壓力與健康：整合分析與模式驗證之研究

Stress and Health: A Meta-Analysis and Model Evaluation

邱兆宏(Chao-Hung Chiu)

指導教授 ： 余麗樺

高雄醫學大學/健康科學院/行為科學研究所/碩士(2004年)

摘要

本研究採用整合分析技術，結合國內關於壓力議題之期刊論文與博碩士論文進行分析，共477篇。由於壓力與健康乃多面向的構念，遂將該兩者各自切分成幾個構面來探討。在壓力方面，將之區分為客觀壓力、主觀壓力；另外，依生活事件發生的領域屬性，將之分為學生壓力、實習壓力、工作壓力、軍旅壓力、病痛壓力、照顧壓力、重大災難。在健康方面，則分為臨床構面、角色表現構面、適應構面、幸福構面，其中臨床構面又細分為心理層面與生理層面。藉此，以通盤地瞭解壓力與健康不同構面間的關聯程度，並探討人口學變項、研究層次變項在此關聯性中可能的調節作用。此外，本研究更援用結構方程模式的統計方法，檢驗本研究所提出之壓力—健康理論模式與得自實徵研究之整合分析資料間的適配程度。
研究結果顯示：（1）壓力與健康有中度偏高的關聯性。（2）各壓力構面與各健康構面間有不同程度的關聯性存在。（3）性別、年齡、婚姻狀況、教育程度、職業類別、社經地位、居處地域等人口學變項，以及發表年代、研究領域、發表型態、研究品質等研究層次變項，會共同調節壓力與健康的關聯性，且各自在此關聯性中具有其特異性。（4）本研究提出之壓力—健康理論模式經修正後，大致與整合分析結果所獲得的實徵資料相適配；此模式顯示出客觀壓力幾乎是需透過主觀壓力的中介作用才會對健康造成衝擊；另一方面，也呈現出因應方式、社會支持、人格特質等變項在壓力與健康間所扮演的角色。
本研究為壓力與健康之研究議題呈現出一個整體性的面貌，並為未來研究提供可參考的方向。

關鍵字

整合分析 ； 健康 ； 壓力

並列摘要

This study adopts meta-analysis technique to analyze 477 journal articles, theses, and dissertations on stress issues which have been investigated in Taiwan. Owing that stress and health are both multi-dimensional constructs, they are divided into several dimensions. Stress is divided into objective stress and subjective stress. According to the nature of life events, stress is further subdivided into student stress, practicum stress, work stress, stress of military service, illness stress, stress of caretakers, and stress of disaster experience. As for health, it is divided into clinical dimension, role-performance dimension, adaptive dimension, and eudemonistic dimension. Furthermore, clinical dimension is subdivided into psychological sub-dimension and physical sub-dimension. Thus, an overall understanding of the degree of relationship of different dimensions between stress and health, and possible moderation of demographic variables and study-level variables in the relationship can be obtained. Moreover, this study adopts statistical method of structure equation modeling to evaluate the degree of fitness between a proposed stress-health theoretical model and meta-analysis data obtained from this empirical study.
The results of this study reveal that: (a) the relationship between stress and health is medium to high. (b) distinct degrees of relationship exist in stress dimensions and health dimensions. (c) demographic variables—gender, age, marital status, level of education, occupation, socio-economic status, and where people live—and study-level variables—year of publication, field of study, type of publication, and quality of study—would mutually moderate the relationship between stress and health, and respectively exist the difference in this relationship as well. (d) the revised stress-health theoretical model approximately accords with empirical data from meta-analysis. This model shows that objective stress will cause impact on health almost by intermediary function of subjective stress; on the other hand, the model also reveals the roles that coping, social support, and personality play between stress and health.
This study presents a complete aspect of stress and health issues, and provides guiding references for future research.

並列關鍵字

meta-analysis ； health ； stress

參考文獻

邱啟潤、許淑敏、吳瓊滿（2002）。主要照顧者負荷、壓力與因應之國內研究文獻回顧。醫護科技學刊，4（4），273-290。

陳惠敏、王瑞霞（1999）。南部某護專三年級學生生活壓力事件、壓力症狀和社會支持系統。護理雜誌，46（6），45-56。

尹業珍（1994）。施虐父母與非施虐父母之童年經驗、社會支持、親職壓力與虐待兒童傾向之研究。文化大學兒童福利學系碩士論文，未出版，台北市。

王秀枝、吳英彰（1987）。生活事件、生活壓力及身心疾病的動力性關係。中華心理衛生學刊，3（2），155-170。

王秀紅（1999）。統合分析的概念及其在護理的應用。護理研究，7（2），183-191。