臺灣博碩士論文加值系統

極低出生體重早產兒的出院轉銜讓父母感到壓力，降低父母的生活品質，尤其罹患肺支氣管發育不全之極低出生體重早產兒在照顧上更為一大挑戰。而復原力可視為壓力因應的能力，故本研究欲探討極低出生體重早產兒轉出新生兒加護病房前及出院一個月時，父母壓力、復原力及生活品質的變化，同時探討有無罹患肺支氣管發育不全之極低出生體重早產兒，其父母壓力、復原力以及生活品質的差異，並分析復原力是否在父母壓力及生活品質間具有中介的效果。
本研究於北部某醫學中心採方便取樣，72名極低出生體重早產兒的父母於極低出生體重早產兒轉出加護病房前及出院一個月時，填寫壓力感受量表、生活品質量表台灣簡明版以及復原力量表。結果顯示相較於極低出生體重早產兒轉出加護病房前，僅有父親的壓力在極低出生體重早產兒出院一個月時顯著下降；而轉出加護病房前父母壓力無差異，但出院一個月時，母親壓力則顯著大於父親。父母在復原力方面則無顯著變化；相較於轉出加護病房前，出院一個月時父母的生活品質皆顯著下降。父母復原力越高，壓力對生活品質的影響降低。當極低出生體重早產兒轉出加護病房及出院一個月時，父母壓力與生活品質間，復原力中介影響力分別為47%、45.7%及48.9%、41%。而極低出生體重早產兒是否罹患肺支氣管發育不全對於父母壓力、復原力及生活品質皆無顯著影響；早產兒性別為影響父親復原力的因素；出生體重及家庭月收入則為母親復原力以及生活品質的影響因素。
本研究結果可知，無論極低出生體重早產兒是否罹患肺支氣管發育不全，都必須重視父母復原力提升的重要性，建議可及早從新生兒加護病房內開始，以家庭為中心進行提升父母復原力的介入計畫。

The very-low-birth-weight (VLBW) preterm infants’ transition from hospital to home often makes their parents feel stressed and affects their quality of life. It is a great challenge especially for the parents of VLBW preterm infants with bronchopulmonary dysplasia (BPD) but resilience is considered as a person’s ability to cope with stress. The aim of this study was to 1) understand the changes of parental stress, resilience and quality of life at their VLBW preterm infants’ transfer from the neonatal intensive care unit (NICU) and one month after discharge; 2) examine how resilience mediated between parental stress and quality of life. In addition, whether the parents of the VLBW preterm infants with or without BPD had different stress, resilience and quality of life.
This study adopted convenient sampling in the NICU of a medical center in Northern Taiwan. A total of 72 couples of the VLBW preterm infants filled the Perceived Stress Scale (PSS), the brief version of the World Health Organization Quality of Life (WHOQOL-BREF), and the Connor-Davidson Resilience Scale at the VLBW preterm infants’ transfer from the NICU and one month after discharge. The results showed that compared to the stress at the transfer from the NICU, father’s but not mother’s stress at one month after discharge decreased significantly. There was no difference between the parent’s stress at the transfer from the NICU, but at one month after discharge, mothers had significantly higher stress than fathers. There was no significant change in parental resilience but quality of life of both fathers and mothers decreased significantly at one month after discharge from the hospital. Whether the infants with or without BPD had no significant relationship between parental stress and quality of life. Both father’s and mother’s resilience partially mediated the relationships between the stress and quality of life, The mediating effects of resilience between parental stress and quality of life at the transfer and one month after discharge were 47%, 45.7% for fathers and 48.9% and 41% for mothers respectively. While gender of VLBW preterm infants related to paternal resilience, infant’s birth weight and household income affected maternal resilience and quality of life. Regardless of the VLBW preterm infants with BPD or not, a family-centered care intervention including promotion of parental resilience should be initiated early in NICU.

中文摘要 i
英文摘要 ii
目次 iv
表次 vi
圖次 vii
第壹章 緒論 1
第貳章 文獻探討 3
第一節 極低出生體重早產兒現況及併發症 3
第二節 極低出生體重早產兒出院返家之轉銜 4
第三節 早產兒父母壓力及相關因素 6
第四節 早產兒父母生活品質及相關因素 7
第五節 早產兒父母復原力及相關因素 8
第六節 壓力、生活品質及復原力之相關研究 10
第參章 研究方法 14
第一節 研究設計 14
第二節 研究對象及場所 15
第三節 研究工具 15
第四節 資料收集過程 18
第五節 資料分析 19
第肆章 研究結果 21
第一節 極低出生體重早產兒及其父母之基本屬性 21
第二節 極低出生體重早產兒轉出加護病房及出院一個月時父母壓力、復原力和生活品質的變化 24
第三節 人口學、父母壓力感受、復原力與生活品質之相關性 27
第四節 復原力於壓力感受及生活品質間的中介效果 33
第伍章 討論 39
第一節 父母壓力感受、復原力及生活品質差異 39
第二節 復原力的中介效果及影響因素 42
第陸章 結論與建議 45
第一節 結論 45
第二節 護理應用 45
第三節 限制與建議 46
參考文獻 47
中文部分 47
外文部分 49
附錄 62
附錄一 基本資料表 62
附錄二 壓力感受量表問卷使用同意書 63
附錄三 中文版Connor-Davidson復原力量表使用同意書 64
附錄四 世界衛生組織生活品質問卷(臺灣簡明版) 授權同意書 65
附錄五 國立台灣大學醫學院附設醫院研究倫理試驗委員會同意證明書 66

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