老年癌症患者憂鬱症狀、自尊、復原力及其相關因素探討

Depressive Symptoms, Self-Esteem, Resilience and Related Factors Among Older Adults With Cancer

楊蕙菱(HUI-LING YANG)

指導教授 ： 張秀如

臺北醫學大學/護理學院/護理學研究所/碩士(2009年)

摘要

本研究主要目的為（1）翻譯中文版復原力量表及檢定其信效度，（2）探討老年癌症患者憂鬱症狀、自尊及復原力之相關因素。採橫斷式研究設計，以臺灣北部某區域教學醫院血液腫瘤科門診、社區護理室以及北市某健康服務中心為研究場所，採立意取樣方式，共招募癌症患者共101位，社區民眾共60位。研究工具為結構式問卷，包括（1）個人基本資料表（2）簡易老年憂鬱量表（3）Rosenberg自尊量表（4）復原力量表。資料分析包括描述性統計、相關分析、獨立樣本t-檢定、卡方檢定、共變數分析、因素分析及多元迴歸分析等推論性統計以檢定各變項之相關性以及影響憂鬱症狀的主要影響因子。研究結果顯示「復原力量表」具有可接受的信效度指標。在排除人口學變項中之性別、教育程度及慢性病總數之影響後，老年癌症患者及社區民眾在憂鬱症狀及復原力具有顯著差異。癌症患者之合併症總數、自尊及復原力可做為預測憂鬱症狀之影響因子；而社區民眾之宗教信仰、慢性病總數、自尊及復原力為預測憂鬱症狀之影響因子。本研究結果可以提供臨床醫護人員探討老年癌症患者及社區民眾之心理健康狀態之參考，由於復原力對於老年人心理健康具有重要影響，心理健康方案應考量促進復原力之因素，以提昇老年人心理健康狀態。

關鍵字

老年癌症患者 ； 憂鬱症狀 ； 自尊、復原力 ； 信度 ； 效度

並列摘要

The major purposes of this study were to 1) translate the Resilience Scale (RS) into Chinese version and examine its reliability and validity, and 2) explore the predictors of depressive symptoms for older adults with cancer. A cross-sectional research design with convenience sampling technique was used in this study. Participants included 101 older adults with cancer recruited from one local teaching hospital in Taipei and 60 older adults without cancer recruited from community. A set of structured questionnaire was used that included: 1) Demographic and disease characteristics; 2) the Geriatric Depression Scale—short form; 3) the Rosenberg Self-Esteem Scale , and 4) the Resilience Scale. Data were analyzed by descriptive statistics, correlation, independent sample t-tests, Chi-square test, analysis of covariance, factor analysis, and multiple regression analysis. Results revealed that the Chinese version of the RS owned appropriate reliability and validity. After controlling for gender, education level and number of chronic illness, depressive symptoms and resilience differed significantly between older adults with cancer and their counterpart. Number of complication, self-esteem, and resilience significantly predicted depressive symptoms for older adults with cancer. Religious, number of chronic illness, self-esteem and resilience significantly predicted depressive symptoms for community older adults without cancer.
Results from this study could provide important implications to clinical staff for investigating mental health issues in older adults with cancer and community older adults without cancer. Due to the important effect of resilience on older adults, mental health strategy should incorporate the concept of resilience in order to enhance mental health for older adults.

並列關鍵字

Older adults with cancer ； Depressive symptoms ； Self-esteem ； Resilience ； Reliability ； Validity

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