- 學位論文
目標調適量表之發展：癌症患者目標調適、情緒因應、罹癌影響知覺、與情緒適應間相關之探討
The development of Goal Adjustment Scale: A study of the relationships among goal adjustment, emotional coping, perceived of cancer influence and emotional adaption in cancer patients
摘要
罹患癌症對於患者而言是一個重大事件，除了身體健康之外，可能衝擊患者的生命目標，從過去研究可了解，個體能夠停止投入無法達成的目標，且重新投入新的目標，對其幸福感與情緒適應有正面的影響(Wrosch, Scheier, Miller, Schulz, & Carver, 2003)。提升患者的情緒適應與生活品質甚至進而影響其預後的存活率與復發機率(Gotay, Ransom, & Pagano, 2007)。本研究欲檢視C. Wrosch, et al. (2003)所發展的目標調適量表---停止投入與重新投入分量表之信效度，尤其是探討目標調適與疾病適應之間的關聯，並加入重要生活領域的概念，了解癌症患者目標調適的歷程，協助未來臨床介入與情緒理論發展。 本研究為調查研究，立意取樣於南部某醫學中心進行收案，邀請97位罹患癌症之患者，並於知情同意後，參與填寫情緒適應、癌症影響、情緒調節策略與目標相關問卷。 根據分析結果，目標重新投入分量表具良好的信效度，停止投入分量表信效度較差。目標調適、情緒因應、罹癌影響知覺與情緒適應的相關則顯示：若能重新投入新目標、增加各方面目標投入愈佳，則個體愈知覺到罹癌的正面影響，以及愈會使用適應性的情緒調節策略，情緒適應愈佳；反之，個體愈減少各方面目標的投入度，則愈知覺到罹癌負面影響，愈會使用不適應性的情緒調節策略，情緒適應愈不佳。停止投入目標與癌症影響、情緒因應之關係未符合預期，將進一步探討其原因。在生活領域目標方面，則顯示個體罹癌後目標的投入與重視程度愈高，則其疾病適應愈佳。透過上述結果，不同的目標調適策略對其情緒適應效果不同，臨床工作者協助癌症患者重新探索與投入新的生命目標，有助於增進患者的適應與生活品質。
並列摘要
Being ill with cancer comes with severe effects. It impacts patients’ goals of life in addition to their physical health. The research shows that individuals are able to disengage from unattainable goals and reengage in new goals can be beneficial to psychological well-being(C. Wrosch, et al., 2003). Enhancing patient’s emotional adjustment and quality of life will affect their prognosis and recurrence probability(Gotay, et al., 2007). Therefore, this study will discuss the reliability and validity of the Goal Adjustment Scale (including disengagement and reengagement subscale), and the relationships among goal adjustment, coping, perception of cancer influence and emotional adaption. This study also adds in the concept of significant areas of life and goal adjustment to develop the goal adjustment process. It will develop clinical intervention and emotional theory in cancer patients. The present study is a survey research, using purposive sampling. Ninety-seven cancer patients were referred by physicians, or recruited in an outpatient cancer center of a southern Taiwan medical hospital. Patients were invited to complete the questionnaires in the waiting area, with informed consent. According to the analysis results, the goal reengagement subscale has good reliability and validity, and disengagement subscale has fair reliability and validity. When individuals more able to disengage from unattainable goals, reengage new goals, increase goal engagement, avoid decreasing goal engagement, the better emotional adaption. The individuals will aware positive effect and use the better emotion regulation strategies, if individuals more able to reengage new goals, increase goal engagement, better goal engagement change. Individuals reduce more goal engagement, the more aware of the negative impact, as well as using poor emotion regulation strategies. However, the relationship among goal disengagement, cancer effects, and emotion regulating strategies do not meet the hypothesis. If cancer patients more engage and emphasis the goals after diagnosis, the better adjustment. Through these results, there are different effects on emotional adjustment by different goal adaptation strategies. The clinical workers can help cancer patients re-exploring and engaging new goals to enhance adaptation and quality of life of patients.
參考文獻
延伸閱讀
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