憂鬱之概念分析

Depression: A Concept Analysis

黃淑儀(Shu-Yi Huang) ； 宋惠娟(Huei-Chuan Sung)

《榮總護理》 33卷2期 (2016/06) Pp. 204-211

https://doi.org/10.6142/VGHN.33.2.204

摘要

世界衛生組織(World Health Organization, WHO)指出，2020年憂鬱症將是造成人類失能(disability)的第二大原因，因而被稱為「二十一世紀的癌症」。美國國家心理衛生研究院(National Institute of Mental Health, NIMH)前主席Lewis Judd亦指出憂鬱症是新世紀的黑死病(depression as the plague of the modern era)。憂鬱症的病因包含生物性、心理性、社會性三個層面，據臨床上推論，憂鬱症是由腦中神經傳導物質，如血清素(serotonin)、正腎上腺素(norepinephrine)或多巴胺(dopamine)不平衡所造成，而生活壓力事件、體質的脆弱性、支持系統功能不彰及性格因素等皆扮演一定的角色。憂鬱症不僅提高社會經濟成本，人類痛苦的代價更是無法估計，嚴重憂鬱症可以摧毀一個家庭以及患者的生命。本篇文章依據Walker及Avant (2011)的概念分析法，界定憂鬱症的定義性特徵及其發生的前因後果，列舉典型案例、邊緣案例、相關案例及相反案例，並介紹多個具信效度的測量工具以提供醫護人員即早篩檢憂鬱，透過概念分析，可有助於專業人員更瞭解憂鬱的概念及臨床運用。

關鍵字

憂鬱 ； 概念分析 ； 護理

並列摘要

The World Health Organization started that depression will be the second major cause of human disability by 2020. This condition has thus been called ＂the cancer of the 21st century.＂ Lowis Judd, the former chairman of the National Institute of Mental Health, confirmed depression to be the plague of the modern era. The causes of depression include biological, psychological, and social factors. Clinical inferences have indicated that depression results mainly from imbalances among neurotransmitters in the human brain, such as serotonin, norepinephrine, and dopamine. Several factors, such as stressful life events, physical vulnerability, dysfunctional support systems and personality also play crucial roles. Depression involves not only social and economic costs but also causes tremendous human suffering. Serious depression can destroy a family as well as the lives of patients. Using the concept analysis (CA) method developed by Walker and Avant (2011), we defi ned the characteristics of depression and the causes and effects of its occurrence. Typical, marginal, relevant, and opposite cases were also described and analyzed. Several valid and reliable screening tools were introduced to help health professionals conduct early screenings for depression in clinical settings. This concept analysis may assist health professionals in improving their understanding of depression and clinical application.

並列關鍵字

depression ； concept analysis ； nursing

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