No description available.

研究目的：失眠影響國人身心健康甚多，藥物取向治療為當代最廣泛的失眠治療方式。研究顯示許多失眠患者，可藉由短期服用助眠藥物改善失眠，避免個體失眠慢性化，且於停藥後未有任何藥物副作用困擾。然而，臨床上仍觀察到不少個案，對助眠藥物產生依賴，需長期服用助眠藥物，此舉不僅造成醫療資源之浪費，其安全性與有效性仍受爭議。而心理因素在藥物依賴扮演重要的角色，同樣是長期服用助眠藥物，不同的助眠藥物使用者卻可能存有相異的用藥心態，因此助眠藥物使用者的用藥行為以及用藥相關心態，可能會組合成不同的用藥型態，而探討助眠藥物之不同使用型態與其心理機轉，有助於進一步瞭解助眠藥物使用現象。故本研究旨在用量化方法探討助眠藥物使用型態之差異，試圖將不同的助眠藥物使用型態進行分群，並提出可能影響助眠藥物使用型態的相關因子。 研究方法與結果：本研究招募了272名曾經或目前正在服用助眠藥物的使用者填寫研究問卷，透過對兩個外顯用藥行為變項（用藥總時間、用藥頻率）與六個用藥相關心理變項（對助眠藥物的渴求程度、對助眠藥物的正、負向態度、主觀規範、以及促進、抑制之知覺控制）的集群分析，我們將助眠藥物使用型態分為「慣性使用」、「矛盾依賴」、「控制使用」以及「輔助使用」四種型態。在外顯用藥行為方面，「慣性使用」集群與「矛盾依賴」集群皆展現較長的用藥時間與高頻率的使用，「控制使用」群集與「輔助使用」群集則展現較短的用藥時間與低頻率的使用。然而，四組群集皆展現其獨特的心理特徵。「慣性使用」群集對助眠藥物的渴求程度最強，正向態度比負向態度高，主觀認為重要他人支持自己服用助眠藥物，傾向持續服用助眠藥物；「矛盾依賴」群集呈現對助眠藥物正向與負向態度皆高的矛盾狀態，且主觀認為自己無法控制藥物之使用；「控制使用」群集雖也對助眠藥物出現正向、負向態度皆高的表現，但其可對藥物使用進行控制；「輔助使用」群集的個案對於助眠藥物的負向態度高於正向態度，藥物渴求程度低，且傾向避免使用助眠藥物。多項式邏輯斯回歸的分析結果則進一步顯示年齡較大、失功能睡眠信念問卷分數較高的個案，較容易落入「慣性使用」組；被診斷過情緒疾患、失眠時間較長、睡前激發程度問卷分數較高的個案，較容易落入「矛盾依賴」組；受教育年限較高的個案，較傾向落入「控制使用」組；最後，年紀較輕、失功能睡眠信念問卷分數較低的個案，則容易落入「輔助使用」組。 結論：本研究結果顯示相似的用藥行為仍有相異的用藥相關心理狀態，且部分心理相關變項可能會影響助眠藥物之使用型態，故推測用藥心理與助眠藥物使用者的特質扮演影響用藥型態的重要因素。此結果可提供臨床工作者，初步了解助眠藥物使用之心理機轉，亦能將其運用於協助不同類型的安眠藥物使用者擬訂減藥處遇。 / Purpose：Insomnia has great impact on people's health in Taiwan. Pharmacological approaches are the most commonly used treatment for insomnia. Although short-term hypnotic use could improve sleep, however some patients use hypnotics for a prolonged period of time and have difficulty to discontinue using them. This would lead to great cost of the individuals and societies. Psychological factors have been found to play an essential role in the long-term use of other substances. Clinical observation also showed that there were individual differences in the psychological aspects of medication use in spite of similar medication use behaviors. Therefore, it is possible to use hypnotic-related behaviors and psychological factors to categorize hypnotic users in order to further the understanding the mechanism underlying chronic hypnotic use. The purpose of this research is to identify hypnotic use patterns by exploratory quantitative method and the characteristics associated with different hypnotic usage patterns. Methods and Results: 272 previous or current hypnotic users were recruited to complete a package of questionnaires. Through cluster analysis with two explicit medication behavior variables (total duration of hypnotic use, frequency of hypnotic use) and six hypnotic-related psychological variables (craving for hypnotic, positive and negative attitudes towards hypnotic, subjective norm, facilitating and inhibiting perceived behavioral control), four hypnotic usage patterns were identified, which were “habitual use”, “paradoxical dependence”, “controlling use”, and “supplementary use”. In terms of explicit medication behaviors, “habitual use” and “paradoxical dependence” clusters both show longer time and higher frequency of hypnotic use. On the other hand, “controlling use” and “supplementary use” clusters showed similar medication use behaviors with