臺灣博碩士論文加值系統

背景：家庭暴力具有慢性、長期及重複發生的特質，因而造成家庭暴力受害人長期處於慢性且複雜的身心創傷壓力。婚姻暴力造成受害者有憂鬱及創傷後壓力症候群的情形，對其生活品質有非常大的影響。本研究目的在探討影響婚姻暴力受害婦女心理健康狀態之相關因素。
對象：以求助於臺灣北部某醫學中心與某婦女基金會的婚姻暴力受害婦女為對象，於2010年1月到2010年12月共收案108名。
方法：採橫斷性描述性相關性研究，以自填式問卷收集資料。研究工具包括基本資料表、危險評估量表、社會支持量表、憂鬱量表、創傷後症狀量表。使用SPSS 17版軟體進行資料統計及分析，主要統計方法包括描述性統計資料、T檢定、單因子變異數分析、皮爾森相關係數、階層迴歸分析及Sobel test。
結論：研究發現婚暴婦女的憂鬱量表平均得分為25.23分，創傷後壓力症候群量表平均得分為67.81分，重度憂鬱者有31位(28.7%)，75位(69.4%)有創傷後壓力症候群。年齡、就業情形與創傷後症候群呈現相關。家庭危險程度與創傷後壓力症候群(r=0.54, p<0.01)及憂鬱程度(r=0.43, p<0.01)均成正相關。而創傷後壓力症候群與憂鬱程度也成正相關，階層迴歸分析結果顯示，創傷後壓力症候群程度的重要預測因子為家庭危險程度，憂鬱程度的重要預測因子為創傷後壓力症候群。經Sobel中介變項分析發現創傷後壓力症候群程度可能為家庭危險程度與憂鬱程度之顯著中介變項，結果顯示家庭危險程度對憂鬱的影響，有88.32%會透過創傷後壓力症候群程度之中介影響。
討論：婚姻暴力受害婦女身處於高危險的環境中，且憂鬱程度及創傷後症候群程度相當高，希望能喚起醫護人員重視此問題，能提供此群弱勢族群適當的心理衛生輔導，或搭配相關的心理諮詢，進一步提供自我保護的方法與庇護，作為婦女保護自己與家人的參考。

Background: Intimate partner violence is the most common type of domestic violence and has huge impacts on victims’ physical and psychological health. Intimate partner violence can cause serious depression and post-trauma stress disorder (PTSD) in the victims and can also affect their families’ quality of life greatly. If we can be more aware of the influencing factors of these womens’ psychological health, we may be able toprovide better help for them.
Object: The purpose of study is to explore influencing factors of psychological health in women who suffered from intimate partner violence.
Methods: This study was a descriptive correlational design and cross-sectional data was collected using questionnaires. A convenience sample of 108 battered women was recruited from a women foundation and a medical center in Taiwan. The study questionnaires included questions on demographics, Danger Assessment (DA) Scale, Social Support Sacle, CES-D and Davidson Trauma Scale. Data were collected from January 2010 to December 2010. Descriptive statistics, T-test, one way analysis of variance, Pearson Product Moment correlation coefficient, hierarchical regression and sobel test were applied to explore clients’ psychological health and its related factors.
Result: The average scores of depression and PTSD were 25.2 (SD=9.6) and 67.8 (SD=34.1), respectively. Among the 108 participants, 31 (28.7%) of them had major depression, and 75 (69.4%) of them had a PTSD. The severity of PTSD was associated with age and work status The level of intimate partner violence risk was positively associated with the severity of PTSD (r=0.54, p<0.01) and the degress of depression (r=0.43, p<0.01). In addition, the level of PTSD was positively associated with the degree of depression among these women. The Sobel test showed that PTSD was a mediator between the level of intimate partner violence risk and depression and had a 88.3 precent mediating effect. Results of hierarchical regressions showed that DA was a important predictor of PTSD and PTSD was a important predictor of depression in women who suffered from intimate violence.
