臺灣博碩士論文加值系統

吸菸是現代流行病學的其中一個代表。隨著吸菸率增加，與吸菸相關的其它疾病之共病現象更引發了公共衛生領域的重視。然而近年來國內對吸菸的研究大多著重在菸害的防治，較少以心理學的角度去探討吸菸行為之所以持續的背後原因。但事實上心理學與菸的淵源相當深，自1960年代起便有學者以因素分析方法探討人們吸菸的理由，同時期也有許多研究，試圖瞭解吸菸者與非吸菸者在人格特質上的不同，第一個香菸(尼古丁)依賴量表便是當時的心理學者所發展。當生活品質的概念被發展出來並作為評估的指標以後，關於吸菸狀態與生活品質的相關研究更是不勝枚舉。以上三類議題在學界皆已經累積相當大量的研究成果。本研究試圖將原本兩兩相關的研究整合為一個包含三者的整體架構，以結構方程模式對吸菸行為、人格特質與生活品質做更全面的探討及嘗試提出解釋。研究一首先進行測量工具的翻譯與驗證其信效度；研究二進一步以吸菸動機作為人格特質與吸菸行為之中介變項，說明特質如何藉由不同動機反應出相同行為；研究三則針對神經質人格的可能成癮模式，以結構方程模式討論人格特質、吸菸行為如何影響生活品質，並進行整體模型的分析與討論。

Smoking is the forefront representation of common epidemiology. With the increasing rate of smoking and the co-morbidity of diseases related to smoking, it brings public health to the researcher’s attention. Nevertheless, recent research on smoking in Taiwan has been focused on the prevention of smoking and it is uncommon to explore the mechanism of smoking behavior and addiction from a psychological standpoint. Despite that there has been a long and prominent history between the relationship of psychology and smoking, few researchers in Taiwan are interested in this topic. Since the 1960s, researchers abroad have been using factor analysis to study the reasons behind smoking. Many studies explored the relationship between personality and addiction; the first nicotine dependency scale was an invention of a psychologist. When the construct of quality of life had been developed as an evaluated index, related research of smoking status and quality of life became connected. The three topics mentioned above have had significant findings in the field. The present study attempts to consider smoking behavior, personality and quality of life within a single frame, and measure the relations simultaneously by structure equation model.
In study 1, the measurement instrument had been translated and evaluated, results support the instrument have good reliability and validity. The second study uses the motivation behind smoking as a mediation variable between personality and smoking behavior, showing different personality forms the same behavior by different motives. Study 3 aims at the potential mediation model of neuroticism and explore how personality and smoking behaviors can affect the quality of life.

第一章 前言與文獻回顧.......................................................................1
第一節 前言與研究動機.................................................................................1
第二節 關於吸菸行為.....................................................................................6
第三節 人格特質與吸菸行為.......................................................................15
第四節 人格特質與生活品質.......................................................................18
第五節 生活品質與吸菸行為.......................................................................20
第六節 人格特質、吸菸行為與生活品質的關係...... .................................22
第七節 研究目的...........................................................................................24

第二章 研究一.....................................................................................25
第一節 研究目的...........................................................................................25
第二節 研究工具...........................................................................................25
第三節 研究方法...........................................................................................30
第四節 研究結果...........................................................................................33
第五節 討論與結論.......................................................................................46

第三章 研究二.....................................................................................49
第一節 研究目的與假設...............................................................................49
第二節 研究工具...........................................................................................51
第三節 研究方法...........................................................................................52
第四節 研究結果...........................................................................................54
第五節 討論與結論.......................................................................................66
第四章 研究三.....................................................................................69
第一節 研究目的與假設...............................................................................69
第二節 研究工具...........................................................................................70
第三節 研究方法...........................................................................................71
第四節 研究結果...........................................................................................72
第五節 討論與結論.......................................................................................76

第五章 總結.........................................................................................79

