LDM)
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論文摘要
論文名稱:重鬱症個案自殺企圖與生活型態防衛機轉相關性之探討
研究所名稱:台北醫學大學護理學研究所
研究生姓名:周幸玲
畢業時間:九十六學年度 第二學期
指導教授:蕭妃秀 台北醫學大學護理學院 副教授
  研究背景:重鬱症病人的壓力因應與自殺企圖發生有關,國內研究著重在找出自殺高危險群重鬱症個案,尚缺乏對於重鬱症個案面對生活情境壓力所使用的防衛機轉進行探討。
研究目的:(1)重鬰症有無自殺企圖於生活型態防衛機轉使用之差異。(2)了解重鬰症有無自殺企圖者於憂鬱嚴重程度之差異。(3)了解重鬰症個案憂鬱嚴重程度與生活型態防衛機轉之相關。
研究方法:本研究設計為描述性、相關性研究,以北區某專科教學醫院及某醫學綜合醫院精神科的門診、急診及急性病房為收案場所,經專科醫師診斷為重鬱症的個案為研究對象。樣本數共145人,依過去兩週是否出現自殺企圖分為:重鬰症自殺企圖組42人,重鬰症無自殺企圖組103人。問卷包含個人資料、生活型態防衛機轉量表和貝克憂鬱量表。
研究結果:(1)在理性情緒的防衛(Rationality/ Emotional Defensiveness; R/ED)、理性的防衛(R/ED - rationality defensiveness ; R/ED-r)、情緒的防衛(R/ED- emotional defensiveness; R/ED-e)分數中,重鬱症有自殺企圖組平均值高於重鬱症無自殺企圖組。在理性的防衛(R/ED-rationality defensiveness ; R/ED-r)分數上達邊緣性統計差異(p=0.05)。結果指出重鬱症無自殺企圖組傾向使用較多的理性防衛機制。(2)在貝克憂鬱量表(The Beck Depression Inventory; BDI)分數方面,結果顯示重鬱症自殺企圖組平均分數為重度憂鬱等級,而重鬱症無自殺企圖組為中度憂鬱等級。此結果達顯著的差異(p<0.001)。結果說明重鬱症個案的自殺企圖與貝克憂鬱量表分數達到重度憂鬱等級有關。(3)貝克憂鬱量表(The Beck Depression Inventory; BDI)與理性的防衛(R/ED -rationality defensiveness ; R/ED-r )、情緒的防衛(R/ED- emotional defensiveness; R/ED-e)、自我犧牲(NH-self sacrifice; NH-ss)呈現正相關。結果說明重鬱症症狀嚴重度與面對生活情境壓力使用過多以上的防衛機制有關。
結論:憂鬱症狀嚴重度達重度為自殺企圖行為產生之主要因素。重鬱症的自殺企圖可能是由於在壓力因應上理性防衛的減弱,而因此增加了自殺衝動性。
關鍵字:重鬰症、生活型態防衛機轉、憂鬱狀態。
Abstract
Title of Thesis: A study of the relationship between suicide attempt and lifestyle defense mechanisms in patients with major depressive disorder.
Institution: Graduate Institute of Nursing, Taipei Medical University
Author: Hsing – Ling Chou
Thesis directed by: Fei - Hsiu Hsiao, RN, PhD, Associate Professor,
College of Nursing, Taipei Medical University
Background: Major depressive disorder patients stress coping skill is association with suicide attempt.
The Purposes of the study: (1)To understand the differences in uses of lifestyle defense mechanisms in major depressive disorder patients with or without suicide attempt (2)To understand the differences in depression scale level in major depressive disorder patients with or without suicide attempt
(3) To understand the relationship between major depressive disorder patient’s depression scale level and lifestyle defense mechanisms.
Method: This study adopts describing association design.The patients was from emergency, outpatient department and acute ward in two teaching hospital in Taipei. Total sample size 145, according to with or without suicide attempt during past two weeks; 42 sample in major depressive disorder patients with suicide attempt ; 103 sample in major depressive disorder patients without suicide attempt. Questionnaire include personal data, Lifestyle Defense Mechanisms Inventory and The Beck Depression Inventory.
