學齡期注意力缺陷過動症兒童之母親憂鬱及其相關因素之探討

背景：在台灣注意力缺陷過動症盛行率約7.5%，佔學齡期兒童約5%，會出現成績低落、人際關係差或行為上等問題。家庭中養兒育女的重擔以母親為主，所以母親會產生較多的身心問題，母親憂鬱不僅危害女性本身，同時會對家庭和社會造成負面的影響。目的：探討學齡期注意力缺陷過動症兒童之母親憂鬱及其相關因素。方法：採橫斷式相關性研究，立意取樣88位南區某醫學中心精神科門診之學齡期注意力缺陷過動症兒童的母親為研究對象，使用結構式問卷收集資料，問卷內容包含：兒童及母親之基本屬性、親職壓力量表、社會支持量表及貝克憂鬱量表。將所得資料以SPSS 17.0套裝軟體進行統計分析，以描述性統計分析人口學基本屬性資料、獨立樣本t檢定、單因子變異分析、皮爾森積差相關分析母親憂鬱及其相關因素，並以逐步複迴歸分析母親憂鬱之重要預測因子。結果：（一）病童母親之親職壓力稍偏高、社會支持顯不足；（二）病童母親之憂鬱程度屬正常範圍，但其中有39.77% 的母親有憂鬱情形。（三）病童母親之「教育程度高低」及「家庭每月總收入」在母親憂鬱上有顯著性差異。（四）病童母親之親職壓力與母親憂鬱呈顯著正相關 (r= .666, p< .001)。（五）病童母親之社會支持與母親憂鬱呈顯著負相關 (r= - .331, p< .01)。（六）「親職壓力」及「家庭每月收入25,000元(含)以下」為母親憂鬱之重要預測因子，解釋總變異量為46.2%，以「親職壓力」為最重要之預測因子，解釋總變異量為43.8%。結論：研究結果有助於醫護人員面對學齡期注意力缺陷過動症兒童之母親時，評估母親憂鬱、親職壓力及社會支持的情形，尤其對低社經地位、高親職壓力之母親，即需注意病童母親之憂鬱情形，提供親職管教訓練，教導有效親職管教策略，增加社會支持，預防母親嚴重憂鬱對個人及家庭的傷害。

關鍵字

學齡期兒童；注意力缺陷過動症；母親憂鬱；親職壓力；社會支持

並列摘要

Background: In Taiwan, the prevalence of attention-deficit hyperactivity disorder (ADHD) is about 7.5%, which makes up 5% of school-aged children. School-aged children with attention-deficit hyperactivity disorder exhibit problems such as low achievement, poor interpersonal relationships and deviant behaviors. Since mothers take on most of the burden of raising children in a family, they tend to have more physical and psychological problems; maternal depression not only harms the women themselves, but also has a negative impact on family and society. Purpose: To study maternal depression and its related factors in mothers of school-aged children with attention-deficit hyperactivity disorder. Methods: This was a cross-sectional study that used a purposive sample of 88 mothers whose school-age children with attention-deficit hyperactivity disorder were being treated at a psychiatric outpatient clinic of a medical center in southern Taiwan. The data were collected using structured questionnaires including: basic characteristics of child and mother, the Parenting Stress Index (PSI), a social support scale, and the Beck Depression Inventory (BDI). Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS 17.0). Descriptive statistics were used to analyze demographic characteristics data. An independent samples t test, a one-way analysis of variance (ANOVA), and a Pearson product moment correlation test were used to analyze maternal depression and related factors. Stepwise multiple regression was used to analyze significant predictors of maternal depression. Results: (1) Mothers of sick children had slightly higher parenting stress and inadequate social support. (2) The depression level for mothers of sick children was in the normal range; however, 39.77% of the mothers had depression symptoms. (3) ‘Education level’ and ‘monthly total household income’ had significant effects on maternal depression of mothers with sick children. (4) Parenting stress and maternal depression of mothers of sick children displayed a positive correlation (r = .666, p < .01). (5) Social support and maternal depression of mothers of sick children displayed a negative correlation (r = -.331, p < .01). (6) ‘Parenting stress’ and ‘monthly total household income NT$25,000 (and) lower’ were significant predictors of maternal depression, and had a total explained variance of 46.2%. ‘Maternal stress’ was the most significant predictor; its total explained variance was 43.8%. Conclusions: The results of this study will help medical staff when facing the mothers of school-aged children with attention-deficit hyperactivity disorder to evaluate maternal depression, parenting stress, and social support. It will especially help in evaluation of maternal depression symptoms of those mothers who have both low socio-economic status and high parenting stress. Providing these mothers parenting training, educating them on effective parenting and discipline strategies, and increasing social support can prevent harm to individuals and family caused by severe maternal depression.