| 研究生: |
錢映融 |
|---|---|
| 論文名稱: |
以交叉延宕分析探討乳癌患者的創傷後成長與因應策略之關係 The Relationships Between Coping Strategies and Posttraumatic Growth Among Women With Breast Cancer: A Cross-lagged Analyses |
| 指導教授: | 許文耀 |
| 學位類別: |
碩士
Master |
| 系所名稱: |
理學院 - 心理學系 Department of Psychology |
| 論文出版年: | 2014 |
| 畢業學年度: | 102 |
| 語文別: | 中文 |
| 論文頁數: | 77 |
| 中文關鍵詞: | 乳癌 、創傷後成長 、因應策略 、交叉延宕分析 |
| 外文關鍵詞: | breast cancer, posttraumatic growth, coping, cross-lagged analyses |
| 相關次數: | 點閱:329 下載:67 |
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本研究主要目的在探討不同治療階段中創傷後成長與因應策略之關係。由於過去創傷後成長與因應策略之間的研究,均是將創傷後成長視為個體因應後的結果,而忽略創傷後成長的經驗對個體的影響,因此本研究透過雙面神模式的理論,以更多元的角度來檢視「創傷後成長」,並將追蹤三個時間點,根據不同治療階段進一步提出三個假設模式,並採用交叉延宕分析(Cross-lagged analyses)來檢驗。
研究方法採立意取樣,以中部某教學醫學之乳房中心的乳癌患者為對象,共262 人,蒐集患者之「基本資料」、「創傷後成長」及「因應策略」,並在術後三個月、術後六個月及術後一年進行問卷調查。資料分析以探索性因素分析將因應策略分為三個因素:「自我導向因應」、「社會導向因應」及「逃避因應」,並與創傷後成長進行交叉延宕分析。
研究主要發現如下:(一)診斷時年齡愈小及教育程度愈高者,可以預測術後三個月較高的「自我導向因應」、「社會導向因應」及「創傷後成長」;(二)術後三個月到六個月之間,「自我導向因應」與「創傷後成長」呈現互惠關係,即術後三個月較高的「自我導向因應」可以預測術後六個月較高的「創傷後成長」,而術後三個月較高的「創傷後成長」也可以預測術後六個月較高的「自我導向因應」;(三)術後六個月的「創傷後成長」可以預測術後一年的「社會導向因應」,即在術後六個月時「創傷後成長」愈高,可以預測後續較高的「社會導向因應」;(四)三個時間點中,「逃避因應」均無法預測「創傷後成長」,「創傷後成長」亦無法預測「逃避因應」。
最後將根據研究結果提出其貢獻與實務運用,並依據研究限制提出相關建議,以供臨床工作者與未來研究學者參考。
This study is aimed to investigate the relationships between coping strategies and Posttraumatic Growth (PTG) on three different timing of the breast cancer treatment. According to Janus-Faced Model, PTG is assumed as both a coping effort and a coping result. In order to investigate the possible relationships between coping strategies and PTG, three hypothetic models were proposed and tested by cross-lagged analyses.
By purposive sampling, 262 participants were recruited from the breast center unit at a hospital in central Taiwan. Demographic and disease-related information were gathered after surgery. The Posttraumatic Growth Inventory (PTGI) and the Brief Coping Orientations to Problems Experienced scale (Brief COPE) were assessed 3, 6 and 12 months later. The Brief COPE included 3 factors: self-sufficient coping, socially-supported coping and avoidant coping. Each was assumed to associate with PTG differently.
Results of the current study were as follows:
1. Younger patients or women of higher education level reported more PTG, self-sufficient coping and socially-supported coping at T1.
2. The reciprocal relation was found between self-sufficient coping and PTG within 6 months postsurgery, which indicated the positive effect of T1 self-sufficient coping on T2 PTG, as well as the reciprocal effects of T1 PTG on T2 self-sufficient coping.
3. Higher level of PTG at T2 predicted more socially-supported coping at T3.
4. Within 1 year postsurgery, there were no significant cross-lagged effects between avoidant coping and PTG, but only autoregressive correlations within constructs over time.
Implications of these findings are discussed, along with potential directions for future research.
第一章 緒論..........................................1
第二章 文獻探討.......................................5
第一節 乳癌的特性.....................................5
第二節 創傷後成長.....................................12
第三節 創傷後成長與因應................................22
第四節 研究假設及架構..................................26
第三章 研究方法......................................28
第一節 參與者........................................28
第二節 收案程序......................................29
第三節 研究工具......................................30
第四節 資料分析......................................33
第四章 研究結果......................................34
第一節 描述統計與相關分析..............................34
第二節 交叉延宕分析...................................39
第五章 研究討論....................... ..............54
第一節 前置變項與創傷後成長及因應策略之關係...............54
第二節 交叉延宕分析...................................54
第三節 研究貢獻與限制.................................59
參考文獻……….........................................61
一、中文部分.........................................61
二、英文部分.........................................62
附錄……………..........................................71
附錄一 問卷.........................................71
附錄二 自我導向因應與創傷後成長之結構方程模式圖-含修正殘差估計值(標準化解)...75
附錄三 社會導向因應與創傷後成長之結構方程模式圖-含修正殘差估計值(標準化解)...76
附錄四 逃避因應與創傷後成長之結構方程模式圖-含修正殘差估計值(標準化解)......77
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