Conclusion:The intimate partner violence women are staying in the higher risk environment and encounter more serious of depression and PTSD in this research. We hope that the result can help health care providers to understand mental health status of intimate partner violence women and provide information for further treatment strategies for intimate partner violence women.

目 次
摘要............................................................... i
ABSTRACT......................................................... iii
目次............................................................... v
表次............................................................... vii
圖次............................................................... viii
第一章 緒論
第一節 研究背景與動機........................................... 1
第二節 研究目的................................................. 2
第三節 研究重要性及預期貢獻..................................... 2
第二章 文獻查證
第一節 家庭暴力在台灣之現況..................................... 4
第二節 女性角色與受暴婦女的心理反應............................. 5
第三節 婚姻暴力對被害人生理健康之影響 .......................... 6
第四節 婚姻暴力對被害人心理健康之影響........................... 8
第五節 影響婚暴婦女心理健康之因素............................... 12
第三章 研究方法
第一節 研究設計.......................... ...................... 19
第二節 研究架構.......................... ...................... 19
第三節 研究假設.......................... ...................... 21
第四節 研究對象與場所.......................... ................ 21
第五節 研究工具.......................... ...................... 22
第六節 資料收集過程.......................... .................. 26
第七節 資料處理分析方式.. .......................... .............27
第八節 倫理考量.......................... ...................... 28
第四章 研究結果
第一節 研究對象之人口學特性與受暴經驗........................... 29
第二節 研究對象之家庭危險程度狀況............................... 32
第三節 研究對象之社會支持狀況................................... 34
第四節 研究對象之憂鬱狀況....................................... 36
第五節 研究對象之創傷後壓力症候群狀況........................... 38
第六節 研究對象人口學特性、受暴經驗與心理健康狀態之關係......... 39
第七節 研究對象人口學特性、受暴經驗與家庭危險程度之關係......... 44
第八節 家庭危險程度、社會支持與心理健康狀態之關係............... 46
第九節 創傷後壓力症候群及憂鬱程度之重要預測因子................. 47
第十節 家庭危險程度、創傷後壓力症候群程度與憂鬱程度之關係........ 52
第五章 討論
第一節 婚暴婦女的心理健康狀態................................... 54
第二節 影響婚暴婦女心理健康狀態的相關因素....................... 55
第三節 家庭危險程度、創傷後壓力症候群程度與憂鬱程度之關係........ 60
第六章 結論與建議
第一節 結論..................................................... 62
第二節 建議..................................................... 63
第三節 研究限制................................................. 64
參考資料
中文部分.........................................................66
英文部分.........................................................68
附錄
附錄一 受訪同意書................................................ 72
附錄二 基本資料..................................................74
附錄三 社會支持量表.............................................. 75
附錄四 中文版CESD量表........................................... 76
附錄五 中文版戴氏創傷量表......................................... 77
附錄六 危險評估量表.............................................. 78
附錄七 SOBEL results............................................79
附錄八 授權同意書................................................ 80

