壓力模式與壓力分析在家庭醫學部病人之應用：初探

The Application of Stress Model and Stress Analysis in Patients of the Department of Family Medicine: A Preliminary Study

鄭逸如(Yih-Ru Cheng) ； 呂碧鴻(Bee-Horng Lue) ； 陳秀蓉(Hsiu-Jung Chen) ； 李宇芬(Yu-Fan Lee) ； 吳英璋(En-Chang Wu) ； 陳慶餘(Ching-Yu Chen)

《臺灣家庭醫學研究》 Volume 1 Issue 1 (2003/10) Pp. 22-32

https://doi.org/10.29475/TFMR.200310.0003

Abstracts

隨著身心醫學的發展及疾病型態的轉變，1977年Engel提出之「生物心理社會模式」的醫療照顧廣受重視。由之衍生的「壓力模式」嘗試應用於臨床實務中，提供病患壓力衡鑑與調適之服務，根據研究結果，這項醫療服務具有具體的臨床效果。
某醫學中心家庭醫學部，在提供以壓力模式為基礎的壓力診療多年後，於1999年正式成立「身心諮商特別門診」。本研究即以此門診第一年之個案為對象，探討其身心壓力的現象。根據51位完整個案的分析，主要的研究結果如下：(1)以壓力模式為基礎的壓力分析確實可適切呈現壓力現象。(2)絕大多數個案都出現身心症狀；所有個案都有負向情緒；大約半數的個案完全不表達情緒或只做非常少的表達；半數以上的個案對情緒的處理不但未能解決問題，甚至反而使問題惡化。(3)壓力適應不良的發生是由生活事件以及環境與資源等外在因素，以及個人的內在因素共同決定。(4)絕大部分個案對目前壓力的不利認知都有泛化的現象，而有一部份個案則不能覺知或錯誤覺知所承受的壓力及其來源。(5)壓力模式在研究與臨床服務上，確實都是值得發展及應用的實務架構。

Parallel abstracts

Along with the development of psychosomatic medicine and the changes of disease pattern, George Engel's biopsychosocial model has been emphasized in medical health care. In Taiwan, researchers started to develop the stress model from the biopsychosocial perspective since about ten years ago. Furthermore, the clinical application of stress assessment and management based on the stress model also showed its effectiveness in patient care.
For better patient care and to fulfill the social need, we set up a special clinic for stress assessment and counseling in the Department of Family Medicine in a medical center in January, 1999 We conducted this study by analyzing 51 patients' assessment records for the purpose of investigating the nature and related factors of their stresses as well as the applicability of the stress model. The results were as follows:
(1) Stress model is appropriate for analyzing phenomenon of stress.
(2) Most of the cases had psychosomatic symptoms; all of them had negative emotions; half of them did not or rarely express emotions; more than half of them did not resolve or even worsen the problems.
(3) There were no cases of stress maladaptation purely ensued from the external-environmental or personal-characteristic factors. Stress adjustment problems were the results of these two factors.

Parallel keywords

stress model ； stress analysis