華人憂鬱病患致病信念:以致中和宇宙觀理論探討

研究指出，病患對於自身疾病發生的信念，將影響他們後續對於疾病的求助行動、改變動機、因應方式、治療策略的選擇及治療結果有效性的評估。為評估並預測疾病治療過程及結果的有效性與可能碰到的阻礙，本研究旨在以華人傳統「致中和」宇宙觀理論為基礎，另結合國外文獻研究結果做為研究架構，來探討台灣憂鬱症患者對於自身疾病導致原因的想法內容，即致病信念。本研究針對67位南部某教學醫院精神科之20歲以上具有憂鬱症診斷病患，進行貝克憂鬱量表及開放性致病信念問卷的調查，最後針對問卷內容運用質性資料編碼及統計分析描述多項致病信念內容、出現頻率及與人口變項的相關性。研究結果支持本研究所提出的假設，無論是信念內容上或人口學變項上，台灣人對於憂鬱症的致病信念內容架構異於西方文化社會，但由於現代社會對於憂鬱症情感性疾患的逐漸重視加上西方醫療體系人員推動的相關心理疾病衛教工作，台灣人致病信念內容在依循華人致中和信念的脈絡下也融合了部分西方社會致病信念。

關鍵字

憂鬱症；致中和宇宙觀；致病信念

並列摘要

Researches indicate that the patients’ beliefs of their diseases affected their consequent help-seeking, motivation, coping strategies, treatment, and the outcome evaluation. For evaluating and predicting the effectiveness and possible obstacles, this study aimed to investigate depressed Taiwanese patients for the causes of beliefs for the occurrence of their diseases, based on Equilibrium and Harmony and foreign studies. This study enrolled 67 depressed patients aged over 20 from a Medical Center. Beck depression inventory and open questionnaire were used. Qualitative data encoding and statistical analyses were used to describe the beliefs and its occurrence frequency. The results supported the hypothesis that the content of Taiwanese patients’ beliefs about depression were different in the Western society. However, due to the increased values of depression and its psycho-education from Western training medical staff in our modern society, the beliefs of diseases in Taiwanese followed the content of Equilibrium and Harmony which synthesized partial beliefs of diseases from Western culture.