中文部分：
行政院內政部家庭暴力暨性侵害防治委員會（2009）。97至98年5
月家庭暴力事件通報類型統計，2009年6月17日取自
http://dspc.moi.gov.tw/mp.asp
行政院內政部家庭暴力暨性侵害防治委員會（2009）。94至96年
家庭暴力事件通報類型統計，2009年6月17日取自
http://dspc.moi.gov.tw/mp.asp
孔繁鐘(2000)。精神疾病的診斷與統計。臺北：合記。
田秀蘭(1996)。自我效能預期與女性之生涯發展。諮商與輔導，123，32-33。
吳韻淑、羅筱芬、鄭春秋(2008)。成人健康護理中生理及病理的層面。劉雪娥總校閱，成人內外科護理上，(pp.145-149)．臺北：華杏。
李引玉(1995)。情感性障礙病人護理。載於鍾信心、周照芳總校閱，精神科護理學(pp.149-166)。臺北：匯華。
李約整、陳建志、許豪沖 (2004)。焦慮症。基層醫學，19（7），158-163。
周月清(1994)。臺灣受虐婦女社會支持探討之研究。婦女與兩性學刊，5，69-108。
林明傑、沈勝昂(2003)。我國婚姻暴力加害人之危險評估—DA量表在我國適用之研究。犯罪學期刊，6(2)，177-216。
汪素敏(1997)。心臟移植術後病人症狀困擾、社會支持與自我照顧行為相關之探討。國防醫學院，未發表碩士論文。
張高賓(2005)。自我效能預期與受虐婦女的生涯發展。諮商與輔導，229，16-19。
全國法規資料庫(2009)。家庭暴力防治法，2009年6月17日取自http://law.moj.gov.tw/Scripts/NewsDetail.asp
陳玉芳(2009)。慢性焦慮，不能承受的「重」—廣泛焦慮症。諮商與輔導，278，25-31。
陳蕙雅、丘亮、林忠順(2004)。憂鬱症。基層醫學，19(11)，264-269。
黃志中、陳三能、黃文儀、張淳茜、鄧淑如、陳建州、黃瑛琪、張高賓(2003) 。婚姻暴力受虐婦女的身體症狀。台灣家醫誌，14(1)，25-34。
楊明仁、何啟功、蘇以菁、楊美賞(1997)。工作壓力、社會支持與心理健康：以重工業工廠男作業員工為例。The Kaohsiung Journal of Medical Sciences , 13,332-341。
蔡欣茹(2005)。受婚姻暴力婦女在婚姻關係中自我認定之初探。諮商與輔導，233，20-22。
謝璧甄、岳修平(2007)。九二一地震對暨南大學學生調適策略與心理健康關係之研究。農業推廣學報，23，1-18。
臺北市政府家庭暴力暨性侵害防治中心（2009）。近年接案數服務
成果統計，2009年6月17日取自
http://www.dvsa.taipei.gov.tw/
英文部分：
Barnett, O.,& LaViolette, A. (1993).It could happen to anyone. CA: Sage.
Beck, A., Ward, C., Mendelson, M., Mock, J.,& Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.
Beck, A. T., & Beck, R. W. (1972). Screening depressed patients in family practice: A rapid technic. Postgraduate Medicine, 52(6), 81-85.
Beck, A., Steer, R.,& Garbin, M.(1988). Psyhometric properties of the Beck depression inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100.
Betz, N.,& Hackett, G.(1981). The relationship of career related self-efficacy expectations to perceived career options in college women and men. Journal of Counseling Psychology, 28, 399-410.
Brown, C., Reedy, D., Fountain, J., Johnson, A.,＆ Dichiser, T.(2000). Battered women’s career decision-making self-efficacy: Further insights and contributing factors. Journal of Career Assessment, 8, 251-265.
Campbell, J.(1986). Nursing assessment for risk of homicide with battered women. Advances in Nursing Science, 8(4), 36-51.
Campbell, J.(2002). Health consequences of intimate partner violence. The Lancet, 359, 1331-1336.
Campbell, J. (2004).Helping women understand their risk in situations of intimate partner violence. Journal of Interpersonal Violence, 19, 1464-1477.
Campbell, J., & Soeken, K,(1999). Women’s respones to battering over time: An analysis of change. Journal of Interpersonal Violence, 14, 21-40.
Caplan, G.(1974).Support system. In G. Caplan (ed.), Support system and community mental health. New York: Basic Book.
Cassel, J.(1974).Psycholocial process and “stress”: Theoretical formulation. Internation Journal of Health Services, 4(3), 471-482.
Chen, C., Lin, S., Tang, H., Shen, W.,＆ Lu, M.(2001）.The Chinese version of the Davidson trauma scale：A practice test for validation. Psychiatry and Clinical Neuroscience, 55,493-499.
Cohen, S.,& Wills, T.(1985). Stress, social support, and the buffering hypothesis. Psyological Bulletin, 98(2), 310-357.