shorter duration and lower frequency of hypnotic use. In addition, the four clusters exhibited different psychological profiles. Users in “habitual use” cluster have strongest craving for hypnotic, higher positive than negative attitude toward hypnotic use, and believe that significant others support their medication behavior. Users in “paradoxical dependence” cluster showed paradoxical attitude toward hypnotics, and reported less control over their hypnotic use. Users in “controlling use” cluster also had paradoxical attitude toward hypnotic, but their craving level of hypnotic was lower than users in “paradoxical dependence” cluster. In addition, users in “controlling use” cluster feel they can control their hypnotic use. Users in “supplementary use” cluster had lowest craving level, higher negative attitude toward hypnotic, and tend to avoid taking hypnotic when possible. Multiple logistic regression further showed that (1) people with older age or higher score on the Dysfunctional Beliefs and Attitudes About Sleep Scale (DBAS) tend to classified into “habitual use” cluster; (2) people with mental disorder diagnosis, long history of insomnia, or higher score in Pre-Sleep Arousal Scale (PSAS) tend to be classified into the "paradoxical dependence " cluster; (3) patient with more years of education more likely fall into “controlling use” cluster, finally, (4) the hypnotic users who are younger or lower score in DBAS are easier classified into the “supplementary use ” cluster. Conclusions：The results of the current study indicates that similar medication behavior could have different hypnotic-related psychological status. Therefore, psychological factors are needed to be assessed in order to understand the process of long-term hypnotic use. The results provides a further understanding of the psychological mechanisms of hypnotic use, and also help clinician in related-field to develop insomnia treatment plan or hypnotic discontinuation program based on insomniacs’ characteristics and their psychological variable toward hypnotic use.

本論文以自我敘說的方式探索生命經驗，呈現我如何在與創傷的關係中，那種無法解決痛苦的痛苦中，一步步地幫助自己從幻幕到真實。在這樣的歷程中，學習如何在信任與不信任關係中苦苦掙扎，冒險敞開自己的心，努力學習與他人「分享」脆弱與羞愧，學習向外尋求支持與幫助。同時，對內，則很努力地修復與自己疏遠的關係，學習當個我想成為的好媽媽，傾聽我內在小孩的需求。 我的歷程，並非直線性地一步步從幻幕走向真實，而是在虛幻與真實間、在遺棄與接觸內在孩童間不斷來來回回，緩慢螺旋向下的歷程。最終，成人的我，帶著害怕關係斷裂的恐懼、因照顧自己而產生的罪惡感，仍願意為了我的內在小孩，採取行動照顧她的需求，維護自己的界限，讓內在小孩在這過程中，經驗到自己的價值。進而承諾自己，不再遺棄我的內在小孩。希望我的經歷，能夠對與我有類似經歷的人有幫助、能夠讓諮商師對這類型的個案有更深的理解。 在我往內走向真實的歷程中，我同時身為實習諮商心理師，我不只接受諮商與治療，我也在諮商、治療別人，同時，我也在接受督導，督導象徵權威，我也在處理我與權威間的關係，我們彼此間的議題，都會互相碰撞影響。有時候，我的議題會影響我諮商個案，尤其當我身為新手治療師，對自己有很高的期望，當我看到自己還過不去的議題影響到諮商時，我也會對自己又氣又急可又很無奈，也曾因此懷疑過自己是否適合當個諮商師。可是慢慢地，我開始接納自己的狀態、接納自己也是個人，不是個完美的諮商師，當我對自己有愈多接納跟允許時，我也對個案有更多的涵容，希望我的經歷能對其他實務工作者能夠有所助益。 / This thesis explored life experience of the author, presented how the author overcame the trauma and marched forward to the real from illusion by self-narrative process. In the process of recovering, I learned how to make balance when struggling in the relationship of believing and unbelieving, open my mind to others, share the vulnerable and shame and ask for help. At the same time, from the inside of my heart, the cold and detached relationship to the inner child was gradually rebuilt and a good-enough-mother who was able to listen to the needs of inner child was formed. The process of the recovering was not straightly going from illusion to real but moving back and forth between the illusion and real, and the abandon and contact inner child, again, again, and again. Finally, the adult part of me overcame the fear of broken relationship and the guilty of taking care of myself to care for the needs of inner child and establish the boundary between me and others. The inner child experienced the self-value in this process. Moreover, a promise for not abandoning the inner child again was established firmly by the adult. As the process of going to real, I was both a client and an intern counselor; besides, I was supervised. The supervisor symbolized the authority; therefore, I was also dealing with the authority issue. The issue between me and the authority also influence both of us. Sometimes, my issue also influenced my clients, especially when I was a freshman who had high expectation to herself. When the issue that was not yet been overcome effected the counseling, I was mad and disappointed at myself. Step by step, in the processing of recovery, I started to accept that situation and accept that I was also a human and an imperfect counselor. With the increasing acceptance, I contained my clients more. I hope my experience may be able help the client who had the same experience and help the counselor to understand the client deeply.

本研究旨在瞭解桃園縣國民中學校長分布式領導、教師心理賦權與教師學術樂觀之現況，並分析不同背景變項之教師在知覺校長分布式領導、教師心理賦權與教師學術樂觀之差異情形，且探討三者之間的關係，最後藉由校長分布式領導與教師心理賦權對教師學術樂觀進行預測。 本研究採調查研究法，共計抽樣30所學校，發出690份問卷，回收480份有效問卷，問卷有效率達69.97%。資料處理分別以描述性統計、獨立樣本t檢定、單因子變異數分析、皮爾遜積差相關及多元逐步迴歸分析等統計方式進行統計分析。 本研究獲致以下之結論： 一、 桃園縣國民中學教師知覺校長分布式領導為中高程度，以「校長的自信與謙遜」之知覺程度為最高，「營造信任的文化」之知覺程度最低。 二、 桃園縣國民中學教師有中高程度之教師心理賦權表現，以「影響力」的知覺為最高，「能力」之知覺為最低。 三、 桃園縣國民中學教師有中高程度之教師學術樂觀表現， 以「效能感」的知覺為最高，「學術強調」之知覺為最低。 四、 桃園縣國民中學教師，因其年齡、擔任職務、學校規模及學校歷史之不同，而有不同的校長分布式領導知覺感受，以51歲（含）以上之主任，並服務於學校規模12班（含）以下擁有21年（含以下）、41-60年、及61年（含以上）學校歷史之教師知覺程度較高。 五、 桃園縣國民中學教師，因其年齡、服務年資、學校規模及學校歷史之不同，而表現出不同程度的教師心理賦權，以年齡51歲（含）以上且年資超過21年，目前服務於學校規模13-48班擁有20年以下學校歷史之教師在知覺教師心理賦權程度較高。 六、 桃園縣國民中學教師，因其年齡及服務年資之不同，而有不同的教師學術樂觀知覺感受，以年齡51歲（含）以上並服務超過21年之學校教師在知覺教師學術樂觀程度較高。 七、 桃園縣國民中學校長分布式領導、教師心理賦權與教師學術樂觀的知覺及各分層面，彼此之間具有正相關的關係。 八、 桃園縣國民中學校長分布式領導、教師心理賦權對教師學術樂觀具有預測作用，以「校長分布式領導」的預測力最佳。 最後依據研究結果與結論，提出具體建議，以供教育行政機關、學校校長與教師以及未來研究的參考。 / The purpose of this study was to investigate the current development of principal’s distributed leadership, teachers’ psychological empowerment, and teachers’ academic emphasis in secondary schools of Taoyuan County, and to analyze the difference between teachers of different background variables, and to explore the relationship among the three variables. This study has aimed to predict teachers’ academic emphasis through principal’s distributed leadership and teachers’ psychological empowerment. Through the use of questionnaire survey method, data were collected from 30 secondary schools, distributing 690 questionnaires in total. Valid questionnaires of 480 were collected, with a usable rate of 69.97%. All data were analyzed by the methods of descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation, and multiple regression. The conclusions of this study are as follows: 1. Secondary school teachers’ perception of principal’s distributed leadership is above average, in which the item “principals’ self-confidence” and “humility”was the highest, and “creating a culture of trust” was the lowest. 2. Secondary school teachers’ perception of teachers’ psychological empowerment is above average, in which the item “impact” was the highest, and “competence” was the lowest. 3. Secondary school teachers’ perception of teachers’ academic optimism is above average, in which the item “self-efficacy” was the highest, and “academic emphasis” was the lowest. 4. There are significant differences in the secondary school teachers’ perception of principals’ distributed leadership in terms of age, position, scale of school, and age of school. 5. There are significant differences in the secondary school teachers’ perception of teachers’ psychological empowerment in terms of age, years of service, scale of school, and age of school. 6. There are significant differences in the secondary school teachers’ perception of academic emphasis in terms of age and years of service. 7. There is a positive correlation among the principals’ distributed leadership, teachers’ psychological empowerment, and teachers’ academic optimism. 8. Principal’s distributed leadership and teachers’ psychological empowerment have a predictive effect on teachers’ academic optimism.

輪班工作者除了睡眠片段化、睡眠品質降低等困擾外，工作時間的嗜睡與警醒度下降亦是常見問題，這些影響都可能跟輪班造成的內在晝夜節律與輪班工作時間的不一致有關。根據Minors & Waterhouse (1983)提出的定錨睡眠的概念，每天若能有四個小時在固定時間的睡眠，會有穩定內在晝夜節律、減少位移的效果，然而過去研究未曾探討定錨睡眠應用在輪班工作者的效果。因此，本研究的目的在於以模擬輪班的方式，比較採用定錨睡眠者與非定錨睡眠者在模擬輪班工作中的主觀嗜睡度、心理動作警覺度，以及睡眠指標，以探討定錨睡眠對於輪班工作者的睡眠與警覺度的影響，以期有助於輪班工作中的適應。 本研究採混合實驗設計，招募睡眠品質良好的受試者，並排除極端夜貓型或極端早晨型晝夜節律型態者，共包含20名受試者、依據性別配對隨機分派至定錨睡眠與無定錨睡眠組（各7名女性、3名男性，平均年齡24歲）。受試者需進行11天的模擬輪班，進行白班與大夜班的輪班；班表為：2天白班-1天休假-2天大夜班-1天休假-2天白班-1天休假-2天大夜班，受試者在實驗期間均配合配戴活動記錄儀與填寫睡眠日誌，並在第二次輪值的工作時間測量心理動作警覺作業（psychomotor vigilance task，PVT）與史丹福嗜睡度量表（Stanford Sleepiness Scale，SSS）。研究結果以三因子及雙因子變異數分析進行統計考驗。 研究結果發現在PVT的反應時間中位數與疏漏次數上，採用定錨睡眠者在白班至大夜班所增加的反應時間與疏漏次數低於非採用定錨睡眠者，且採用定錨睡眠者在工作時有較低的主觀嗜睡度、持平的主觀警醒度；在睡眠指標上，定錨睡眠組入睡後醒覺時數較短、夜班的主觀睡眠品質較佳。整體來說，研究結果顯示採用定錨睡眠能增進在工作中的心理動作警覺度、降低主觀嗜睡度，並促進睡眠的穩定度及夜班主觀睡眠品質，提供定錨睡眠運用在實際的輪班工作場域的初步證據。 / Sleep fragmentation, poor sleep quality, as well as sleepiness and decreased alertness at work are all common problems in shift workers. It is assumed that these problems are associated with the dyssynchronization of endogenous circadian rhythms and shift-work schedule. According to the concept of anchor sleep proposed by Minors & Waterhouse (1983), consistent sleep for few consecutive days can stabilize endogenous circadian rhythm and prevent the phase shift. However, previous studies have not investigate the effect of anchor sleep in shift workers . The current study used an experiment-manipulated shift work schedule to explore the effects of anchor sleep on sleep, sleepiness and psychomotor vigilance at work in a simulated shift work, in order to evaluate the possibility of applying anchor sleep in the assistance of adaption to shift work. Twenty participants with good sleep quality, intermediate types of morning-eveningness, were divided according to gender and randomly assigned to an anchor-group and a non-anchor-sleep control group (7 females and 3 males in each group, mean age 24). They were required to follow an eleven-day schedule that simulate the schedule of shift work. The subjects were required to wear actigraphy and keep sleep logs throughout the experimental period and their psychomotor vigilance and subjective sleepiness at the second work shifts were measured with psychomotor vigilance task (PVT) and Stanford Sleepiness Scale (SSS). The data was analyzed using three-way and two-way ANOVA. The data showed that PVT median reaction time and the number of lapses increased less from day-shift to night-shift in anchor sleeper, the anchor sleeper also had lower sleepiness, and more steady subjective alertness during the working time. Also, they had better subjective sleep quality in night-shift and shorter wake after sleep onset time than the control subjects. The findings of the current study suggest that anchor sleep can reduce the deterioration of subjective sleepiness and vigilance at work in shift workers, and maintain the sleep quality in night-shift. It provides preliminary evidence that support the use of anchor sleep in the assistance of the adjustment of shift work.

本研究採用Ryff (1989a)的心理幸福滿足感架構，探討社會支持、人格特質、個人屬性與老年人的心理幸福滿足感的關係。受試是文山區老人服務中心、台北聯合門診中心、政治大學附近的公園與台北市私立愛愛院等四處共150位老年人。以社會支持行為量表、人格特質量表、心理幸福滿足感量表與個人屬性問卷等作為研究工具。資料分析方式採用皮爾森積差相關與多元迴歸。 研究結果顯示：1.四種社會支持型態與社會支持滿意度或多或少和心理幸福滿足感的六個部分有顯著正相關，其中以情緒支持的影響最為明顯；2.控制源、統整性、內化性等人格特質大多與心理幸福滿足感的六個部分有顯著正相關，其中統整性、內化性與心理幸福滿足感的六個部分皆有顯著正相關；3.教育程度、經濟狀況、婚姻狀況、健康狀況、家庭生活狀況等個人屬性也大多與心理幸福滿足感的六個部分有顯著正相關；4.統整性與內化性愈高，傾向內控，加上家庭生活狀況也較好的老年人，其整體老年心理幸福滿足感較佳。 最後根據研究結果與討論，針對老年人心理幸福滿足感之增進，以及未來研究方向提出若干建議。

本研究旨在比較不同背景和臨床因素的乳癌患者其因應策略、正向情緒和心理症狀的差異情形。本研究除了關注個體所採取的因應策略與情緒的關聯性；另一方面，研究者認為患者的情緒亦可能影響其因應策略之選擇，因此因應策略與情緒間的變化關係，亦為本研究目的之一。 本研究採立意取樣，並以中部某一教學醫學乳房中心初診斷之乳癌患者共計113位為研究對象，蒐集患者之｢基本資料表｣、｢短版因應策略量表｣、｢醫院版焦慮-憂鬱量表｣和｢情緒平衡量尺｣，並以術後3個月和6個月進行追蹤研究。 資料處理以相關分析、t考驗、單因子變異數分析及階層迴歸分析等統計方法為主。由於本研究擬以Brief COPE作為臺灣乳癌病患因應壓力之測量工具，因此將採用探索性因素分析(Exploratory Factor Analysis；EFA)，探討此量表在初診斷乳癌患者身上的因素結構。 依據本研究問題與假設，主要發現摘述如下: 一、本研究以主成分分析法抽取Brief COPE量表因素，並以斜交轉軸進行因素轉軸，依據陡坡圖和平行分析結果抽取三個因素。此三因素的解釋總變異量為62.1%。研究者將因素I命名為｢趨近因應｣；因素II命名為｢情緒性因應｣和因素III命名為｢逃避因應｣。 二、教育程度、收入和有無職業與正向情緒呈正相關；現有小孩人數和年齡與正向情緒呈負相關；年齡和副作用與憂鬱具有正向關係，教育程度則與憂鬱呈負相關;副作用與焦慮呈正相關。有無結婚、有無職業、教育程度、收入、乳房重建與趨近因應呈正相關，期數和年齡則和趨近因應有顯著負相關；有無職業和情緒性因應呈正相關。 三、乳癌患者於術後3、6個月最常採用的因應策略為趨近因應，其次為情緒性因應，最少採用逃避因應。 四、焦慮對逃避和趨近因應有獨特的預測力，即焦慮程度愈高會愈使用逃避和趨近因應策略；憂鬱則對趨近因應有獨特的預測力，憂鬱程度愈高者，其趨近因應的使用愈少；在因應策略的部分，只有趨近因應可顯著預測正向情緒；正向情緒在趨近因應和焦慮的關係中並無法形成部份或完全中介之角色。 