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  • 學位論文

921震災後20週年的災後心理變動、因應、因應資源及災後心理適應

The Effect of Post-disaster Psychosocial Changes, Coping, and Coping Resources on Post-disaster Adjustment 20 Years After the Chi-Chi- Earthquake

指導教授 : 洪福建

摘要


研究背景與目的-西元1999年的集集大地震震撼全台,個體除了經歷生命直接的威脅外,在心理適應上也面臨相當大的挑戰,若能了解災後個體適應的歷程,將有利於未來提供災民適性的災後救助與專業心理資源。本研究旨在探討災難過後受創者的心理社會變動壓力、因應資源以及因應策略如何影響受創者的身心反應,並嘗試找出哪些災後身心反應的預測因子隨時間變化仍會不斷地影響受創者的身心反應。 研究方法-參與者為420位埔里與東勢的居民,包含早年參與九二一災後心理調查的成人倖存者與新參與者,平均年齡為56.02歲,66.9%為女性。使用自陳式量表來蒐集資料,包含:基本資料、地震暴露指標(EEI)、心理社會變動量表(PCQ)、資源量表、簡明因應問卷(Brief COPE)、創傷後壓力反應指標(PTSRI)與病患健康量表(PHQ-9)。 研究結果與結論-相關分析指出當個體有更多的因應資源,且目前在生活各個範疇(包含社會經濟、人際關係、個人健康)比地震前來得更好,其在震後所引發的創傷後壓力反應與憂鬱症狀也會較易下降。而當個體所擁有的因應資源越少,個體則會較傾向採取逃避式的與社會支持式的因應策略,其在震後所引發的創傷後壓力反應與憂鬱症狀則會相較於因應資源較多者來得更多。中介效果檢驗則發現社會支持式因應在災後心理社會變動壓力與創傷後壓力反應以及憂鬱症狀間具中介效果;因應資源會中介災後心理社會變動壓力與自我支持式因應,但於其他類型之因應策略中則不具中介效果。調節效果檢驗則顯示個體的因應資源對於逃避式因應對創傷後壓力反應以及憂鬱症狀的關係有調節作用。逐步迴歸分析結果顯示災後1.5年的個人健康變動壓力、災後20年的因應資源與逃避式因應可預測災後20年之創傷後壓力反應與憂鬱症狀。此外,年齡、性別、教育程度等變項亦為受創者於震後所引發的身心反應之風險因子。

並列摘要


Background and purpose-The Chi-Chi earthquake in 1999 shocked the whole Taiwan. Impacted individuals may have not only experiencing direct threat of life, but also facing considerable challenges in psychological adaptation. To understand the victims with or without appropriate post- disaster beliefs and related adjustment would provide beneficial information for post-disaster trauma work. This study aimed to explore how psychosocial changes, coping resources and coping strategies of the victims affect their physical and mental responses after a disaster, and to find out which predictors would affect physical and mental health along time course. Method-420 participants of Puli and Dongshi, including adult survivors who participated in the psychological survey after the September 21 disaster in the early years, and new participants. The average age was 56.02 years old and 66.9% were women. Use self-reporting scales to collect data, including basic data, Earthquake Exposure Index(EEI), Psychosocial Change Questionnaire(PCQ), Resource Scale, Brief COPE, Posttraumatic Stress Reaction Index(PTSRI) and Patient Health Questionnaire(PHQ-9). Result and Discussion-Correlation analysis points out that when individuals have more coping resources and are currently better in all areas of their life (including social economy, interpersonal relations, and personal health) than before the earthquake, the earthquake caused traumatic stress responses and depression symptoms will also be easier to decrease. When the individuals have fewer coping resources, the individuals are more inclined to use avoidant and social supportive coping strategies, and their post-traumatic stress responses and depressive symptoms will be more than the individuals who have more coping resources. The mediating effect test found that social supportive coping will mediate between post-disaster psychosocial change stress and post-traumatic stress response and depression symptoms; coping resources will mediate post-disaster psychosocial change stress and self-support coping, but not found in the other types of coping strategies. Regression analysis shows that the individual's coping resources has a moderating effect on the relationship between avoidant coping with post-traumatic stress response and depression symptoms. The results of stepwise regression analysis show that the strains of personal health changes in the 1.5 years after the disaster, the coping resources and the avoidant coping in the 20 years after the disaster can predict the post-traumatic stress responses and depression symptoms in the 20 years after the disaster. In addition, such as age, gender, and education are also risk factors for the physical and mental reactions after the earthquake.

參考文獻


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中文部分
王國輝(1996)。現階段實行社區參與地震災難防救之探討: 以嘉義市四個社區為例。National Taiwan University Department of Building and Planning。
伍新春、王文超、周宵、陈秋燕、林崇德 (2018)。 汶川地震 8.5 年后青少年身心状况研究。心理发展与教育, 34(1),頁 80-89。

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