研究背景與目的：疲勞為現代社會常見的一種生理抱怨，影響個體工作效能與生活品質。目前對於造成持續性疲勞之原因尚未有所定論，所謂「壓力相關疲勞」一詞即強調壓力為引發個體疲勞之重要因素之一。然而，個體面對相同的壓力經驗所引發之壓力反應不盡相同，自我效能於其中扮演壓力評估與減緩壓力衝擊的重要角色。因此，本研究主要目的在於探討自我效能如何影響個體疲勞知覺，分為兩條路徑進行：由心理生理反應影響的直接途徑與因應行為所中介影響之間接途徑。

研究方法：於研究一之心理生理反應直接途徑，研究採用22的實驗設計（疲勞自我效能），受試者共64位女性護理人員，依其個人體力檢核表分數分為疲勞組與健康組，兩組受試者各自以隨機分派至高因應自我效能或低因應自我效能之實驗操弄。以生理回饋儀紀錄受試者之心率變異、指溫、皮膚電位反應以及末梢血流之心理生理指標，並比較不同組其各項指標於壓力反應率與恢復率之表現。研究二為間接途徑之研究，共計212位研究生，測量之量表包含個人體力檢核表、貝克憂鬱量表第二版、自我效能量表以及簡明因應量表。以多元迴歸分析因應策略於自我效能與疲勞知覺間的中介效果。

研究結果：研究一假設疲勞、自我效能對於個體壓力心理生理反應具有顯著關聯，且兩者間應具有顯著交互作用存在。結果顯示健康組受試者末梢血流恢復率顯著優於疲勞組，且本研究中發現疲勞與自我效能間具有交互作用：疲勞受試者於知覺自我效能提升時，皮膚電位反應恢復率較健康組受試者緩慢，亦慢於知覺效能維持或降低之疲勞組受試者，此部分與研究假設自我效能提升應能有效緩解個體壓力心理生理反應之假設不符，推測可能與壓力相關疲勞者其因應行為與資源投入程度具有關聯。研究二間接途徑之研究結果與假設一致：正向與負向自我效能皆能顯著影響個體疲勞程度，當研究生有較高負向自我效能時，疲勞程度相對增加；反之，當其具有較高的正向自我效能時，其所知覺的疲勞嚴重度越低。因應策略於自我效能與疲勞的中介效果則僅在逃離因應策略顯現，當個體抱持負向自我效能時，逃離因應策略的使用將會增加其疲勞嚴重度，亦降低個體的心理健康適應品質。

討論：研究支持自我效能於壓力相關疲勞扮演重要角色，且自我效能影響疲勞嚴重度之直接途徑與間接途徑均得到進一步支持；研究結果顯示自我效能對於個體疲勞間之關聯，可能與其因應資源具有顯著關聯。協助個體改善自我效能信念、評估其資源與因應策略間之平衡，將可作為介入與未來研究之建議。

Background: Fatigue is a common physical complaint in the modern world, and it affects the effectiveness of individuals’ work and their quality of life. The exact reason for sustained fatigue has not yet been determined. The term “stress-related fatigue” indicates that stress is one of the main causes of fatigue. However, different individuals have different stress responses to the same stressful experience. Self-efficacy plays a vital role in identifying stressors and reducing the impact of stress. Therefore, the present study was designed to explore how self-efficacy influences perceived fatigue. Two fundamental pathways of influence were determined: the direct psychophysiological reaction and the indirect coping behaviors.

Method: The first study on the psychophysiological reaction pathway was a 2  2 experimental design (fatigueself-efficacy), in which 64 female nurses were categorized into either a fatigue or health group on the basis of their total score on the Checklist Individual Strength Questionnaire. Thereafter, a random procedure was used to manipulate self-efficacy to influence their coping self-efficacy and identify a high and low self-efficacy group. Heart rate variability, skin temperature, skin conductance level, and blood volume pulse were recorded using biofeedback (ProComp Infiniti™). The psychophysiological reactivity and recovery of each psychophysiological index are compared. A secondary study on the indirect coping behaviors pathway examined 212 university graduate students, who completed a set of questionnaires, which included the Checklist Individual Strength Questionnaire, Beck Depression Inventory-Second Edition, Self-Efficacy Inventory, and Brief COPE. Multiple regression analysis was used to determine the mediation effect of coping strategies between self-efficacy and fatigue.

