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題名 以交叉延宕分析探討乳癌患者的創傷後成長與因應策略之關係
The Relationships Between Coping Strategies and Posttraumatic Growth Among Women With Breast Cancer: A Cross-lagged Analyses作者 錢映融 貢獻者 許文耀
錢映融關鍵詞 乳癌
創傷後成長
因應策略
交叉延宕分析
breast cancer
posttraumatic growth
coping
cross-lagged analyses日期 2013 上傳時間 29-七月-2014 16:11:08 (UTC+8) 摘要 本研究主要目的在探討不同治療階段中創傷後成長與因應策略之關係。由於過去創傷後成長與因應策略之間的研究，均是將創傷後成長視為個體因應後的結果，而忽略創傷後成長的經驗對個體的影響，因此本研究透過雙面神模式的理論，以更多元的角度來檢視「創傷後成長」，並將追蹤三個時間點，根據不同治療階段進一步提出三個假設模式，並採用交叉延宕分析（Cross-lagged analyses）來檢驗。\n 研究方法採立意取樣，以中部某教學醫學之乳房中心的乳癌患者為對象，共262 人，蒐集患者之「基本資料」、「創傷後成長」及「因應策略」，並在術後三個月、術後六個月及術後一年進行問卷調查。資料分析以探索性因素分析將因應策略分為三個因素：「自我導向因應」、「社會導向因應」及「逃避因應」，並與創傷後成長進行交叉延宕分析。\n 研究主要發現如下：（一）診斷時年齡愈小及教育程度愈高者，可以預測術後三個月較高的「自我導向因應」、「社會導向因應」及「創傷後成長」；（二）術後三個月到六個月之間，「自我導向因應」與「創傷後成長」呈現互惠關係，即術後三個月較高的「自我導向因應」可以預測術後六個月較高的「創傷後成長」，而術後三個月較高的「創傷後成長」也可以預測術後六個月較高的「自我導向因應」；（三）術後六個月的「創傷後成長」可以預測術後一年的「社會導向因應」，即在術後六個月時「創傷後成長」愈高，可以預測後續較高的「社會導向因應」；（四）三個時間點中，「逃避因應」均無法預測「創傷後成長」，「創傷後成長」亦無法預測「逃避因應」。\n最後將根據研究結果提出其貢獻與實務運用，並依據研究限制提出相關建議，以供臨床工作者與未來研究學者參考。
This study is aimed to investigate the relationships between coping strategies and Posttraumatic Growth (PTG) on three different timing of the breast cancer treatment. According to Janus-Faced Model, PTG is assumed as both a coping effort and a coping result. In order to investigate the possible relationships between coping strategies and PTG, three hypothetic models were proposed and tested by cross-lagged analyses.\n By purposive sampling, 262 participants were recruited from the breast center unit at a hospital in central Taiwan. Demographic and disease-related information were gathered after surgery. The Posttraumatic Growth Inventory (PTGI) and the Brief Coping Orientations to Problems Experienced scale (Brief COPE) were assessed 3, 6 and 12 months later. The Brief COPE included 3 factors: self-sufficient coping, socially-supported coping and avoidant coping. Each was assumed to associate with PTG differently. \n Results of the current study were as follows:\n 1. Younger patients or women of higher education level reported more PTG, self-sufficient coping and socially-supported coping at T1. \n 2. The reciprocal relation was found between self-sufficient coping and PTG within 6 months postsurgery, which indicated the positive effect of T1 self-sufficient coping on T2 PTG, as well as the reciprocal effects of T1 PTG on T2 self-sufficient coping.\n 3. Higher level of PTG at T2 predicted more socially-supported coping at T3.\n 4. 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國立政治大學
心理學研究所
99752002