最後，根據研究結果與限制提出若干具體建議，以供臨床工作者及未來研究之相關人員參考。 / The purpose of this study is to explore the differences of coping strategies, positive affect and psychological symptoms among newly-diagnosed breast cancer patients in different sociodemographic backgrounds. Research has found that coping strategies predict psychological outcomes; however, a few studies have also reported that psychological symptoms could predict the use of coping strategies. Therefore, the relationship between coping strategies and psychological symptoms was the first aim of the current study. One-hundred and thirteen participants were recruited by purposive sampling. The data were draw from newly-diagnosed breast cancer patients in a breast center unit at a hospital in central of Taiwan. Demographic and clinical data were gathered at the first time point, and the Brief Coping Orientations to Problems Experienced scale (Brief COPE), the Hospital Anxiety and Depression Scale (HADS), Positive Affect subscale of Affect Balance, and side effect checklists were gathered 2 times during the first 3- and 6-month after discharge respectively. Pearson product-moment correlation, t-test, one-way ANOVA, post Scheffe test and hierarchical regression analysis were applied. In an attempt to confirm the factor structure of the Brief COPE, the Exploratory Factor Analyses (EFA) were performed before those analyses. The major findings of the current study were as follows： 1.Using principal components factor analysis with oblique rotation, scree plot and parallel analyses revealed three factors for the Brief COPE were the best factor structure of the current sample: (1) approach coping, (2) emotional coping, and (3) avoidance coping. These 3 factors accounted for 62.1% of the total variance of the data. 2.Education, income and employment status were significantly correlated with positive affect. Number of kids and age were found to be inversely correlated with positive affect. Age and side effects were positively correlated with depression. Side effects were found to be correlated with anxiety. Marital status, employment status, cancer stage, education, income, age, breast reconstruction surgery were found to be correlated with approach coping. Meanwhile stage and age were found to be negatively correlated with emotional coping. 3.Approach coping was the most commonly used coping strategies, while avoidance coping was the least commonly used coping strategies. 4.Anxiety could reliably predict the use of avoidance and approach coping. High anxiety level predicted more use of avoidance and approach coping, whereas depression predicted the use of approach coping, high depressive mood predicted less use of approach coping. Approach coping predicted higher positive affect, but positive affect was fail to be the mediator between approach coping and anxiety. Implications for these results were discussed. The results can also serve as a helpful reference for healthcare professionals.

