自閉症孩童母親的日常職能活動經驗與主觀安適感

The Daily Occupational Experiences and Subjective Well-Being of Mothers of Children with ASD

謝雅琳(Ya-Lin Hsieh)

指導教授 ： 羅鈞令

國立臺灣大學/醫學院/職能治療研究所/碩士(2009年)

https://doi.org/10.6342/NTU.2009.00227

摘要

自閉症孩童母親因為其孩童的特質，而有不同於一般孩童母親的日常職能活動經驗。相較於一般孩童母親，自閉症孩童母親可能缺乏休息，也容易有較多挫折和不愉快的經驗，其主觀安適感可能受影響。然而，目前的研究有限，尚不足以支持此假設。為此，本研究探討自閉症孩童母親的職能經驗，以及其職能經驗與自身主觀安適感的關係。此外，亦探討自閉症孩童母親之主觀安適感與孩童的職能參與表現和能力發展狀況的關係。
於大台北地區之醫療院所與發展中心徵求育有2~6歲之自閉症孩童母親40位，另於幼稚園徵求育有年齡與自閉症孩童相配對之一般孩童母親40位。所有母親以填寫日記記錄的方式，記下自己一週的職能，並同時記錄參與職能時感受到的生產性、充電性和愉悅性經驗的程度。再以「正向與負向情緒量表」，以及「生活滿意度量」表評估母親的主觀安適感，並用獨立t檢定比較兩組母親職能經驗與主觀安適感的差異。此外，以「幼兒日常職能活動量表」和「學齡前兒童發展量表」分別評估孩童的職能參與表現和能力發展狀況。以皮爾森積差相關和逐步迴歸分析檢視自閉症孩童母親的主觀安適感，與其職能經驗和孩童的職能參與表現、能力發展狀況的關係。
研究結果顯示，相較於一般孩童母親，自閉症孩童母親的充電性和愉悅性經驗較低，主觀安適感亦較差。而在自閉症孩童母親的主觀安適感的相關性檢驗結果方面，母親的充電性和愉悅性經驗與其主觀安適感之情感和認知層面有正相關，而愉悅性經驗是母親主觀安適感的最佳預測因子。孩童的職能參與表現和能力發展狀況則與母親的主觀安適感無關。
由於自閉症孩童之行為表現的不可預測性，母親於參與日常職能時可能較缺乏充電性和愉悅性經驗，而此狀況可能進而影響母親的主觀安適感。本研究結果提醒母親，能藉由安排自身參與能讓自己產性愉悅性經驗的職能來提升自我的主觀安適感。而研究結果亦提高健康相關專業人員對自閉症孩童母親主觀安適狀態的敏感度，以利其對母親提供必要的支持與協助。

關鍵字

職能活動經驗 ； 主觀安適感 ； 自閉症 ； 母親

並列摘要

Mothers of children with autism may have different occupational experience from mothers of typical children due to their children’s unique characteristics. They may lack of rest and experience more frustration and unpleasant affection than the mothers of typical children. Therefore, their subjective well-being (SWB) may be affected. However, there are limited evidences to support this hypothesis. The purpose of this study was to investigate the occupational experiences of mothers of children with autism and the relationship between their daily occupational experiences and SWB levels. The relationships between mother’s SWB levels and their child’s occupational participation level and developmental level were also investigated.
Forty mothers with a child aged between 2~ 6 with a diagnosis of autism were recruited from the rehabilitation department of hospitals or developmental centers in Taipei area. Another forty mothers with a typical child of the same age range were recruited as a comparison group. All the mothers recorded their daily occupations with a diary-log for one week and rated the levels of productivity, restoration and pleasure they experienced during each occupation. The mothers’ SWB levels were then measured with the Positive and Negative Affect Scale (PANAS) and the Satisfaction with Life Scale (SWLS). The daily occupational experiences and SWB levels of the two groups of mothers were compared by using independent t tests. In addition, children’s occupational participation level and developmental level were evaluated by Pediatric Daily Occupational Scale (PDOS) and Chinese Child Development Inventory (CCDI) respectively. The relationships between mothers’ SWB levels and their daily occupational experiences, and children’s occupational participation and developmental level were analyzed further by using Pearson’s product-moment correlation and stepwise regression analyses.
The results showed that, comparing with the mothers of typical children, mothers of children with autism experienced less restoration and pleasure in their daily occupations, and their levels of SWB were lower also. As to the relationship between mothers’ SWB levels and their daily occupational experiences, and children’s occupational participation and developmental level, mothers’ pleasure and restoration level experienced during daily occupation related positively to their affective and cognitive SWB levels, and the pleasure experience level was the best predictor of SWB. The children’s occupational participation and developmental levels were not related to mothers’ SWB.
Due to the unpredictability of the performance of children with autism, their mothers might experience less restoration and pleasure during their daily occupations and this then affected their SWB. The findings of this study suggested that mothers might improve their SWB levels by consciously arranging more occupations in which they could experience more pleasant affections. The results of this study would increase the health care professionals’ sensitivity to the SWB of mothers of children with autism and provide imperative support to them.

並列關鍵字

Occupational experience ； Subjective well-being ； Autism ； Mother

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