102資料來源 http://thesis.lib.nccu.edu.tw/record/#G0997520021 資料類型 thesis dc.contributor.advisor 許文耀 zh_TW dc.contributor.author (作者) 錢映融 zh_TW dc.creator (作者) 錢映融 zh_TW dc.date (日期) 2013 en_US dc.date.accessioned 29-七月-2014 16:11:08 (UTC+8) - dc.date.available 29-七月-2014 16:11:08 (UTC+8) - dc.date.issued (上傳時間) 29-七月-2014 16:11:08 (UTC+8) - dc.identifier (其他 識別碼) G0997520021 en_US dc.identifier.uri (URI) https://ah.lib.nccu.edu.tw/item?item_id=76258 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 心理學研究所 zh_TW dc.description (描述) 99752002 zh_TW dc.description (描述) 102 zh_TW dc.description.abstract (摘要) 本研究主要目的在探討不同治療階段中創傷後成長與因應策略之關係。由於過去創傷後成長與因應策略之間的研究，均是將創傷後成長視為個體因應後的結果，而忽略創傷後成長的經驗對個體的影響，因此本研究透過雙面神模式的理論，以更多元的角度來檢視「創傷後成長」，並將追蹤三個時間點，根據不同治療階段進一步提出三個假設模式，並採用交叉延宕分析（Cross-lagged analyses）來檢驗。\n 研究方法採立意取樣，以中部某教學醫學之乳房中心的乳癌患者為對象，共262 人，蒐集患者之「基本資料」、「創傷後成長」及「因應策略」，並在術後三個月、術後六個月及術後一年進行問卷調查。資料分析以探索性因素分析將因應策略分為三個因素：「自我導向因應」、「社會導向因應」及「逃避因應」，並與創傷後成長進行交叉延宕分析。\n 研究主要發現如下：（一）診斷時年齡愈小及教育程度愈高者，可以預測術後三個月較高的「自我導向因應」、「社會導向因應」及「創傷後成長」；（二）術後三個月到六個月之間，「自我導向因應」與「創傷後成長」呈現互惠關係，即術後三個月較高的「自我導向因應」可以預測術後六個月較高的「創傷後成長」，而術後三個月較高的「創傷後成長」也可以預測術後六個月較高的「自我導向因應」；（三）術後六個月的「創傷後成長」可以預測術後一年的「社會導向因應」，即在術後六個月時「創傷後成長」愈高，可以預測後續較高的「社會導向因應」；（四）三個時間點中，「逃避因應」均無法預測「創傷後成長」，「創傷後成長」亦無法預測「逃避因應」。\n最後將根據研究結果提出其貢獻與實務運用，並依據研究限制提出相關建議，以供臨床工作者與未來研究學者參考。 zh_TW dc.description.abstract (摘要) This study is aimed to investigate the relationships between coping strategies and Posttraumatic Growth (PTG) on three different timing of the breast cancer treatment. According to Janus-Faced Model, PTG is assumed as both a coping effort and a coping result. In order to investigate the possible relationships between coping strategies and PTG, three hypothetic models were proposed and tested by cross-lagged analyses.\n By purposive sampling, 262 participants were recruited from the breast center unit at a hospital in central Taiwan. Demographic and disease-related information were gathered after surgery. The Posttraumatic Growth Inventory (PTGI) and the Brief Coping Orientations to Problems Experienced scale (Brief COPE) were assessed 3, 6 and 12 months later. The Brief COPE included 3 factors: self-sufficient coping, socially-supported coping and avoidant coping. Each was assumed to associate with PTG differently. \n Results of the current study were as follows:\n 1. Younger patients or women of higher education level reported more PTG, self-sufficient coping and socially-supported coping at T1. \n 2. The reciprocal relation was found between self-sufficient coping and PTG within 6 months postsurgery, which indicated the positive effect of T1 self-sufficient coping on T2 PTG, as well as the reciprocal effects of T1 PTG on T2 self-sufficient coping.\n 3. Higher level of PTG at T2 predicted more socially-supported coping at T3.\n 4. Within 1 year postsurgery, there were no significant cross-lagged effects between avoidant coping and PTG, but only autoregressive correlations within constructs over time.