慢性病患者之死亡威脅、慢性病威脅與憂鬱：個人建構理論的觀點

Death Threat, Chronic Disease Threat, and Depression of Patients with Chronic Disease: The Viewpoint of Personal Construct Theory

鄭逸如(Yih-Ru Cheng) ； 吳治勳(Chih-Hsun Wu) ； 黃芸新(Yun-Hsin Huang)

《中華心理衛生學刊》 21卷1期 (2008/03) Pp. 51-73

https://doi.org/10.30074/FJMH.200803_21(1).0003

摘要

研究目的：探討慢性病與死亡對患者所造成的威脅及其與憂鬱之間的關係。研究方法：以個人建構理論的觀點為基礎，翻譯與編修根據此理論所設計的工具－威脅指標(the Threat Index)，以某醫學中心之家庭醫學部門診患者為對象收集與分析相關現象，初步探索慢性病患者是否可能在患病過程中經歷了建構的調整。研究結果：(1)慢性病組並未比無慢性病組自覺不健康及感到憂鬱。(2)慢性病組感受到的慢性病與死亡的威脅比無慢性病組低。(3)慢性病組雖能調適慢性病與死亡對真實自我造成的威脅，但理想中仍懷抱與慢性病有較大落差的理想自我，此落差越大，越覺得自己不健康。(4)無論是慢性病組或無慢性病組，都是自我實現的失落越大，主觀健康自評越低，也越憂鬱。研究結論：本研究結果初步支持個人建構理論，顯示慢性病患者可能在調適的過程中主動建構了自己的慢性病與死亡，因此減輕了慢性病與死亡的威脅以及憂鬱。

關鍵字

慢性病威脅 ； 死亡威脅 ； 憂鬱 ； 個人建構理論 ； 威脅指標

並列摘要

Purpose: Exploring the threat of disease and death and its relationship with depression. Methods: This study based on personal construct theory. The Threat Index scale, established on it, was modified and used on patients of Department of Family Medicine of a medical center. Results: (1) Relative to non-chronic disease group (Gnc), chronic disease group (Gc) did not evaluate themselves more unhealthy nor feel more depressed. (2) Threat related with chronic disease and death of Gc were lower than that of Gnc. (3) For Gc, subjective health rating negatively correlated with threat of chronic disease to preferred self. (4) Depression positively correlated with threat of preferred self for both groups. Conclusions: The results supported the viewpoint of personal construct theory. It also showed Gc possibly reconstrued their chronic disease and death, and less depressed than those without chronic disease.

並列關鍵字

chronic disease threat ； death threat ； depression ； personal construct theory ； Threat Index

參考文獻

Bannister, D.,Mair, J. M. M.(1986).The evaluation of personal constructs.London:Academic Press.

Brannon, H.(2004).Chronic physical pain and psychosocial-spiritual suffering: A holistic perspective.Dissertation Abstracts International: Section B: The Science & Engineering.64(11),5831.

Hendon, M. K.,Epting, F. R.(1989).A comparison of hospice patients with recovering and ill patients.Death Studies.13,567-578.

Kelly, G. A.(1995).The psychology of personal constructs.New York:W.W. Norton & Company.

Krieger, S. R.,Epting, F. R.,Hays, C. H.(1979).Validity and reliability of provided constructs in assessing death threat..Omega: Journal of Death and Dying.10,87-95.