近年來，台灣職場環境日益浮現關於超長工時、過勞與壓力等身心問題，且自殺消息頻傳，影響員工甚鉅。因此，專家學者紛紛呼籲企業要重視員工的心理健康與福利，應實施員工協助方案(employee assistance programs, EAP)。然而，儘管此福利方案立意良善，但其低落的使用率卻往往使企業基於成本考量而缺乏設置意願。根據管理學知名大師彼得杜拉克（Peter F. Drucker）所言:「過去衡量企業好壞的指標，是看其員工創造了多少經濟價值，但以後會看企業如何對待它的員工」，足見善待員工，是判斷企業為「好企業」的依據。企業重視員工的福祉，將能傳達企業關懷員工的訊息，在員工心中創造一個良好的「雇主品牌」。因此，本研究試圖採取社會交換理論之觀點，以員工對於EAP的知曉與心理契約滿足程度為自變數，並透過知覺組織支持的中介，探討其與建立「以員工為本的品牌權益(employee-based brand equity, EBBE)」之間的關聯性。 本研究以公司有實施EAP的員工為研究對象進行問卷調查，共回收有效問卷218份。藉由路經分析可發現，透過知覺組織支持的完全中介，員工對於EAP的知曉與心理契約滿足程度將正向顯著地影響以員工為本的品牌權益之形成。此研究結果證實了，無論員工是否使用EAP，只要公司根據員工對於服務內容的需求設置EAP，並透過EAP的宣傳、推廣增進員工對於EAP的認識，讓員工感受到公司對於員工身心健康的重視，將能夠強化員工心中的雇主品牌，促使員工展現與公司品牌一致的行為表現，產生以員工為本的品牌權益，為組織創造更大的效益。

本研究之目的：一為探究年輕思覺失調症患者，於荒野臨界中如何形塑其此際體態；二為探討患者主要照顧者面對精神分裂體驗，從何接應患者，如何賦予其心理照顧意義。而後，以對元結構方式，探討患者及其照顧者雙方的心理經驗。研究者將患者「生命經驗」及其主要照顧者「照顧經驗」並置於現象場脈絡中，透過深度訪談，進行現象還原，以接近患者的內在經驗，反思照顧者照顧行動意義。方法上，本研究採取立意抽樣，以年輕思覺失調症患者與其主要照顧者作為研究對象，以配對方式進行資料蒐集，共三對受訪者（6位）接受訪談，患者部分為三位男性，而雙親照顧者部分為一位男性、兩位女性。資料蒐集後，以Henri Ellenberger之現象學分析方法（林耀盛，2002）分析。研究結果發現，年輕思覺失調症患者與其雙親主要照顧者共構之置身結構經驗的定向軌跡為：（1）超常隱匿於日常偽裝之下；（2）超常現身，即特異性經驗被看見，包含病者與雙親照顧者；（3）芻思心緒，反覆思索當前之事件；（4）經驗賦義，理解所發生的事，並給出位置，將其涵容於自我之中；（5）存有的流變：希望與憂懼心思。研究貢獻為在臨床心理實務上可能的幫助：可協助狀態逐漸穩定之個案進行經驗之整理，使其看見自己的狀態，而非僅僅使其擁有病識感、願意配合醫療處遇。而對雙親做為主要照顧者，可協助其釐清對於疾病狀態的未知，及自我照顧技藝的發展。礙於現實收案狀況，難以擴大取樣具異質性的思覺失調症患者，資料豐富度較為不足，為未來研究可改善之處。 / Purpose: This study is exploring (1) how the young schizophrenic patient perceived who he/she is in “the wilderness”; (2) how their caregivers faced with the schizophrenic experiences and constructed the meaning of caring; and (3) disclosing the patients and their caregiver’s mutual situated experiences by the meta-dyadic structure. Methods: Taking a qualitative approach grounded in phenomenological psychology, this study conducted in-depth interviews by which researchers strived to observe, analyze and understand, from their first-person perspective, how they live under such situation. The participants were recruited through purposive sampling. Three patient-caregiver dyads (three male schizophrenic patients with one male and two female caregivers) were interviewed. The analysis step is adopted by Henri Ellenberger’s existential-phenomenological method (Yaw-Sheng Lin, 2002). Results: Five over-arching themes emerged in the analysis on the transformation of experiences of suffering and caring. (1) Camouflaging the “extra-normal” in daily life. (2) “Extra-normal” is understood through the singularity in the daily life, including the patient and caregiver can “encounter” the unique experience. (3) Ruminative reflection about what happening? (4) Make sense of schizophrenic experiences through blurry the boundary between the normal and abnormal to integrate self into life orientation. (5) Existential experience as becoming process through the state of mind of “hope” and “Angst”. Conclusions: The outcome is implicated in clinical practice: (1) Return to young schizophrenic patients’ lifeworld beyond psychopathology comprehension to articulate the intersubjective understanding relationships. (2) Help caregiver to understand their uncanny situation and cultivate the caring ethics for self and the other. Limitation, future research agenda and suggestion are discussed and proposed.