\n Implications of these findings are discussed, along with potential directions for future research. en_US dc.description.tableofcontents 第一章 緒論..........................................1\n\n第二章 文獻探討.......................................5\n第一節 乳癌的特性.....................................5\n第二節 創傷後成長.....................................12\n第三節 創傷後成長與因應................................22\n第四節 研究假設及架構..................................26\n\n第三章 研究方法......................................28\n第一節 參與者........................................28\n第二節 收案程序......................................29\n第三節 研究工具......................................30\n第四節 資料分析......................................33\n\n第四章 研究結果......................................34\n第一節 描述統計與相關分析..............................34\n第二節 交叉延宕分析...................................39\n\n第五章 研究討論....................... ..............54\n第一節 前置變項與創傷後成長及因應策略之關係...............54\n第二節 交叉延宕分析...................................54\n第三節 研究貢獻與限制.................................59\n\n參考文獻……….........................................61\n一、中文部分.........................................61\n二、英文部分.........................................62\n\n附錄……………..........................................71\n附錄一 問卷.........................................71\n附錄二 自我導向因應與創傷後成長之結構方程模式圖－含修正殘差估計值（標準化解）...75\n附錄三 社會導向因應與創傷後成長之結構方程模式圖－含修正殘差估計值（標準化解）...76\n附錄四 逃避因應與創傷後成長之結構方程模式圖－含修正殘差估計值（標準化解）......77 zh_TW dc.format.extent 14935368 bytes - dc.format.mimetype application/pdf - dc.language.iso en_US - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0997520021 en_US dc.subject (關鍵詞) 乳癌 zh_TW dc.subject (關鍵詞) 創傷後成長 zh_TW dc.subject (關鍵詞) 因應策略 zh_TW dc.subject (關鍵詞) 交叉延宕分析 zh_TW dc.subject (關鍵詞) breast cancer en_US dc.subject (關鍵詞) posttraumatic growth en_US dc.subject (關鍵詞) coping en_US dc.subject (關鍵詞) cross-lagged analyses en_US dc.title (題名) 以交叉延宕分析探討乳癌患者的創傷後成長與因應策略之關係 zh_TW dc.title (題名) The Relationships Between Coping Strategies and Posttraumatic Growth Among Women With Breast Cancer: A Cross-lagged Analyses en_US dc.type (資料類型) thesis en dc.relation.reference (參考文獻) 一、中文部分\n李作英、周桂如、穆佩芬、李惠玲、葉美玲（2012）。初診斷乳癌婦女其壓力感受。腫瘤護理雜誌，12，25-36。\n李靜雯（2002）。乳癌病患手術後一個月之症狀困擾和情緒狀態之改變及其相關性。台北醫學院護理學研究所碩士論文，未出版，台北市。\n邱皓政（民95）。結構方程模式：LISREL的理論、技術與應用。台北市：雙葉。\n許玉雲、陳彰惠（1999）。身體心像概念分析。護理雜誌，46，103-109。\n張金堅、吳清山（2007）。乳房診治照護全書。台北市：原水文化。\n陳美芳（2002）。乳癌手術後婦女症狀困擾與因應策略之相關研究。陽明大學臨床護理研究所碩士論文，未出版，台北市。 \n陳美芳、馬鳳歧（2004）。乳癌手術後婦女症狀困擾與因應策略之相關性探討。護理雜誌，51，37-43。\n陳惠美、馬鳳歧、郭英調、石宜銘（1999）。乳癌術後婦女身心社會調適之探討－以羅氏適應模式為基礎。護理研究，7，321-330。\n葉秀宇（2007）。乳癌存活者的壓力因應歷程之探索性研究。國立臺灣大學心理學研究所碩士論文，未發表，台北。\n癌症登記報告（99年版）【資料檔】。台北市：行政院衛生福利部國民健康署。\n蔡宜樺、楊銘欽、季瑋珠（1998）。乳癌確診之初期罹病成本與相關因子之探討-以台大醫院病患為例。中華衛誌，17，242-251。\n \n二、英文部分\nAlbert, S. 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