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  • 學位論文

第三孕期婦女的壓力、社會支持與憂鬱

Stress, Social Support, and Depression of the Pregnant Women During Their Third Trimester

指導教授 : 陳彰惠
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摘要


本研究目的係探討第三孕期婦女的壓力、社會支持與憂鬱的相關性,並探討孕期憂鬱之重要預測因子。以立意取樣方式在南部一所區域醫院與一所地區醫院門診,進行第三孕期孕婦問卷調查,共收取150位個案。研究工具為結構式問卷,內容包括三部分:(一)個人基本屬性調查表(二)孕期心理壓力量表、(三)成人生活事件壓力量表、(四)孕婦社會支持量表、(五)愛丁堡周產期憂鬱量表。使用統計方式包括因素分析、卡方檢定、t檢定、皮爾森積差相關檢定、對數迴歸分析。 研究結果發現:1.若以愛丁堡周產期憂鬱量表9分為憂鬱的分割點,則48.7%的孕婦有憂鬱情形;若以14分為重度憂鬱的分割點,則20.0%的孕婦有重度憂鬱2. 孕期心理壓力因素,可以區分為「為確保母子健康及安全而引發之壓力感」、「為認同母親角色而引發之壓力感」和「為身體外形和身體活動改變而引發之壓力感」等三個構面。3.有流產經驗者有輕度孕期憂鬱的人數比率比沒有流產經驗者高,家庭主婦有重度孕期憂鬱的人數比率比職業婦女高,意外懷孕者有重度孕期憂鬱的人數比率比計劃懷孕者高。4.憂鬱組(或重度憂鬱組)的孕婦其孕期心理壓力及其因素I、因素II、因素III、成人生活事件壓力均顯著的比非憂鬱組(或非重度憂鬱組)高,而社會支持程度均比非憂鬱組 (或非重度憂鬱組) 低。5.孕期心理壓力及社會支持是孕期憂鬱的顯著預測因子;孕婦有無職業、孕期心理壓力及社會支持是重度孕期憂鬱的顯著預測因子。本研究結果可協助產科護理人員了解壓力、社會支持對孕期憂鬱之影響,並作為提供孕婦健康照護措施之理論基礎。

並列摘要


This study was conducted to investigate the depression of pregnant women during their third trimester and its relationship with pregnancy stress, life-event stress and social support, and to explore the significant predictors. A total of 150 pregnant women who were in the third trimester were recruited to participate in this study from obstetric clinics of one regional and one local hospitals in southern Taiwan. Three instruments were used to collect data:the Basic Characteristics Inventory, the Edinburgh Perinatal Depression Scale, the Pregnancy Stress Rating Scale, the Adult Life-Event Stress Scale, and Maternity Social Support Scale. The data were analyzed by factor analysis, Chi-square test, t test, pearson correlation and logistic regression analysis. The results found that 1. Using the EPDS cutoff score of 10 and above as a score indicative of depression, 48.7% of subjects were identified as depressed; using the EPDS cutoff score of 15 and above as a score indicative of severe depression, 20% of subjects were classified as severely depressed during the third trimester. 2.Factor analysis of the Pregnancy Stress Rating Scale scores defined three factors:(1)Stress from seeking safe passage for herself and her child through pregnancy, labor and delivery,(2)Stress from identifying maternal role, and(3)Stress from altered body structure and body function. 3. The frequency distribution of previous abortion was higher in depressed group, and the frequency distribution of unemployment and unplanned pregnancy were higher in severely depressed group than their comparisons. 4. Both the depressed group and severely depressed group, the pregnancy stress and life-event stress were higher, and the social support was lower than their comparisons. 5.The best subsets to predict the depression of pregnant women included the pregnancy stress and social support. The best subsets to predict the severe depression of pregnant women included the occupational status, pregnancy stress and social support.The results of the study provide evidenced informations for obstetric nurses to understand the effects of the stress and social support on the depression of pregnancy and thus facilitate the development of appropriate nursing services.

參考文獻


中文部分
白璐、溫信財、陸汝斌、郭敏伶(1987)•「成人生活壓力知覺量表」之編修•中華心理衛生學刊,3(1),195-205。
波立特、韓格勒(1999)•護理研究法(史麗珠等譯)•台北:桂冠(原著出版年:1995)。
李明濱(1989)•精神官能症•台北:橘井。
周汎澔、陳彰惠(1991)•構成產婦心理壓力之因素•公共衛生,18 (2),164-171。

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