Result: In accordance with the hypothesis of the first study, the level of perceived fatigue and self-efficacy has a significant correlation with the level of psychophysiological reaction, and there exists an interactive relationship between fatigue and self-efficacy. The results demonstrated that the health group recovered their blood volume pulse more efficiently than the fatigue group, and the two factors fatigue and self-efficacy were found to interact. When the fatigued participants’ perceived self-efficacy was raised, their recovery of skin conductance level was not as efficient as that of health participants or as that of those in the fatigue group who perceived their self-efficacy to be the same or lower. This was incompatible with the hypothesis that high self-efficacy reduces psychophysiological stress responses, that is, stress response or recovery may be influenced by coping behaviors and resource efforts. However, the consequence of the indirect pathway determined by the secondary study was in agreement with the following hypothesis: both positive and negative self-efficacy affected fatigue levels. When graduate students had higher negative self-efficacy, their fatigue level increased relatively and vice versa: with their positive self-efficacy elevation, their fatigue level decreased relatively. The mediation effect was found only when avoidance coping was the mediator of the relationship between negative self-efficacy and fatigue. Individuals with negative self-efficacy and high avoidance coping had higher levels of fatigue as well as poor mental health and poor quality of life.

Discussion: The research result demonstrates that self-efficacy is a key factor with regard to fatigue. Increased support in terms of both the direct psychophysiological reaction pathway and the indirect coping behaviors pathway influence the level of fatigue; the results indicate that the relation between self-efficacy and perceived fatigue may be influenced by the level of coping resources. This may prove to be a useful suggestion for future research and interventions.

摘要…………………………………………………………………………………………………Ⅰ
Abstract………………………………………………………………………………………………Ⅲ
致謝…………………………………………………………………………………………………Ⅴ
目錄…………………………………………………………………………………………………Ⅶ
表目錄………………………………………………………………………………………………Ⅹ
圖目錄………………………………………………………………………………………………XII
第一章緒論……………………………………………………………………………………………1
第二章文獻探討………………………………………………………………………………………5
第一節疲勞概述………………………………………………………………………………………5
一、疲勞定義…………………………………………………………………………………………5
二、疲勞概念的測量…………………………………………………………………………………9
第二節 自我效能與健康………………………………………………………………………………12
一、自我效能概念概述………………………………………………………………………………12
二、自我效能、壓力與健康適應……………………………………………………………………14
