臺灣博碩士論文加值系統

復原力保護模式指保護因素會調節危險因素對於負向結果的影響，但較少研究運用復原力保護模式探討青少年自殺意念的影響因素。本研究目的為(1)了解青少年之危險因素(個人基本屬性、憂鬱症狀、生活壓力、情緒取向因應)、保護因素(自尊、問題取向因應)及自殺意念的現況；(2)探討青少年之之危險因素與自殺意念彼此間之關係；(3)探討保護因素與自殺意念彼此間之關係；(4)探討保護因素是否能調解危險因素與青少年自殺意念之間的關係。採橫斷性、描述性相關性研究設計，於民國105年9月到10月，在台南四所高中職學校，以簡單隨機方式取樣高中職一年級到三年級的390位學生為對象，研究工具為結構式問卷，由研究者發放和回收問卷，問卷內容包含憂鬱症狀、生活壓力、情緒取向因應、自尊、問題取向因應、自殺意念、人口學資料。量表經信效度檢定，包含內在一致性、再測信度、內容效度和建構效度。以SPSS 20.0版套裝軟體，進行描述性統計、獨立樣本t檢定、皮爾森績差相關與階層式複迴歸分析。
研究結果在單變量分析發現性別與總自殺意念、想死慾望和自殺計畫有顯著關係；母親職業與總自殺意念、想死慾望、自殺動機和自殺計畫有顯著關係；憂鬱和生活壓力與總自殺意念、想死慾望、自殺動機和自殺計畫有顯著的正相關；自尊和問題取向因應與總自殺意念、想死慾望、自殺動機和自殺計畫有顯著負相關。階層式複迴歸分析發現憂鬱症狀與總自殺意念有顯著正相關，自尊顯著調解憂鬱症狀與總自殺意念的正向關係，問題取向因應顯著調解情緒取向因應與總自殺意念的正向關係；憂鬱症狀和情緒取向因應與想死慾望有顯著正相關，自尊顯著調解憂鬱症狀與想死慾望的正向關係，問題取向因應顯著調解情緒取向因應與想死慾望的正向關係。但自尊不會顯著調節憂鬱症狀與自殺動機和自殺計畫的正向關係，且問題取向因應不會顯著調解情緒取向因應與自殺動機和自殺計畫的正向關係。本研究重要的發現為自尊為憂鬱症狀與自殺意念的調節因素，問題取向因應為情緒取向因應與自殺意念的調節因素；研究結果可以提供健康照護者和學校人員運用以學校為基礎的計畫，提高青少年自尊和教導遇到壓力使用問題取向因應，減少憂鬱和情緒取向因應對青少年產生自殺意念的負向影響。

The resilience protective model indicated that protective factors moderate the association between risk factors and negative outcome. However, few studies have examined the association between factors and suicide ideation among adolescents by resilience protective model. The purposes of this study were to (1) examine the status of adolescent demographic data, risk factors (depressive symptom, life stress, and emotion-focus coping) and protective factors (self-esteem and problem-focus coping); (2) examine the association between risk factors and suicide ideation among adolescents; (3) examine the association between protective factors and suicide ideation among adolescents; and (4) examine the protective factors as moderators between risk factors and suicide ideation. This was a cross–sectional, correlated and descriptive research design. The participants of this study were grade 9-11 grade students in high schools. This study was conducted from September 2016 to October 2016 in four high schools in the southern area of Taiwan. Simple random sampling was used to select 390 participants, who were asked to complete a self-reported questionnaire. The questions included depressive symptoms, life stress, emotion-focus coping, self-esteem, problem-focus coping, suicide ideation and demographic data. The reliability and validity of the questionnaire has been evaluated for internal consistency, test-retest reliability, content validity and construct validity. The software SPSS 20.0 was employed to perform data analyses. Data analysis was to be performed by using descriptive analysis, independent t-test, Pearson’s correlation, and hierarchical regression. Univariate analysis indicated that sex, mother’s occupation, depressive symptoms, life stress, self-esteem and problem-focus coping were significantly associated with suicide ideation. Hierarchical multiple regression indicated that depressive symptoms and emotion-focus coping were positively associated with suicide ideation. This study also found that the relationship between depressive symptoms and suicide ideation was significantly moderated by self-esteem. The relationship between emotion-focus coping and suicide ideation was significantly moderated by problem-focus coping. Healthcare providers and school personnel should consider school-based programs to improve self-esteem and to teach adolescents under stress to use problem-focus coping in order to reduce suicide ideation in those adolescents with depression and emotion-focus coping.

