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題名 初診斷乳癌患者創傷後成長與因應策略的關係之長期追蹤研究
A Longitudinal Study of the Relationship between Posttraumatic Growth and Coping Strategies in First-diagnosed Breast Cancer Patients
作者 劉尹臻
貢獻者 許文耀
劉尹臻
關鍵詞 乳癌
創傷後成長
因應
潛在成長模式
breast cancer
posttraumatic growth
coping
latent growth model
日期 2015
上傳時間 27-Jul-2015 11:29:11 (UTC+8)
摘要 本研究之目的是檢驗因應與創傷後成長隨時間變化的相互關聯性，除了重複驗證因應與創傷後成長的時序關係之外，考量創傷後成長不同向度之間可能具有不同特性，本研究也進一步探討不同向度的創傷後成長與不同因應向度之間的關係是否有所差異。創傷後成長方面，除了將創傷後成長視為單一構念之外，以Ho等人(2013)針對台灣女性乳癌樣本之因素分析結果為基礎，將創傷後成長初步分為個體內PTG與個體間PTG；因應向度方面，則根據探索性因素分析之結果將因應策略分為自我導向式因應、社會導向式因應和逃避因應等三個因應向度。
本研究採用縱貫研究法，針對中部某教學醫院之初診斷女性乳癌患者進行為期兩年的追蹤研究，分別在術後三個月(T1)、術後半年(T2)、術後一年(T3)以及術後兩年(T4)進行調查，測量參與者在癌症壓力之後所使用的因應策略及創傷後成長，最後完成四個時間點測量的研究參與者共283人。統計分析方法方面，因考量因應與創傷後成長會隨時間而變動的可能性，故採用適合縱貫資料且能估計變項發展軌跡的潛在成長模式 (Latent growth model) 來進行資料分析。
研究結果顯示不同向度的因應與不同向度的創傷後成長之間關聯性不同，但此差異是反映在不同因應向度之間，至於相同因應與不同向度PTG之間的結果則無太大差異：在測量初始點，不管是哪一種因應方式，都跟整體PTG、不同向度PTG具有交互預測的關係，但在斜率方面，只有自我導向因應與整體PTG以及不同向度的PTG具有相互預測性。但是否區分個體內PTG和個體間PTG，對於因應與創傷後成長之關聯性結果差異不大。過去對於PTG是單一構念或多因素的爭論方興未艾，後續討論也納入是否有必要區分創傷後成長不同向度的必要性，最後討論本研究之限制，並提供未來研究可供參考之方向。
Aims: The purpose of this article was to examine the time-varying reciprocal relationships between coping and posttraumatic growth (PTG) as well as their domains. PTG was divided into two dimensions－intrapersonal PTG (intra-PTG) and interpersonal PTG (inter-PTG) as suggested in Ho et al. (2013) while coping was divided into self-sufficient coping, socially-supported coping, and avoidant copingbased on the results of our exploratory factor analysis (EFA).
Methods: Participants were Taiwanese women underwent surgery for breast cancer. Measures of PTG and coping were assessed at three-month, six-month, one-year and two-year. Of the 358 women who were recruited, 283 completed all four measures and were included in the analyses. As coping and PTG may change over time, the data was analyzed using latent growth curve model (LGM).
Results: Our results showed that there’re different relationships between coping strategies and PTG dimensions. At the initial measure, all kinds of coping strategies have a reciprocal relationship with PTGs, but when it comes to the directions between slopes of coping and PTG, only self-sufficient coping has a reciprocal relationship with PTG. There’s almost no difference while comparing different PTG dimensions models. In other words, there’s almost no difference in LGM models between intra-PTG and inter-PTG. In the end of the study, the necessity of the division of PTG and limitations of this study were discussed.
