臺灣博碩士論文加值系統

安適（wellness）仰賴「我擁有…？我是…？我與…有關係？我可以超越…」，近年來，因為「全人健康」理念推展，使得「靈性」領域逐漸受到各學門的重視。本研究主要目的為探討護生靈性健康狀況，並了解護生靈性健康與臨床實習壓力、憂鬱傾向及自覺健康狀態之關係。研究設計採橫斷式問卷調查法進行資料收集，以北部地區護理學校之護生為研究對象，利用等機率比例分配方式抽出班級後，進行資料之收集與分析。所得資料以SPSS/Window 10.0版進行資料建檔與統計分析，統計分析方法包括：描述性統計、變異數分析、皮爾森積差相關、因素分析、回歸分析等。共收集471位研究對象、皆為女性、平均年齡19.37歲、以專科生居多，將重要研究結果整理如下：
1.護生的靈性健康狀態依照自擬之靈性健康量表平均得分為179.64分，顯示研究對象有不錯的靈性健康狀態；靈性健康量表可以包含：「與人締結」、「活出意義」、「超越逆境」、「宗教寄託」與「明己心性」等五個次量表。因此，靈性健康是一種力量也是一種資源，協助個體藉由不斷的超越，實踐屬己的生命意義。
2.護生的人口學變項與情境經驗與靈性健康有關，特別是年齡、制、年級、原住民屬性、宗教虔誠度、父母親的健康狀態、父母的婚姻關係、家庭氣氛、實習次數與實習成績。其中以學制、原住民屬性、宗教虔誠度、父親的健康狀態、家庭氣氛為靈性健康的重要解釋因素。
3.研究對象的實習壓力屬於「中等程度」、35﹪研究對象有程度不等之憂鬱傾向、45.4﹪的研究對象自覺健康狀態屬於「普通」。
4.研究對象靈性健康與實習壓力成負相關，利用回歸分析在控制人口學與情境經驗等變項後，仍具有解釋力。
5.研究對象靈性健康與憂鬱傾向呈負相關，利用回歸分析在控制人口學與情境經驗等變項後，仍具有解釋力。
6.研究對象靈性健康與自覺健康狀態有關，自覺健康狀態不好者其靈性健康狀態低於自覺健康好與普通者。自覺健康狀態好與不好兩組，在控制人口學與情境經驗等變項後，其靈性健康仍有統計之顯著差。

The wellness depends on having, being, relating and transcending. Due to the advocacy of the philosophy of holistic health, the spiritual health has been greatly concerned in many disciplines currently. The purposes of this study were two sections: 1) to explore the health of spirit among the nursing students, and 2) to determine the relationships among spiritual health, clinical practice stress, depressive tendency, and self-rated health status in the population of nursing students. The research design was a cross-sectional survey study by using the structured questionnaires. The sample of this study was nursing students who were enrolled in the nursing schools in northern area of Taiwan. Applying the technique of the probability proportional to size to carry out the study sample. The data were coded and then analyzed by using the Statistical Package for the Social Science (SPSS for windows. Release 10.0). The method of data analysis consisted of describe statistics (means and standard deviations for the continuous data and frequencies and proportions for the nominal data), One-way ANOVA, Pearson’s correlation, factor analysis and regression analysis. The sample for this study consisted of 471 nursing students with mean aged 19.78 who were females’ college students.
The major findings of the study were summarized as following:
1.The result indicated that the spiritual health status in females’ nursing students was good. The total score of the SHS questionnaire in the sample was almost 180. The SHS included 5 subscales: “connecting to others”, “meaning derived from living”, “transcendence ”, “religion attachment” and “introspection for oneself”. The spiritual health may be acted as a power and resource to a person. By means of transcendence, the spiritual health may assist a person to enjoy their meaningful life.
2.The socio-demographic characteristics and situational variables (including age, school attribute, grand, aboriginal, religious affiliation, parents’ health status, parents’ marital status, family atmosphere, times of clinical practice, achievement of clinical practice) were found to be associated with spiritual health. The major explained factors of spiritual health included school attribute, aboriginal, religious affiliation, fathers’ health status and family atmosphere.
3.The stress of clinical practice in the research sample was moderate. About 35% of participants were more likely to have depression. Nearly 45﹪of them rated their self-health status were fair.
4.There were a significantly negative association between spiritual health and the stress of clinical practice while particularly controlling the confounding variables such as socio-demographic variables and situational variables.
5.Spiritual health was significantly negatively correlated to depressive tendency, particularly in controlling the confounding variables such as socio-demographic variables and situational variables.
6.There was a statistical relationship between spiritual health and self-rated health status. Participants who reported lower scores of health status were more likely to reported lower scores in spiritual health. While controlling the confounding variables such as socio-demographical and situational variables, there was a significantly differences in spiritual health between participants with good self-rated health status and those with bad self-rated health status.

