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Please use this identifier to cite or link to this item: http://ir.cmu.edu.tw/ir/handle/310903500/41431

Title: 不孕症患者治療認知、社會支持、壓力與情緒反應之結構方程模式分析
Investigating the Relationships among Treatment Cognition, Social Support, Stress, and Emotional Reactions of Infertile Patients: A Structural Equation Modeling Analysis
Authors: 李依珊
Contributors: 醫務管理學系碩士班
Keywords: 不孕症;焦慮;憂鬱;結構方程模式 Infertility;Anxiety;Depression;Structural Equation Modeling
Date: 2011-07-12
Issue Date: 2011-10-17 16:57:19 (UTC+8)
Publisher: 中國醫藥大學
Abstract: 背景與目的:台灣少子化嚴重,醫治不孕症族群格外重要。臺灣約10%至15%育齡夫妻出現不孕問題。不孕症與其處置使當事人經歷相當的心理壓力,可能之影響為焦慮與憂鬱;此壓力可能因子(Stressors)為治療認知、社會因子、婚姻因子、小孩的重要性、自尊、罪責感、社會支持等。目前臺灣較結構化同時分析此壓力因子與情緒反應之文獻付之闕如,因此,本研究欲增加此心理層面之瞭解,以作為相關醫療實務及衛生政策之參考依據。
研究方法:以便利取樣(Convenience Sampling),針對3家醫療院所不孕症門診病患進行問卷發放,共回收總有效問卷400份。利用結構方程模式(Structural Equation Modeling, SEM)進行統計分析,探討不孕症患者之治療認知、社會因子、婚姻因子、社會支持等壓力因子、壓力程度與焦慮、憂鬱間之相關性。以AMOS 17評估初始模式進而驗證修改後模式,以提出不孕症患者壓力因子與情緒反應之結構方程模型。
研究結果:經結構方程模式驗證並通過適配度檢定(Goodness of Fit),影響壓力感受之因素為婚姻因子、罪責感、社會因子。影響憂鬱之因素為自尊、社會支持及壓力感受。影響焦慮之因素為壓力感受及憂鬱。
結論與建議:社會因子、婚姻因子、小孩的重要性、自尊、罪責感、社會支持及壓力感受對於焦慮與憂鬱情緒反應呈現直接或間接效果。研究結果可作為促進衛教、心理諮商等不孕症醫療實務、不孕症醫療照護的發展方向及制訂相關衛生政策之參考,以預防不孕症患者焦慮與憂鬱等精神疾病發生。
Backgroud: The issue of the fewer children trend has been severe in Taiwan. Therefore, caring and treating infertile patients is extraordinarily important. Reports show that the prevalence of infertility is gradually climbing worldwide and around 10-15% of Taiwanese couples presented infertile symptoms. The infertile and person involved experienced substantial psychological stress during the treatment process. The examination of this stress is two-fold: stressors (treatment cognition, social stressor, marital stressor, importance of children, self-esteem, guilt and blame, social support), and subsequent emotional reactions. Potential impacts of infertility-related stress may include anxiety, depression, and degeneration of physical function. Lack of comprehensive literature on the structural analysis of stressors and emotional reactions for infertility justifies a need to further understand this psychological realm. Study results may serve as a reference for the basis of enhancing medical care and formulating related health policies.

Methods: Adopting convenience sampling in selecting the subjects, the present study targeted 3 hospitals to conduct the structured questionnaires. Total 400 valid samples were collected. This study utilized the AMOS 17 software package as a tool for Structural Equation Modeling (SEM). The initial model for the psychological responses among infertile patients was tested and afterward the modified structural model was presented.

Results: After modification, the final model passed the Goodness of Fit tests. According to the SEM results, the related factors of perceived stress level are marital stressor, guilt and blame, and social stressor. The factors directly related to depression are self-esteem, social support, and perceived stress level. The direct factors of anxiety are perceived stress level, and depression.

Conclusions: Social stressor, marital stressor, importance of children, self-esteem, guilt and blame, social support, perceived stress level demonstrated direct effects or indirect effects to anxiety and depression. The study results may serve as a reference for indicating a prospective direction of advancing the infertile medical care, including providing an effective measurement tool for screening stress and emotional reactions to further prevent the occurrence of anxiety and depression. Besides, study results may be viewed as a referential basis of how to enhance infertile medical practices including health eduction, psychological counseling, and social work and of framing related health policies.
Appears in Collections:[醫務管理學系暨碩士班] 博碩士論文

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