自閉症類群疾患兒童母親親職壓力與憂鬱、絕望感和生活品質的關係：因應策略的中介和調節效果

研究目的：自閉症類群疾患（autism spectrum disorders, ASDs）兒童的家長有偏高的親職壓力，會妨礙個人健康，亦會干擾家庭功能和教養行為。因此，找出親職壓力適當的因應策略是一個重要議題。目前很少有研究針對年幼ASDs兒童的家長，探究其面對壓力的因應策略。本研究以5歲以下學齡前ASDs兒童之母親為對象，探究其因應策略在親職壓力與適應結果之間的影響。研究方法：受試者為93名ASDs兒童母親，兒童平均年齡約35個月。以親職壓力量表（Parenting Stress Index, PSI）和簡明因應量表（Brief Coping Orientations to Problems Experienced Scale, B-COPE）分別測量母親親職壓力與因應策略；以貝克憂鬱量表第二版中文版（Beck Depression Inventory-Second Edition, BDI-Ⅱ）、貝克絕望感量表中文版（Beck Hopelessness Scale, BHS）和台灣簡明版生活品質量表（World Health Organization Quality of Life-BREF, WHOQOL-BREF）分別測量母親憂鬱情緒、絕望感和生活品質。研究結果：（1）B-COPE分量表進行探索性因素分析，得到四個因素：社會支持因應、問題焦點因應、迴避轉移因應，及正向/宗教因應。（2）問題焦點因應與母親憂鬱情緒、絕望感呈現負相關，與生活品質呈現正相關；迴避轉移因應與憂鬱情緒、絕望感呈現正相關；正向/宗教因應與絕望感呈負相關，與生活品質正相關。（3）問題焦點因應策略，在親職壓力與生活品質之間具有部分中介效果；問題焦點因應於親職壓力與絕望感之間具調節效果。研究結論：本研究發現ASDs兒童母親採取逃避、分心的因應策略，與母親不良的適應結果有關；問題焦點因應能有效改善適應結果。本研究結果可作為未來臨床實務工作者提供ASDs兒童家長服務時的參考。

關鍵字

中介變項；自閉症類群疾患；因應策略；調節變項；親職壓力

並列摘要

Background and objectives：Parents of children with autism spectrum disorders (ASDs) experience higher levels of parenting stress, it would impede personal health, also interfere with family functioning and parenting behavior. Therefore, it is important issue to examine adaptive coping strategies for parenting stress. There are few studies investigated the coping strategies for parenting stress focusing on parents of young children with ASDs. The present study focuses on mothers of preschool children with ASDs under 5 years in Taiwan, and investigates the effect of coping strategy on the relationship between parenting stress and adaptational outcomes. Method：There were 93 mothers of children with ASDs whose average age were about 35 months old recruited in this study. The Parenting Stress Index (PSI) and Brief Coping Orientations to Problems Experienced Scale (B-COPE) were used for measuring the parenting stress and coping strategies. The Beck Depression Inventory-Second Edition (BDI-Ⅱ), Beck Hopelessness Scale (BHS) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) were used for measuring the depressed mood, the feelings of hopelessness and the quality of life of mothers. Result：(1)Exploratory factor analysis of B-COPE subscales identified four factors: social support coping, problem-focused coping, avoidance distraction coping, and positive / religion coping. (2)The problem-focused coping negatively correlated to the depressed mood and the feelings of hopelessness of mothers, and positively correlated to the quality of life. The avoidance distraction coping positively correlated to the depressed mood and the feelings of hopelessness. The positive / religion coping negatively correlated to the feelings of hopelessness, and positively correlated to the quality of life. (3)The problem-focused coping strategy was the partial mediator in the relationship between parenting stress and the quality of life. The problem-focused coping were moderating variables in the relationship between parenting stress and the feelings of hopelessness. Conclusion：This study found that taking escape and distraction coping strategies has adverse effects on the adaptive outcomes of mothers; the problem-focused coping can effectively improve the adaptive outcomes of mothers of children with ASDs. The results of this study can be used as a reference for clinical practitioners who can provide the service for the parents of children with ASDs in the future.