第一章 緒論.......................................................................................... 1
第一節 背景及重要性……………………………………………….. 1
第二節 研究目的…………………………………………................ 5
第二章 文獻查證…………………………………………….............. 6
第一節 自殺意念…………………………………………................. 6
一、自殺意念定義…………………………………………………… 6
二、自殺意念現況…………………………………………………… 7
三、自殺意念測量……………………………………………………. 7
第二節 復原力概念與模式……………………………….................. 9
一、復原力概念………………………………………........................ 9
二、復原力模式………………………………………....................... 10
第三節 影響自殺意念的危險因素……………………….................. 15
一、個人基本屬性…………………………………………………….. 15
二、憂鬱症狀………………………………………………………….. 18
(一)憂鬱症狀的定義……………………………………….................. 18
(二)憂鬱症狀與自殺意念………………………………….................. 20
三、生活壓力………………….………………………………............ 21
(一)生活壓力的定義……………………………………….................. 21
(二)生活壓力與自殺意念………………………………….................. 23
四、情緒取向因應………………….…………………….................... 24
(一)情緒取向因應的定義………………………………….................. 24
(二)情緒取向因應與自殺意念……………………….......................... 26
第四節 影響自殺意念的保護因素……………………….................. 27
一、自尊……………………………………………………………….. 27
(一)自尊的定義……………………………………………………….. 27
(二)自尊與自殺意念………………………………………................. 28
二、問題取向因應…….………………………………………………. 30
(一)問題取向因應的定義………………………………….................. 30
(二)問題取向因應與自殺意念……………….………………………. 30
第五節 運用復原力模式於自殺意念影響因素之探討……………... 32
第三章 研究架構與假設…………………………………….............. 35
第一節 研究架構…………………………………………................ 35
第二節 研究假設…………………………………………................. 36
第三節 名詞定義………………………………………….................. 37
第四章 研究方法…………………………………………….............. 39
第一節 研究設計與對象………………………………….................. 39
第二節 研究工具………………………………….............................. 42
第三節 研究工具之信效度檢測………………………….................. 48
第四節 資料收集過程……………………………………................. 53
第五節 研究對象權益之維護…………………………….................. 55
第六節 資料處理與分析………………………………….................. 56
第五章 研究結果…………………………………………….............. 60
第一節 研究變項之描述……………………………………………... 60
一、青少年的基本屬性…………………………………................... 60
二、青少年的憂鬱症狀…………………………………................... 63
三、青少年的生活壓力……………………………………………… 66
四、青少年的情緒取向因應………………………………………… 72
五、青少年的自尊…………………………………………………… 75
六、青少年的問題取向因應…….…………………………………… 77
七、青少年的自殺意念…………………………………................... 79
第二節 各研究變項與自殺意念之關係……………………………... 82
一、青少年的基本屬性在自殺意念總量表及次量表的比較………. 82
二、青少年憂鬱症狀與自殺意念總量表及各次量表之相關…….... 92
三、青少年生活壓力與自殺意念總量表及各次量表之相關………. 93
四、青少年情緒取向因應與自殺意念總量表及各次量表之相關… 94
五、青少年自尊與自殺意念總量表及各次量表之相關……………... 95
六、青少年問題取向因應與自殺意念總量表及各次量表之相關… 96
第三節 自殺意念調節因素之階層式複迴歸分析............................. 97
一、總自殺意念的調節因素………..……………….......................... 100
二、想死慾望次量表的調節因素……………………….................... 103
三、自殺動機次量表的調節因素……………………….................... 106
四、自殺計畫次量表的調節因素……………………….................... 109
第六章 討論………………………………………………………….. 112
第一節青少年的基本屬性…………………………………............... 112
第二節青少年的憂鬱症狀…………………………………................ 113
第三節青少年的生活壓力……………………………………………. 114
第四節青少年的情緒取向因應………………………………………. 116
第五節 青少年的自尊………………………………………..……… 117
第六節青少年的問題取向因應………………………………………. 118
第七節 青少年的自殺意念………………………………….............. 119
第八節 各變項與青少年自殺意念之關係…………………….......... 121
一、青少年基本屬性與自殺意念總量表及次量表之關係…………. 121
二、青少年憂鬱症狀與自殺意念總量表及各次量表之相關………. 123
三、青少年生活壓力與自殺意念總量表及各次量表之相關………. 124
四、青少年情緒取向因應與與自殺意念總量表及各次量表之相關.. 126
五、青少年自尊與自殺意念總量表及各次量表之相關…………….. 127
六、青少年問題取向因應與自殺意念總量表及各次量表之相關…. 128
第九節 青少年自殺意念之調節因素………………………………... 129
第七章 結論與建議…………………………………………………... 133
第一節 結論…………………………………………………………... 133
第二節 建議…………………………………………………………... 136
第三節 研究限制……………………………………………………... 139
參考文獻……………………………………………………………… 141
附件…………………………………………………………………… 165
附件一 守門人協助研究說明書……………………………………. 165
附件二 問卷資訊說明頁-家長版…………………………………… 166
附件三 問卷資訊說明頁-學生版…………………………….......... 167
附件四 研究問卷………………..………………………………….. 168
附件五 量表作者同意書…………………………………………… 176
附件六 人體研究倫理審查委員會通過證明……………………… 180