目 次
頁 次
中文摘要 …………………………………………………… I
英文摘要 …………………………………………………… III
第一章 緒論
第一節 研究動機與重要性…………………………….. 1
第二節 研究目的……………………………………….. 9
第三節 研究問題……………………………………….. 9
第四節 研究假設……………………………………….. 10
第五節 操作性定義…………………………………….. 10
第六節 研究範圍與限制……………………………….. 13
第二章 文獻探討
第一節 靈性、宗教與靈性健康………………………. 15
第二節 靈性健康的重要性……………………………. 22
第三節 靈性健康之測量………………………………. 24
第四節 靈性健康之相關性研究………………………. 27
第三章 研究方法
第一節 研究架構……………………………………….. 35
第二節 研究對象……………………………………….. 36
第三節 研究工具……………………………………….. 39
第四節 研究步驟……………………………………….. 62
第五節 資料處理與分析……………………………….. 64
第四章 結果與討論
第一節 研究對象基本資料…………………………….. 67
第二節 研究對象之靈性健康………………………….. 72
第三節 研究對象人口學特性、情境經驗與靈性健康的關係…………………………………………….. 79
第四節 研究對象實習壓力、憂鬱傾向及自覺健康狀態 93
第五節 靈性健康與實習壓力、憂鬱傾向及自覺健康狀態之關係….……………………………………. 99
第五章 結論與建議
第一節 結論…………………………………………….. 117
第二節 建議…………………………………………….. 118
參考文獻 ………………………………………………….. 123
附錄一 靈性健康量表初稿…………………………….. 139
附錄二 效度考驗專家名單…………………………….. 141
附錄三 靈性健康量表修正版………………………….. 142
附錄四 正式問卷……………………………………….. 144
附錄五 台灣版世界衛生組織生活品質問卷使用授權書…….. 151
附錄六 護生實習壓力量表使用同意書……………….. 152
附錄七 貝克憂鬱量表第二版使用同意書…………….. 153
圖 表 目 次
頁 次
圖3-1 研究架構圖…………………………………….. 35
表1-1 教育程度與職業類別分級…………………….. 11
表1-2 職業等級分類表……………………………….. 11
表2-1 靈性健康測量評估方法……………………….. 25
表3-1 北部地區護理學校學制與班級分布………….. 38
表3-2 預計抽樣研究樣本之分布…………………….. 38
表3-3 研究對象之學制、班級數與人數分布………… 38
表3-4 內容效度指標（CVI值）……………………… 42
表3-5 專家效度各題得分之次數分布與平均值…….. 42
表3-6 靈性健康量表預試之項目分析……………….. 44
表3-7 KMO與Bartlett檢定………………………….. 47
表3-8 因素分析與因素負荷………………………….. 48
表3-9 靈性健康量表之內在一致性………………….. 50
表3-10 靈性健康量表三週再測信度………………….. 51
表3-11 研究目的與統計方法………………………….. 66
表4-1 研究對象社會人口學分布情形………………. 68
表4-2 研究對象之家庭基本資料……………………. 69
表4-3 研究對象重大事件發生之人次與百分比…….. 70
表4-4 研究對象課業與實習之相關資料…………….. 71
表4-5 研究對象靈性健康量表單題得分與標準差..… 72
表4-6 靈性健康各分量表之得分…………………….. 73
表4-7 個人基本資料與靈性健康得分之單因子變異數分析………………..………………………… 80
表4-8 家庭基本資料與靈性健康得分之單因子變異數分析………………..………………………… 81
表4-9 重大事件之有無與靈性健康之t檢定………… 86
表4-10 課業與實習資料與與靈性健康之t檢定與變異數分析……………………………..…………… 87
表4-11 多元迴歸分析前類別變項轉換虛擬變項表….. 90
表4-12 研究對象對靈性健康主要影響因素之共線性分析表………………………………………….. 91
表4-13 研究對象對靈性健康的重要解釋因素……….. 92
表4-14 實習壓力各題得分之平均值與標準差………. 94
表4-15 實習壓力各分量表之得分……………………. 94
表4-16 憂鬱量表平均得分與標準差………………….. 96
表4-17 憂鬱程度分級………………………………….. 96
表4-18 研究對象之自覺健康狀態分布……………….. 98
表4-19 靈性健康總分與實習壓力及憂鬱傾向之皮爾森積差相關.……………………………………. 100
表4-20 研究對象對實習壓力、憂鬱傾向及自覺健康狀態主要影響因素之共線性分析表…………….. 101
表4-21 研究對象對實習壓力的重要解釋因素……….. 102
表4-22 研究對象對憂鬱傾向的重要解釋因素……….. 104
表4-23 個人自覺健康狀態與靈性健康得分之單因子變異數分析………….………………………… 105
表4-24 研究對象對自覺健康狀態的重要解釋因素… 106

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