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描述 碩士
國立政治大學
心理學研究所
100752020
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0100752020
資料類型 thesis
dc.contributor.advisor 許文耀zh_TW
dc.contributor.author (Authors) 劉尹臻zh_TW
dc.creator (作者) 劉尹臻zh_TW
dc.date (日期) 2015en_US
dc.date.accessioned 27-Jul-2015 11:29:11 (UTC+8)-
dc.date.available 27-Jul-2015 11:29:11 (UTC+8)-
dc.date.issued (上傳時間) 27-Jul-2015 11:29:11 (UTC+8)-
dc.identifier (Other Identifiers) G0100752020en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/76906-
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) 100752020zh_TW
dc.description.abstract (摘要) 本研究之目的是檢驗因應與創傷後成長隨時間變化的相互關聯性，除了重複驗證因應與創傷後成長的時序關係之外，考量創傷後成長不同向度之間可能具有不同特性，本研究也進一步探討不同向度的創傷後成長與不同因應向度之間的關係是否有所差異。創傷後成長方面，除了將創傷後成長視為單一構念之外，以Ho等人(2013)針對台灣女性乳癌樣本之因素分析結果為基礎，將創傷後成長初步分為個體內PTG與個體間PTG；因應向度方面，則根據探索性因素分析之結果將因應策略分為自我導向式因應、社會導向式因應和逃避因應等三個因應向度。
本研究採用縱貫研究法，針對中部某教學醫院之初診斷女性乳癌患者進行為期兩年的追蹤研究，分別在術後三個月(T1)、術後半年(T2)、術後一年(T3)以及術後兩年(T4)進行調查，測量參與者在癌症壓力之後所使用的因應策略及創傷後成長，最後完成四個時間點測量的研究參與者共283人。統計分析方法方面，因考量因應與創傷後成長會隨時間而變動的可能性，故採用適合縱貫資料且能估計變項發展軌跡的潛在成長模式 (Latent growth model) 來進行資料分析。
研究結果顯示不同向度的因應與不同向度的創傷後成長之間關聯性不同，但此差異是反映在不同因應向度之間，至於相同因應與不同向度PTG之間的結果則無太大差異：在測量初始點，不管是哪一種因應方式，都跟整體PTG、不同向度PTG具有交互預測的關係，但在斜率方面，只有自我導向因應與整體PTG以及不同向度的PTG具有相互預測性。但是否區分個體內PTG和個體間PTG，對於因應與創傷後成長之關聯性結果差異不大。過去對於PTG是單一構念或多因素的爭論方興未艾，後續討論也納入是否有必要區分創傷後成長不同向度的必要性，最後討論本研究之限制，並提供未來研究可供參考之方向。		zh_TW
dc.description.abstract (摘要) Aims: The purpose of this article was to examine the time-varying reciprocal relationships between coping and posttraumatic growth (PTG) as well as their domains. PTG was divided into two dimensions－intrapersonal PTG (intra-PTG) and interpersonal PTG (inter-PTG) as suggested in Ho et al. (2013) while coping was divided into self-sufficient coping, socially-supported coping, and avoidant copingbased on the results of our exploratory factor analysis (EFA).
Methods: Participants were Taiwanese women underwent surgery for breast cancer. Measures of PTG and coping were assessed at three-month, six-month, one-year and two-year. Of the 358 women who were recruited, 283 completed all four measures and were included in the analyses. As coping and PTG may change over time, the data was analyzed using latent growth curve model (LGM).
Results: Our results showed that there’re different relationships between coping strategies and PTG dimensions. At the initial measure, all kinds of coping strategies have a reciprocal relationship with PTGs, but when it comes to the directions between slopes of coping and PTG, only self-sufficient coping has a reciprocal relationship with PTG. There’s almost no difference while comparing different PTG dimensions models. In other words, there’s almost no difference in LGM models between intra-PTG and inter-PTG. In the end of the study, the necessity of the division of PTG and limitations of this study were discussed.		en_US
dc.description.tableofcontents 摘要 i
Abstract ii
表目錄 v
圖目錄 vi
第一章　緒論 1
第二章　文獻回顧 6
第一節　創傷後成長 6
第二節　影響創傷後成長的因素 13
第三節　因應與創傷後成長 16
第四節　研究問題與假設 23
第三章　研究方法 26
第一節　研究參與者 26
第二節　研究程序 29
第三節　研究工具 30
第四節　資料處理與統計分析 35
第四章　研究結果 41
第一節　描述統計與相關分析 41
第二節　潛在成長模式分析 48
第五章　討論 73
第一節　因應與整體PTG的關聯性 73
第二節　因應與不同向度PTG的關聯性 75
第三節　創傷後成長的自我預測性 78
第四節　研究貢獻、限制及未來研究方向 79
參考文獻 82
附錄 91
附錄：研究工具 91		zh_TW
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dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0100752020en_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zh_TW
dc.subject (關鍵詞) 潛在成長模式zh_TW
dc.subject (關鍵詞) breast canceren_US
dc.subject (關鍵詞) posttraumatic growthen_US
dc.subject (關鍵詞) copingen_US
dc.subject (關鍵詞) latent growth modelen_US
dc.title (題名) 初診斷乳癌患者創傷後成長與因應策略的關係之長期追蹤研究zh_TW
dc.title (題名) A Longitudinal Study of the Relationship between Posttraumatic Growth and Coping Strategies in First-diagnosed Breast Cancer Patientsen_US
dc.type (資料類型) thesisen
dc.relation.reference (參考文獻) 王韋婷（2014），初診斷乳癌患者創傷後成長與心理適應的關係之長期追蹤研究－從創傷後成長異質性變化軌跡的觀點探討。國立政治大學心理學研究所博士論文，未出版，台北市。
台灣精神醫學會（2014），《DSM-5精神疾病診斷準則手冊》。台北︰合記。
行政院衛生福利部（2014）。民國102年主要死因分析。台北：行政院衛生福利部。
余民寧（2014）。縱貫性資料分析：LGM的應用。台北：心理。
錢映融（2014），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。國立政治大學心理學研究所碩士論文，未出版，台北市。
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