臺灣博碩士論文加值系統

女性陰道痙攣是夫妻或伴侶之間親密關係的議題,除了生理需求也影響了婚 姻裡的心理距離,尤其是互不溝通或給予治療,將可能導致夫妻之間感情破裂。 本研究目的探討女性陰道痙攣的疼痛感覺、疼痛信念及其相關預測因素。採橫斷 式相關性研究,以立意取樣,由台北市某所性健康中心100位陰道痙攣個案,依結 構自陳式問卷蒐集個人特性、性行為、性認同、疼痛信念、疼痛感覺等資料,採 用SPSS第14版套裝統計軟體進行資料整理與統計分析。樣本平均30.84歲;98%已 婚;78%具大學或以上學歷。本研究以卡方考驗、皮爾森積差相關、獨立樣本 t 檢 定、單因子變異數分析檢定自變項與依變項是否有顯著差異及相關性,再以多元 線性迴歸分析來驗證,女性陰道痙攣之個人特性變項、疼痛信念、疼痛感覺是否 有顯著預測力。
研究結果發現:陰道痙攣個案疼痛信念與婚齡或交往時間、性行為評估、疼
痛控制信念呈正相關;疼痛感覺與性認同評估、疼痛恐懼信念、疼痛強度呈正相
關。上述變項可有效解釋疼痛信念與疼痛感覺關係確實存在,最具顯著解釋力則
為疼痛恐懼信念導致疼痛感覺之相關之依據。
研究討論:本研究結果有助於瞭解陰道痙攣個案對於疼痛恐懼信念導致此議 題結果,可給予陰道痙攣個案適切之建議。並提供給教育機構,能正向以女性性 健康來宣導與伴侶之間的親密關係之參考。

Vaginismus is an intimate issue between spouses or couples that affect the couples’ physiological needs and causes the distance in a marriage to grow. The condition may lead to a broken relationship if the couple is lacking adequate communication or treatment. The objective of this research aims to examine the pain sensation, pain beliefs, and associated predictive factors of vaginismus. A cross-section method was employed for the sampling and 100 patients with vaginismus from a certain health center in the northern Taiwan were included. A self-assessment survey was conducted to obtain information on the subject’s personal profile, sexual activity, sexual identity, pain beliefs, pain sensation etc. The results were arranged using SPSS software version 14 for statistical analysis.
The average age of the subjects is 30.84 years old and 98% were married. 78% of the subjects received college or higher education. Pearson Product-Moment Correlation Coefficient, Independent-Sample t-Test, and one-way ANOVA were used to examine if significant difference was noted and the relation between the independent and dependent variables. Multiple regression analysis was then used to test the significance of the predictability of personal traits variable of the subjects with vaginismus, pain beliefs, and pain sensation.
This research discovered that the subject’s pain beliefs is positively related to the length of marriage or relationship, evaluation of sexual activity, and pain control perception. In addition, the pain sensation is positively related to the sexual identification, fear of perception of pain, and intensity of pain. The aforementioned variables may provide an effect explanation to the relationship between the pain beliefs
II
and pain sensation and the strongest correlation exist between fear perception of pain leading to the pain sensation.
Discussion: this research provides a possible understanding towards the fear of perception of pain in vaginismus and appropriate advices could therefore be provided to the patients. In addition, the results could be provided to health education organizations as a reference for the promotion of a healthy intimate relation between couples from a women’s health standpoint.

中文摘要 ..........................................................I
英文摘要 ..........................................................II
誌謝 .................................................................IV
目錄 .................................................................V
表目錄 ............................................................VI
第一章 緒論 ..............................................................1
第一節 前言 ..............................................................1
第二節 研究動機 ..............................................................3
第三節 研究目的 ..............................................................7
第四節 名詞釋義 ..............................................................8
第二章 文獻探討 ..............................................................11
第一節 女性陰道痙攣發展史 ..............................................................11
第二節 女性陰道痙攣的診斷標準..............................................................13
第三節 女性陰道痙攣症的心理與諮商治療理論......................................21
第四節 女性陰道痙攣疼痛感覺與疼痛信念..............................................31
第三章 研究方法 ..............................................................39
第一節 研究設計與對象來源................................................39
第二節 研究假設 ..............................................................42
第三節 研究工具 ..............................................................43
第四節 資料分析與統計分析方法 ........................................47
第五節 研究倫理 ..............................................................48
第四章 研究結果與討論 .....................................................49
第一節 陰道痙攣個案人口統計變項與疾病特性分析.................49
第二節 陰道痙攣個案性行為及性認同評估分析......................................54
第三節 陰道痙攣個案疼痛信念及疼痛感覺評估分析..............................59
第四節 不同個人背景的陰道痙攣個案在疼痛信念及疼痛感覺上之差異性 分析..65
第五節 陰道痙攣個案的人口統計變項、疾病特性、性行為、性認同和疼 痛信念之相關分析..76
第六節 陰道痙攣個案人口統計變項、疾病特性、性行為評估、性認同評 估對疼痛信念和疼痛感覺之預測分析..........................................78
第五章 結論與建議. ..............................................................85
第一節 結論 ..............................................................85
第二節 研究限制與建議 ..............................................................88
參考文獻 ..............................................................93
附錄一:參與研究同意書 ..............................................................99
附錄二:問卷調查表 ..............................................................100

表目錄
表4-1-1 陰道痙攣個案人口統計變項分析 ......................................................51
表4-1-2 陰道痙攣個案疾病特性分析.....................................................................53
表4-2-1 性行為評估量表分析結果..........................................................................56
表4-2-2 性認同評估分析結果....................................................................................58
表4-3-1 疼痛控制信念分析結果...............................................................................60
表4-3-2 疼痛忍耐信念分析結果...............................................................................61
表4-3-3 疼痛恐懼信念分析結果...............................................................................63
表4-3-4 疼痛感覺分析結果.........................................................................................64
表 4-4-1 是否曾經就醫的陰道痙攣個案在人口統計變項、疾病特性、性行為評估、性認同評估以及疼痛信念之獨立樣本 t 檢定............................................67
表4-4-2 是否曾經就醫的陰道痙攣個案在疼痛感覺之卡方考驗...........................68
表 4-4-3 不同教育程度的陰道痙攣個案在人口統計變項、疾病特性、性行為評估、性認同評估和疼痛信念之單因子變異數分析...........................................70
表4-4-4 不同教育程度的陰道痙攣個案在疼痛感覺之卡方考驗...........................71 表 4-4-5 不同疼痛感覺的陰道痙攣個案在人口統計變項、疾病特性、性行為評估、性認同評估以及疼痛信念上之差異性分析...............................................74
表 4-4-6 不同疼痛感覺的陰道痙攣個案在人口統計變項和疾病特性之卡方考驗75
表 4-5-1 陰道痙攣個案在人口統計變項、疾病特性、性行為評估、性認同評估和疼痛信念之 Pearson 相關分析 ...............................................................78
表4-6-1 疼痛控制信念之迴歸分析 .........................................................80
表4-6-2 疼痛忍耐信念之迴歸分析..............................................................82
表4-6-3 疼痛強度之迴歸分析........................................................................83

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