Results: (1) In Rationality/ Emotional Defensiveness; R/ED, R/ED - rationality defensiveness ; R/ED-r, R/ED- emotional defensiveness; R/ED-e of mean scores , major depressive disorder patients with suicide attempt mean score is higher than major depressive disorder patients without suicide attempt.(2) In major depressive disorder patients with suicide attempt of The Beck Depression Inventory mean score is severe level, and major depressive disorder patients without suicide attempt is mild level.(3) The Beck Depression Inventory , R/ED-rationality defensiveness ; R/ED-r , R/ED- emotional defensiveness; R/ED-e and NH-self sacrifice; NH-ss are positive association.
Conclusion: Depression symptom in severe level is a major factors for suicide attempte. major depressive disorder patients with suicide attempt may due to rationality defensiveness reduce , and increase suicide impulsivity.
Key words: Major depressive disorder, Lifestyle Defense Mechanisms(LDM),The Beck Depression Inventory(BDI).
目 錄
頁數
致 謝 ………………………………………………………..
中文摘要 ……………………………………………………….. I
英文摘要 ……………………………………………………….. III
目 錄 ……………………………………………………….. V
圖表目次 ……………………………………………………….. VIII

第一章 緒論 1
第一節 研究動機及重要性...………………………………
第二節 研究目的…………………………..……..………… 3
第三節 名詞解釋…………………………………………… 4
第二章 文獻查證 5
第一節 自殺的定義及分類.……….....……….….…………
第二節 憂鬱症與自殺企圖…..……..……………………… 8
第三節 重鬱症自殺企圖者防衛機轉的研究............……… 13
第四節 研究架構…………………………………………… 20
第三章 研究方法
第一節 研究設計…………………………..……..………… 22
第二節 研究對象…………………………..……..………… 23
第三節 研究架設…………………………..……..………… 24
第四節 研究工具…………………………………………… 25
第五節 資料收集流程............………...…………................. 27
第六節 資料分析…………………………………………… 29
第七節 倫理考量…………………………………………… 31
第四章 分析與結果 32
第一節 人口學特性分析……………………………………
第二節 重鬱症有無自殺意念於生活型態防衛機制量表之
結果………………………………………………… 34
第三節 重鬱症有無自殺意念於貝克憂鬱量表之結果……. 37
第四節 重鬱症有無自殺企圖於生活型態防衛機制量表之
結果………………………………………………… 39
第五節 重鬱症有無自殺企圖於貝克憂鬱量表之結果…… 41
第六節 重鬱症有無自殺意念於生活型態防衛機制量表
與貝克憂鬱量表之相關結果……………………… 43
第七節 重鬱症有無自殺企圖於生活型態防衛機制量表與
貝克憂鬱量表之相關結果………………………… 45
第五章 討論 47
第六章 結論建議與限制
第一節 結論………………………………………………… 50
第二節 建議………………………………………………… 51
第三節 限制………………………………………………… 52
參考資料
中文部分 ............………………………………..……..………... 53
英文部分 ............………………………………..……..………... 54
附錄
附錄一 邀請函……..…………………………………………. 59
附錄二 參與同意書………..………………………………….. 60
附錄三 正式研究問卷……...….........………………………… 63
















圖表目次
頁 數
圖一 研究架構 ...................................................................................... 21
圖二 收案流程圖 ................................................................................ 28
表一 重鬱症個案防衛機轉之文獻整理 ................................................19
表二 推論統計方法 ............................................................................ 30
表三 人口學資料 ................................................................................ 33
表四 重鬱症有無自殺企圖於貝克憂鬱量表的結果............................ 36
表五 重鬱症有無自殺企圖於生活型態防衛機制量表.......................
之比較............................................................................................... 38
表六 重鬱症有無自殺意念於生活型態防衛機制量表..........................
之比較............................................................................................... 40
表七 重鬱症有無自殺意念於貝克憂鬱量表的結果................................42
表八 重鬱症有無自殺意念於貝克憂鬱量表的結果................................44
表九 重鬱症有無自殺意念於貝克憂鬱量表的結果................................46
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