乳癌婦女的創傷後成長對其安適感之影響：手術距今時間、診斷期數及人格特質可能的調節角色

The effects of Posttraumatic Growth on Well-Being and Moderating Roles of Time since Surgery, Stage of Disease and Personality Traits in Women with Breast Cancer

王藝陵(Yi-Lin Wang)

指導教授 ： 陳淑惠

國立臺灣大學/理學院/心理學研究所/碩士(2010年)

https://doi.org/10.6342/NTU.2010.01373

摘要

乳癌婦女的創傷後成長對其安適感之影響：
手術距今時間、診斷期數及人格特質可能的調節角色

摘要
創傷後成長（Posttraumatic growth）是指個體在和創傷或高壓力事件奮鬥歷程裡，所經驗到的正向改變。然而，在實證研究裡，如此正向的經驗卻與個體主觀安適感缺乏一致的關聯性。故本研究針對一群經歷過乳癌創傷事件的婦女，探討影響創傷後成長與安適感間相關性的可能因素（如: 調節變項），期許能更廣泛地瞭解創傷後成長的現象，特別是在它對個體安適感的影響。本研究提出四個可能的假設。首先，相較於手術距今時間少於兩年的婦女，當手術距今時間超過2年時，創傷後成長會與安適感呈現較強且較正向的關聯性。第二，對於診斷期數較嚴重的婦女，創傷後成長會與較低安適感（如: 較低生活滿意度和較高的創傷壓力症狀與憂鬱症狀）相關。第三，相較於人格特質較內向的婦女，人格特質較外向的婦女所知覺到的創傷後成長會與較佳安適感相關聯；相較於低神經質的婦女，高神經質的婦女所知覺到創傷後成長會與較差安適感相關。最後，相較於經驗到中等程度創傷後成長的婦女，經驗到低或高程度創傷後成長的婦女將報告較佳的安適感；此意涵著創傷後成長與安適感間的相關性為曲線相關。
此研究為橫斷性研究設計，有效樣本為281位乳癌婦女，選自於乳癌防治基金會或台大醫院。每位受試者均先由外科醫師轉介，在同意參與研究後，請受試者填寫一系列的量表。
基於創傷後成長量表之探索性因素分析的結果，在資料分析裡，創傷後成長不僅以總分進行分析，同時也將它解構為兩個子因素（內在成長與人際成長）加以分析。本研究發現:
1. 手術距今時間僅發現一個調節效果，但卻與預期不符，結果顯現只有在手術距今少於兩年的婦女身上，人際成長與創傷後壓力症狀呈顯著負相關，對於手術距今時間超過兩年的婦女則無顯著相關。
2. 診斷期數與外向性的人格特質並未調節成長與安適感間的關聯性。
3. 神經質的人格特質被證實是成長與安適感間可能的調節變項，不過，仍與假設不符。成長與生活滿意度呈正相關，但如此的關聯性在高神經質的婦女身上更為顯著；此外，成長與憂鬱呈負相關，但僅發生於具有高神經質的婦女身上，對於低或中等神經質的婦女則無顯著相關。
4. 研究結果部份支持成長與安適感呈現曲線相關。相較於知覺到中等程度成長的婦女，知覺到低或高程度成長的婦女傾向報告較少的創傷後壓力症狀與憂鬱症狀。不過，如此的現象並沒有出現在成長與生活滿意度之間的關聯性。
上述結果可能的含意將進一步與過去研究一同討論，並提出未來研究建議。

關鍵詞：創傷後成長、安適感、乳癌、手術距今時間、診斷期數、外向性、神經質、曲線相關。

關鍵字

創傷後成長 ； 安適感 ； 乳癌 ； 手術距今時間 ； 診斷期數 ； 外向性 ； 神經質 ； 曲線相關

並列摘要

The Effects of Posttraumatic Growth on Well-Being and Moderating Roles of Time since Surgery, Stage of Disease and Personality Traits in Women with Breast Cancer

Yi-Lin Wang

Abstract
Posttraumatic growth (PTG) refers to the experiences of positive changes that result from struggling with a trauma or highly stressful event. However, among empirical studies, such positive experiences were hard to found a consistent association with well-being. Therefore, this research was aimed to investigate possible factors which may moderate or affect the relations of posttraumatic growth (PTG) to well-being in a sample of breast cancer (BC) women in Taiwan. It is hoped that the evidence from this research will further our understanding of the phenomenon of PTG more generally, and the association between PTG and well-being more particularly. Four hypotheses have been proposed. Firstly, stronger PTG would relate to greater well-being (e.g., higher life satisfaction, and lower PTSD symptoms and depression) when time since surgery is over 2 years. Secondly, PTG would associate with less well-being (e.g., lower life satisfaction, and higher PTSD symptoms and depression) for BC women with more severe disease stage. Thirdly, among extraverted women, PTG would correlate with higher well-being than introverts; in contrast, for women who have high neuroticism, PTG would associate with less well-being than those with low on neuroticism. Finally, women who perceived low or high level of PTG would report greater well-being than those with intermediate level of PTG, which implies a curvilinear association between PTG and well-being.
This is a cross-sectional research design. Total valid sample of BC women with surgery was 281, recruited from the Foundation of Breast Cancer Prevention and Treatment or National Taiwan University Hospital. Each participant was referred from a surgical physician, and after agreeing to take part in this study, they were then given a series of questionnaires.
According to the result of exploratory factor analysis for posttraumatic growth scale, PTG was analyzed not only as a total score, but also deconstructed into intra- and inter-personal growth. Results of the current study indicate that:
1. One moderating effect of time since surgery was found. It revealed that intrapersonal growth was associated with less PTSD symptoms only for women who had surgery within 2 years, but non-significantly for those with time since surgery over 2 years.
2. Stage of disease and Extraversion did not moderate the relationship between growth and well-being.
3. Neuroticism was found to be a possible moderator of the association between PTG and well-being. However, it was contradictory to expectation. Growth related more positively to life satisfaction for women with high level of neuroticism. Furthermore, PTG was correlated with less depression only for high neuroticism women, but non-significantly for those with moderate or low level of neuroticism.
4. Curvilinear relationship between PTG and well-being was partially supported. Women who perceived low or high level of PTG tended to report less PTSD symptoms and depression than those who had intermediate PTG, but such phenomenon was not observed in the association between PTG and life satisfaction.
The implications of these findings are discussed in relation to previous research, and suggestions for future research are further recommended.

Keywords: Posttraumatic growth, Well-being, Breast cancer, Time since surgery, Stage of disease, Extraversion, Neuroticism, Curvilinear relationship.

並列關鍵字

Posttraumatic growth ； Well-being ； Breast cancer ； Time since surgery ； Stage of disease ； Extraversion ； Neuroticism ； Curvilinear relationship

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