圖表目錄
圖3-1 研究架構圖………..…….......................................................................... 35
表4-1 收案單位一覽表……………………………………................................ 41
表4-2 各量表之信度…………………………………………………………… 49
表4-3 各量表之專家效度……………………………………………………… 51
表4-4 各量表之建構效度……………………………………………………… 52
表5-1 青少年的基本屬性……………………………………………………… 61
表5-2 青少年的憂鬱症狀各題選項與平均得分分布情形…………………… 64
表5-3 青少年生活壓力各題選項與平均得分分布情形……………………… 68
表5-4 青少年情緒取向因應各題選項與平均得分分布情形………………… 73
表5-5 青少年的自尊各題選項與平均得分分布情形………………………… 76
表5-6青少年問題取向因應各題選項與平均得分分布情形………….............. 78
表5-7 青少年自殺意念各題選項與平均得分分布情形……………………… 80
表5-8青少年基本屬性在自殺意念總量表之比較分析……………………...... 84
表5-9 青少年基本屬性在自殺意念之想死慾望次量表之比較分析………… 86
表5-10 青少年基本屬性在自殺意念之自殺動機次量表之比較分析……….. 88
表5-11 青少年基本屬性在自殺意念之自殺計畫次量表比較分析………….. 90
表5-12 青少年年齡與自殺意念總量表及各次量表之相關………………….. 91
表5-13 青少年憂鬱症狀與自殺意念總量表及各次量表之相關…………….. 92
表5-14 青少年生活壓力與自殺意念總量表及各次量表之相關…….............. 93
表5-15青少年情緒取向因應與自殺意念總量表及各次量表之相關………… 94
表5-16 青少年自尊與自殺意念總量表及各次量表之相關………………….. 95
表5-17 青少年問題取向因應與自殺意念總量表及各次量表之相關……… 96
表5-18 青少年危險因素和保護因素與自殺意念總量表及各次量表之相關.. 98
表5-19 階層式複迴歸分析各自變項之共線性診斷………………………….. 99
表5-20青少年自殺意念總量表之階層式複迴歸分析………………………… 102
表5-21青少年自殺意念之想死慾望次量表階層式複迴歸分析……………… 105
表5-22青少年自殺意念之自殺動機次量表階層式複迴歸分析……………… 108
表5-23青少年自殺意念之自殺計畫次量表階層式複迴歸分析….................... 111
圖6-1 研究結果架構圖………………………………………..…132

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