三、自我效能的實驗操弄與量表測量………………………………………………………………16
第三節 自我效能影響疲勞途徑………………………………………………………………………21
一、自我效能對於疲勞之直接途徑：壓力心理生理反應…………………………………………21
二、自我效能對於疲勞之間接途徑：因應策略於壓力與健康之中介角色………………………23
第三章研究方法………………………………………………………………………………………30
第一節研究一：自我效能與壓力心理生理反應……………………………………………………30
一、研究設計與假設…………………………………………………………………………………30
二、研究對象…………………………………………………………………………………………32
三、研究工具與材料…………………………………………………………………………………36
四、研究流程…………………………………………………………………………………………44
五、資料分析…………………………………………………………………………………………46
第二節 研究二：自我效能、因應策略與疲勞………………………………………………………47
一、研究架構與假設…………………………………………………………………………………47
二、研究對象…………………………………………………………………………………………48
三、研究工具…………………………………………………………………………………………50
四、資料分析…………………………………………………………………………………………52
第四章研究結果………………………………………………………………………………………54
第一節 研究一：自我效能與疲勞之直接途徑結果分析……………………………………………54
一、受試者特性與疲勞………………………………………………………………………………54
二、壓力期與因應自我效能操弄效果檢驗…………………………………………………………56
三、不同壓力情境之壓力心理生理反應分析………………………………………………………59
四、疲勞、因應自我效能以及壓力心理生理反應…………………………………………………60
五、疲勞、知覺自我效能以及壓力心理生理反應…………………………………………………65
第二節 研究二：因應策略於自我效能與疲勞中介角色之結果分析………………………………72
一、人口學變項與疲勞程度…………………………………………………………………………72
二、日常生活自我效能與疲勞………………………………………………………………………74
三、因應策略於日常生活自我效能與疲勞間之中介角色…………………………………………75
四、日常生活自我效能、因應策略與身心健康適應………………………………………………76
五、疲勞與身心健康狀況關聯………………………………………………………………………79
第五章討論與建議……………………………………………………………………………………81
第一節 疲勞、自我效能對壓力心理生理反應影響之直接途徑……………………………………81
一、人口學變項與日常生活自我效能以及疲勞之關聯……………………………………………81
二、壓力情境對於壓力心理生理反應之影響………………………………………………………82
三、疲勞、自我效能對壓力心理生理反應影響之探討……………………………………………83
四、自我效能與壓力心理生理反應之綜合討論……………………………………………………86
五、小結………………………………………………………………………………………………89
第二節 因應策略於自我效能與疲勞嚴重度之間接途徑……………………………………………90
一、人口學變項、日常生活自我效能與疲勞………………………………………………………90
二、因應策略於日常生活自我效能與疲勞之中介效果……………………………………………90
三、日常生活自我效能、因應策略與健康品質……………………………………………………91
四、小結………………………………………………………………………………………………94
第三節 自我效能與壓力相關疲勞之綜合討論………………………………………………………95
一、因應策略於直接途徑所扮演角色………………………………………………………………95
二、壓力心理生理反應於間接途徑所扮演角色……………………………………………………95
三、由資源觀點思考疲勞者之資源投入與整體適應………………………………………………96
四、小節………………………………………………………………………………………………97
第四節 研究貢獻、研究限制與未來研究方向………………………………………………………98
一、研究貢獻…………………………………………………………………………………………98
二、研究限制…………………………………………………………………………………………99
三、未來研究方向……………………………………………………………………………………100
參考文獻………………………………………………………………………………………………102
附錄一研究參與同意書………………………………………………………………………………118
附錄二基本資料問卷（研究一）……………………………………………………………………119
附錄三基本資料問卷（研究二）……………………………………………………………………120
附錄四個人體力檢核表(ChecklistIndividualStrength)…………………………………………………121
附錄五自我效能量表…………………………………………………………………………………122
附錄六簡明因應量表…………………………………………………………………………………123
附錄七台灣版簡短健康量表-36授權同意書……………………………………………………… 125
附錄八疲勞組別、因應自我效能組別、壓力情境與各壓力心理生理指標分析結果……………126
附錄九疲勞組別、因應自我效能組別對各壓力心理生理反應率與恢復率分析結果……………129
附錄十疲勞組別、知覺效能、壓力情境與各壓力心理生理指標分析結果………………………131
附錄十一疲勞組別、知覺效能對各壓力心理生理反應率與恢復率分析結果……………………133

