學齡前自閉症類群障礙症兒童父母親職壓力與心理健康的關係：因應策略的中介效果

The Relationships between parenting stress and mental health among mothers and fathers of preschool children with Autism Spectrum Disorder: Mediation of coping strategies

李孟怡(Meng-I Lee)

指導教授 ： 吳進欽

高雄醫學大學/人文社會科學院/心理學系碩士班/碩士(2021年)

摘要

研究背景與目的：自閉症類群障礙症（autism spectrum disorder, ASD）兒童父母的親職壓力及因應策略的使用，會影響其心理健康問題。過去較少研究比較ASD兒童父親與母親間因應策略使用，以及親職壓力與心理健康之差異。本研究以5歲以下學齡前ASD兒童之父母為對象，探究其因應策略在親職壓力與心理健康之間的中介效果。
研究方法：參與者為117對育有ASD兒童的父母親，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）分別測量父親與母親的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）和台灣簡明版生活品質量表（World Health Organization Quality of Life-BREF, WHOQOL-BREF）分別測量其憂鬱症狀和生活品質。
研究結果：（1）B-COPE分量表進行探索性因素分析，得到三個因素，分別為：問題焦點因應策略、分心因應策略及迴避因應策略。（2）因應策略使用方面，父親與母親皆較常使用問題焦點因應策略，母親在分心因應策略的使用顯著高於父親，而父親在迴避因應策略的使用顯著高於母親。（3）因應策略與心理健康相關性：父母雙方均為問題焦點因應策略與憂鬱症狀負相關，與生活品質正相關；迴避因應策略則與父母的憂鬱症狀正相關，與母親的生活品質負相關。（4）因應策略與親職壓力及心理健康間關係：問題焦點因應策略，在父親與母親的親職壓力與生活品質間，具有中介效果。
研究結論：學齡前ASD兒童父母親採取問題焦點因應策略能改善心 理健康問題，提升其生活品質。本研究結果比較父親與母親在教養ASD兒童中親職壓力、心理健康、與因應策略使用之差異，可作為臨床實務工作者提供ASD兒童家庭服務時的參考。

關鍵字

自閉症類群障礙症 ； 因應策略 ； 中介效果 ； 心理健康 ； 親職壓力

並列摘要

Background and purpose: Parents stress and coping strategies of children with autism spectrum disorder (ASD) have effects on their mental health (i.e. depressive symptoms and quality of life). However, fewer studies examined the difference between mothers and fathers of children with ASD. The present study investigated the mediations of coping strategies in the relationships between parenting stress and mental health among Taiwanese mothers and fathers of preschool children with ASD under 5 years.
Methods: The study recruited 117 pairs of mothers and fathers of children with ASD. Using the Parenting Stress Index (PSI) and Brief Coping Orientations to Problems Experienced Scale (B-COPE) to measure the parenting stress and coping strategies in parents of preschool children with ASD, respectively. In addition, the Beck Depression Inventory-Second Edition (BDI- II) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) were used for measuring the depressive symptoms and quality of life among parents of preschool children with ASD.
Results: The finding of the study showed: (1) Factor analysis identified three coping categories which we termed problem-focused coping, distraction coping, and avoidance coping. (2) The problem-focused coping was the most frequently reported by both mothers and fathers. The findings suggested that mothers use more distraction coping strategy than fathers, and fathers use more avoidance coping strategy than mothers. (3) The problem-focused coping negatively correlated to mothers’ and fathers’ depressive symptoms and positively correlated to mothers’ and fathers’ quality of life. In addition, the avoidance coping positively correlated to mothers’ and fathers’ depressive symptoms, and negatively correlated to mothers’ quality of life. (4) Finding the results revealed problem-focused coping mediated the association between parenting stress and quality of life among mothers and fathers of children with ASD.
Conclusion: This study investigated the mediation effects of coping and indicated the difference between stress, mental health and coping strategies in gender. Using problem-focused coping could buffer the impact of parenting stress on the quality of life among parents of children with ASD. The results of this study could provide implications for designing services for parents and families of children with ASD.

並列關鍵字

autism spectrum disorder ； coping strategies ； mediation ； mental health ； parenting stress

參考文獻

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