Cohen, S.＆ Syne, S.(1985).Issue in the study and application of social support. Social Support and Health, Orlando,: Academic.
Cobb, S.(1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38, 300-314.
Davidson, J., Book, S.,＆ Colket, J.(1997). Assessment of a new self-rating scale for posttraumatic stress disorder. Psychological Medicine, 27, 153-160.
Gerlock, A. (1999). Health impact of domestic violence. Issues in Mental Health Nursing, 20(4), 373-385.
Gianakos, I.(1999). Career counseling with battered women. Journal of Mental Health Counseling, 21, 1-14.
Hou, W., Wang, H.,＆ Chung, H.(2003). Post-traumatic responses of abused women to marrital violence. The Kaohsiung Journal of Medical Sciences, 19(7),352-357.
Ibrahim, F.,＆ Herr, E.(1987). Battered women: A developmental life-career counseling perspective. Journal of Counseling and Development, 65, 244-248.
Kumar, S., Jeyaseelan, L., Suresh, S.,＆ Ahuja, R.(2005）. Domestic violence and its mental health correlates in Indian women. British Journal of Psychiatry, 187, 62-67.
Kear, M.(2000). Concept analysis of self-efficacy. Graduate Research in Nursing, 2(2). No pagination.
Lin, N.(1986). Concepualizing social support. In Lin, N., Dean, A. & Enswl. W.(eds.) Social support, life event, and depression. Orlando, :Academic press.
Dugas, M., Freeston. M., Ladouceur, R., Rheaume,J., Provencher, M., ＆Boisveot, J.(1998). Worry themes in primary GAD, secondary GAD, and other anxiety disorders. Journal of Anxiety Disorders, 12(3), 253-261.
Niles, S., & Sowa, C.(1992). Mapping the nomological network of career self-efficacy. Career Development Quarterly, 41, 13-21.
Olive, P.(2007). Care for emergency department patients who have experienced domestic violence: A review of the evidence base. Journal of Clinical Nursing, 16(9), 1736-1748.
O’Reilly, P.(1988). Methodological issues in social support and social network research. Social Science & Medicine, 26(8), 863-873.
Parsons, L. & Harper, M.(1999). Violence maternal death in North Carolina. Obstetrics & Gynecology, 94, 990-993.
Pico-Alfonso, M., Garcia-Linares, M., Celda-Navano, N., Blasco-Ros, C., Echeburua, E. & Martinez, M.(2006). The impact of physical, psychological and sexual intimate male partner violence on women’s mental health： Depressive symptoms, posttraumatic stress disorder, state anxiety, and suicide. Journal of Women’s Health, 15(5), 599-611.
Rand, M.(1997). Violence-related injuries treated in hospital emergency departments, Bureau of Justic Statistcs special report. Washington, DC: US Department of Justic.
Ratner, P.(1993). The incidence of wife abuse and mental health status in abused wives in Edmonton, Alberta. CanadIaN Journal of Public Health. 84, 249-246.
Sato-DiLorenzo, A., & Sharps, P.(2007). Dangerous intimate partner relationships and women's mental health and health behaviors. Issues in Mental Health Nursing, 28(8), 837-848. .
Schaefer, C., Coyne, J., & Lazarus, R.(1981).The health-related functions of social support. Journal of Behavioral Medicine, 4, 381-406.
Silva, C., McFarlane, J., Soeken, K., Parker, B. & Reel, S.(1997). Symptoms of posttraumatic stress disorder in an abuse women in a women primary care setting. Jounal of Women Health, 6, 543-552.
Tiden, V.(1986). New perspectives on social support. Nurse Practitioner, 11(1), 61-62.
Thoits, P.(1986). Social support as coping assistance. Journal of Consulting and Clinical Psychology, 54(4), 416-423.
Weingourt, R., Maruyama, T., Sawada, I., & Yoshino, J.(2001).
Domestic violence and women’s mental health.
International Nursing Review, 48（2）, 102-108.