表目錄
表2-1-1 慢性疲勞症候群定義…………………………………………………………………8
表2-1-2 疲勞相關量表彙整……………………………………………………………………11
表2-2-1 偽造回饋相關研究整理………………………………………………………………18
表2-2-2 自我效能評估量表彙整………………………………………………………………20
表2-3-1 趨近與逃離因應分類與定義…………………………………………………………29
表3-1-1 研究一各實驗分組人數統計…………………………………………………………33
表3-1-2 研究一之人口學變項統計結果………………………………………………………35
表3-1-3 個人體力檢核表計分方式……………………………………………………………37
表3-1-4 時域分析指標…………………………………………………………………………41
表3-1-5 頻域分析指標…………………………………………………………………………41
表3-1-6　 研究一實驗流程……………………………………………………………………44
表3-2-1 研究二之人口學變項統計結果………………………………………………………49
表4-1-1 研究一之日常生活自我效能與個體疲勞嚴重度知覺………………………………55
表4-1-2 疲勞組別、因應自我效能組別對特定作業自我效能之變異數分析摘要表………56
表4-1-3 特定作業自我效能於因應自我效能操弄前後效果比較……………………………57
表4-1-4 各項生理指標於基準期與壓力期Ⅰ之平均數（標準差）…………………………58
表4-1-5 不同壓力情境之各項壓力心理生理指標平均數（標準差）………………………59
表4-1-6 疲勞組別、因應自我效能、壓力情境對皮膚電位反應之變異數分析摘要表……61
表4-1-7 疲勞組別、因應自我效能組別對末梢血流恢復率之變異數分析摘要表…………63
表4-1-8 特定作業自我效能於因應自我效能操弄後分組改變情形統計……………………64
表4-1-9 本研究所界定之自我效能名稱與定義………………………………………………64
表4-1-10疲勞/知覺自我效能分組人數統計………………………………………………… 65
表4-1-11 疲勞組別、知覺效能、壓力情境對皮膚電位反應之變異數分析摘要表……… 66
表4-1-12 壓力情境對皮膚電位反應之單純主要效果分析整理…………………………… 67
表4-1-13 疲勞組別、知覺效能組別、壓力情境對LF/HF之變異數分析摘要表…………68
表4-1-14 疲勞組別、知覺效能別對皮膚電位反應率Ⅱ之變異數分析摘要表…………… 70
表4-1-15 疲勞組別、知覺效能別對皮膚電位恢復率之變異數分析摘要表……………… 70
表4-2-1 各人口學變項之疲勞程度統計分析…………………………………………………73
表4-2-2 日常生活自我效能對疲勞嚴重度之迴歸分析………………………………………74
表4-2-3 因應策略於日常生活自我效能與疲勞之中介效果檢驗……………………………75
表4-2-4 正向自我效能對SF-36身心健康品質之迴歸分析結果摘要表……………………76
表4-2-5 負向自我效能對SF-36身心健康品質之迴歸分析結果摘要表……………………77
表4-2-6 因應策略於日常生活自我效能與身心健康之中介效果檢驗………………………78
表4-2-7 疲勞程度與身心健康適應之相關分析………………………………………………79
附表1-1 疲勞組別、因應自我效能組別、壓力情境對指溫之變異數分析摘要表…………126
附表1-2 疲勞組別、因應自我效能組別、壓力情境對末梢血流之變異數分析摘要表…… 126
附表1-3 疲勞組別、因應自我效能組別、壓力情境對LF之變異數分析摘要表……………127
附表1-4 疲勞組別、因應自我效能組別、壓力情境對HF之變異數分析摘要表……………127
附表1-5 疲勞組別、因應自我效能組別、壓力情境對LF/HF之變異數分析摘要表……… 128
附表2-1 疲勞組別、因應自我效能組別對皮膚電位反應率Ⅰ之變異數分析摘要表………129
附表2-2 疲勞組別、因應自我效能組別對皮膚電位反應率Ⅱ之變異數分析摘要表………129
附表2-3 疲勞組別、因應自我效能組別對皮膚電位恢復率之變異數分析摘要表…………129
附表2-4 疲勞組別、因應自我效能組別對指溫反應率Ⅰ之變異數分析摘要表……………129
附表2-5 疲勞組別、因應自我效能組別對指溫反應率Ⅱ之變異數分析摘要表……………130
附表2-6 疲勞組別、因應自我效能組別對指溫恢復率之變異數分析摘要表 ………………130
附表2-7 疲勞組別、因應自我效能組別對末梢血流反應率Ⅰ之變異數分析摘要表………130
附表2-8 疲勞組別、因應自我效能組別對末梢血流反應率Ⅱ之變異數分析摘要表………130
附表3-1 疲勞組別、知覺效能、壓力情境對指溫之變異數分析……………………………131
附表3-2 疲勞組別、知覺效能、壓力情境對末梢血流之變異數分析摘要表………………131
附表3-3 疲勞組別、知覺效能、壓力情境對LF之變異數分析摘要表………………………132
附表3-4 疲勞組別、知覺效能、壓力情境對HF之變異數分析摘要表………………………132
附表4-1 疲勞組別、知覺效能對皮膚電位反應率Ⅰ之變異數分析摘要表…………………133
附表4-2 疲勞組別、知覺效能對指溫反應率Ⅰ之變異數分析摘要表………………………133
附表4-3 疲勞組別、知覺效能對指溫反應率Ⅱ之變異數分析摘要表………………………133
附表4-4 疲勞組別、知覺效能對指溫恢復率之變異數分析摘要表…………………………133
附表4-5 疲勞組別、知覺效能對末梢血流反應率Ⅰ之變異數分析摘要表…………………134
附表4-6 疲勞組別、知覺效能對末梢血流反應率Ⅱ之變異數分析摘要表…………………134
附表4-7 疲勞組別、知覺效能對末梢血流恢復率之變異數分析摘要表……………………134

圖目錄
圖3-1 研究架構圖……………………………………………………………… 30
圖3-2-1 研究二研究架構圖…………………………………………………… 47
圖3-2-2 簡明因應量表驗證性因素分析結果………………………………… 51
圖4-1-1 皮膚電位反應之壓力情境變項主要效果變化……………………… 62
圖4-1-2 疲勞組別與知覺效能於皮膚電位反應之交互作用………………… 68
圖4-1-3 健康組於知覺效能與壓力情境之心率變異交互作用……………… 69
圖4-1-4 疲勞組別與知覺效能於皮膚電位恢復率之交互作用……………… 71
圖4-2-1 因應策略於日常生活自我效能與疲勞之顯著中介效果…………… 76
圖5-1-1 實驗操弄因應自我效能組別於知覺效能維持組心率變異之作用… 85

參考文獻
中文部分
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