參考文獻..................................................................................................85
附錄........................................................................................................105
附錄一 WISDM-37翻譯過程各版本..................................................................105
附錄二 戒菸門診紀錄表(含FTND中文版6題) ................................................112
附錄三 研究問卷..................................................................................................113

圖目次

圖1-1 強化歷程與吸菸類型........................................................................................7
圖1-2 1960以來每年關於生活品質的文獻發表數量...............................................20
圖2-1 中文版WISDM-37翻譯流程..........................................................................26
圖2-2研究一各步驟簡介與流程圖............................................................................33
圖2-3平行分析法模擬之資料與實際資料進行EFA之特徵值比較陡坡圖...........38
圖2-4 三因素模式之整體驗證性因素分析之因素結構與因素負荷量..................43
圖3-1 Baron & Kenny 中介模式檢驗步驟圖示........................................................53
圖3-2 神經質中介模型之路徑係數及顯著性..........................................................57
圖3-3 外向性人格吸菸動機歷程中介模型之標準化路徑係數及顯著性..............58
圖3-4 神經質人格─動機─行為效標之結構方程模型路徑係數與顯著性............61
圖3-5 外向性人格─動機─行為效標之結構方程模型路徑係數與顯著性............62
圖3-6 人格─動機─行為效標之結構方程模型路徑係數與顯著性........................65
圖4-1 人格特質、吸菸動機及行為與生活品質之假設架構....................................70
圖4-2 人格特質─吸菸行為─生活品質（心理）整體模型架構及估計路徑係數....72

表目次

表 1-1 93-95年成人與青少年吸菸行為調查..............................................................4
表 1-2 最早編製測量吸菸理由的不同工具之因素結構比較.................................11
表 1-3 近年研究者所發展之多向度尼古丁依賴量表及簡介.................................14
表 1-4 關於壓力及負向情緒對吸菸行為之影響.....................................................22
表 2-1 原英文版理論向度、題號、題目內容及翻譯中文版結果對照....................27
表 2-2 篩選題目與問卷回收率整理.........................................................................31
表 2-3 總受試樣本人口學與吸菸相關變項描述統計.............................................32
表 2-4 原版WISDM-37之11子向度驗證性因素分析結果...................................34
表 2-5 原版WISDM-37全部題目之描述統計結果................................................36
表 2-6 拆分為兩樣本後比較人口學及吸菸相關變項之描述統計結果.................37
表 2-7 平行分析法模擬之資料與實際資料進行EFA之特徵值比較....................38
表 2-8 中文版WISDM題目進行探索性因素分析之因素解..................................39
表 2-9 中文版WISDM-18之因素與所包含之題目對照表....................................42
表2-10 三因素模式之整體驗證性因素分析適配度指標........................................43
表2-11 以WISDM-18三向度對兩不同效標進行迴歸分析....................................45
表3-1 NEO-PI-R五因素人格量表之高階因素範疇與其下各層面.........................51
表3-2 大五人格特質與中文版WISDM-18三向度吸菸動機的皮爾森積差相關..54
表3-3 以Baron & Kenny法分段檢驗神經質人格特質之中介模型迴歸分析表....56
表3-4 以Preacher & Hayes法檢驗神經質中介模式各變項之係數與解釋變異....57
表3-5 以Preacher & Hayes法檢驗外向性中介模式各變項之係數與解釋變異....58
表3-6 研究二變項之描述統計..................................................................................61
表3-7 神經質人格─動機─行為效標之結構方程模型模式適配度指標一覽........62
表3-8 外向性人格─動機─行為效標之結構方程模型模式適配度指標一覽........63
表 3-9 外向性人格吸菸動機歷程修正模型模式適配度指標一覽.........................64
表3-10 人格─動機─行為效標歷程之結構方程模型模式適配度指標一覽..........65
表 4-1 研究三所使用變項之描述統計.....................................................................72
表 4-2 人格特質─吸菸行為─生活品質(心理)模型適配度指標............................73
表 4-3 模型比較所使用變項之描述統計.................................................................75
表 4-4 原心理範疇模型與其它效標模型比較表.....................................................75

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