心理衛教暨身心靈賦能團體治療對台灣男性憂鬱症患者成效之初探

The Preliminary Study of Efficacy of Psychoeducational With Body-mind-spirit Empowerment Group Therapy Among Taiwanese Men With Depressive Disorders

黃國峰(Kuo-Feng Huang)

指導教授 ： 蕭妃秀

臺北醫學大學/護理學院/護理學研究所/碩士(2006年)

摘要

本研究的目的是要探討心理衛教暨身心靈賦能團體對改善男性憂鬱症患者的憂鬱症狀、生活品質及門診規則返診的成效，以及了解男性憂鬱症患者對團體效果之主觀經驗。 本研究採用類實驗法(Quasi-experimental design)，自民國94年1月28日至94年7月30日以立意取樣方式將36位門診憂鬱症患者分為實驗組與控制組，實際完成者實驗組13人、控制組13人，實驗組接受8週每次約120分鐘團體治療的介入措施及精神科藥物治療，控制組僅接受精神科藥物治療，兩組成員在參與研究前後皆接受「貝克憂鬱量表」及「生活品質量表」之測量，並經由病歷確認門診規則返診之情形。實驗組個案在最後一次團體時參與半結構式會談的方式瞭解他們對團體治療效果的主觀經驗。 實驗組與控制組憂鬱症狀與生活品質之組間比較採Wilcoxon-Mann- Whitney rank sum test統計方法，結果發現兩組在減輕憂鬱症狀(Z = -3.746，p < 0.001)以及改善生活品質(Z = -3.438，p = 0.001)達顯著差異。結果顯示實驗組較控制組改善憂鬱症狀和提高生活品質。根據Fisher’s Exact test檢定，門診規則返診在兩組間並無顯著差異(X2 = 0.688，p = 0.344)，結果顯示兩組對規則返診重要性態度接近，間接推論兩組或許對規則服藥態度也相似。個案分享自團體的獲益經質性分析可歸納為六個範疇：情緒宣洩、指導、自我瞭解、人際學習—付出、普同感及團體凝聚力，這些範疇說明團體治療療效因子的產生如何幫助男性憂鬱患者的心理及人際問題。 心理衛教暨身心靈賦能團體可改善憂鬱症狀及提升生活品質的效果，合併精神科醫師治療及心理衛教暨身心靈賦能團體治療，可以增進門診憂鬱症患者之照護品質。

關鍵字

憂鬱症 ； 心理衛教團體 ； 身心靈賦能團體治療 ； 生活品質 ； 療效因子 ； 男性門診患者

並列摘要

Aims. This study aims to understand the effects of psychoeductional with body-mind-spirit empowerment group therapy on reducing depression and increasing quality of life among Taiwanese men with depressive disorders. In addition, this study examines group participants’ views on what aspects of group therapy worked to help their psychological and interpersonal problems. Methods. This study is a quasi-experimental design. Subjects were recruited from outpatient department of psychiatry from 28/01/2005 to 30/07/2005. This subjects were purposively assigned into experimental group and control group. Thirteen subjects were in experimental group and thirteen subjects were in control group. The subjects in control group received usual care of physican’s treatment at the outpatient department. In addition to usual care, the subjects in experimental group received 8 sessions of weekly group therapy of 120 minutes each. The outcome variables including symptoms of depression and quality of life were evaluated at baseline (pre-treatment) and post treatment. The rate of adherence to scheduled outpatient appointment was collected through medical chart. Data were analyzed using nonparametric statistics. The subjects in experimental group were invited to participate in a semi-structured interview regarding their perceptions of the change mechanisms in the group therapy. Results. The result of Wilcoxon-Mann-Whitney rank sum test indicated that there were significant differences in reducing depression (Z = -3.746，p < 0.001)and improving quality of life (Z = -3.438，p = 0.001) between experimental group and control group. The result suggested that subjects in experimental group appeared to have a better reduction of depression and improvement of quality of life. According to Fisher’s Exact test, there was no significant difference in rate of adherence to scheduled outpatient appointments (X2 = 0.688，p = 0.344) between two groups. The result suggested that there was a similarity of compliance to scheduled outpatient appointments. Therefore both subjects’ attitudes toward compliance of medication might be similar. The qualitative analysis yielded six domains: (1) catharsis, (2) imparting of information, (3) self understanding, (4) interpersonal output, (5) universality, and (6) group cohesiveness. These domains illustrate how the curative factors worked to help male depression patients’ psychological and interpersonal problems. Conclusions. The psychoeductional with body-mind-spirit empowerment group therapy could improve symptoms of depression and quality of life. Combination physcian’s treatment and psychoeductional with body-mind-spirit empowerment group could improve quality of care for outpatient with depression therapy.

並列關鍵字

depression ； psychoeductional with body-mind-spirit empowerment group ； quality of life ； curative factor ； male outpatient

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