本研究旨在探究校長正向領導與學校效能之相關情形，透過整合15篇相關研究數據，採用後設分析為研究方法，期以巨觀角度探究我國校長正向領導與學校效能關係之現況，並分析調節變項之影響情形。本研究樣本的調查對象為現職初等、中等學校之教職員，並以教師性別（男性比）、擔任職務（兼行政職務比）、研究地區（分為北部6篇、中南部3篇、全國6篇研究）及學校教育階段（分為國小9篇、國中3篇、中等學校3篇研究）為調節變項加以分析。 本研究獲致結論如下： 壹、正向領導與學校效能相關研究有成長趨勢，又以北部地區、國小教育階段居多。 貳、整體正向領導與學校效能關係為正相關，具大效應量。 參、正向領導分層面與學校效能關係均為正相關，且為大效應量。 肆、建立正向關係與學校效能間相關程度最高。 伍、研究地區、學校教育階段對於整體正向領導與學校效能關係具有調節效果。 一、研究地區：關聯程度北部大於中南部。 二、學校教育階段：關聯程度隨學校教育階段升高而有提升之趨勢。 陸、研究地區、學校教育階段對於校長正向領導分層面與學校效能關係皆具有調節效果，另，教師性別為正向溝通與學校效能關係之調節變項。 一、研究地區：北部地區校長正向領導分層面與學校效能的關聯性均較中南部地區為高。 二、學校教育階段：正向領導分層面的正向氣氛、正向關係、正向溝通與學校效能之關係隨學校教育階段愈高而愈強；正向意義與學校效能關係之強度隨著學校教育階段的升高而有降低之趨勢。 三、教師性別：男性教師所佔的比率越高，正向溝通與學校效能的關聯性越高。 最後，根據研究發現提出建議，以供學校校長、學校教育人員及未來研究者參考。 壹、積極實施校長正向領導以促進學校效能。 貳、從正向關係著手，有效實施正向領導。 參、以南部學校為重，加強推廣正向領導。 肆、從中等學校著手，積極推動正向領導。 伍、從初等學校著手，強調賦予正向意義。 陸、與男性教師相處可多運用正向溝通。 / The purpose of this study is to explore the relationships between principals’ positive leadership and school effectiveness by integrating the findings of 15 researches related. In order to understand the current status of the relationships between principals’ positive leadership and school effectiveness in Taiwan on a macroscale and explore the influences from moderator variables, the present research employs meta-analysis as methodology. Educators of elementary and secondary education were recruited as samples, and teachers’ gender (male ratio), positions (administrative ratio), location of research (including six papers of the north, three papers of the central south, and six papers of national) and education level of school (including nine papers of elementary school, three papers of junior high school, and three papers of secondary) were adopted as moderator variable. The findings of this study were summarized as follows: 1.The researches about principals’ positive leadership and school effectiveness showing a growth trend, and mostly in the north and elementary school. 2.The overall principals’ positive leadership is positively correlated with school effectiveness, and the effect size is large. 3.The sub-variables of principals’ positive leadership are positively correlated with school effectiveness, and the effect size are large. 4.The correlation between positive relationship and school effectiveness is strongest. 5.The location of research and education level of school as a moderator variable in the relation between overall principals’ positive leadership and school effectiveness. (1) The location of research: the correlation of the north is bigger than the central South. (2) The education level: the correlation will enhance as the education level increases. 6.The location of research and education level of school as a moderator variable in the relation between sub-variables of principals’ positive leadership and school effectiveness. In addition, teachers’ gender has moderating effects only between positive communication and school effectiveness. (1) The location of research: the correlation between sub-variables of principals’ positive leadership and school effectiveness of the north are stronger than the south. (2) The education level: the correlation between positive climate, positive relationship, positive communication, positive meaning, and school effectiveness will enhance as the education level increases; however, the correlation between positive meaning and school effectiveness will decrease as the education level increases. (3) Teachers’ gender: the higher the proportion of male teacher is, the stronger the correlation between positive communication and school effectiveness will be. Suggestions were made based on the findings of this study to serve as reference for school principals, school educators and future researches. 1.Implement principals’ positive leadership positively to promote school effectiveness. 2.To implement positive leadership effectively, one has to start with positive relationship. 3.Put schools of the south first and keep popularizing positive leadership. 4.Promote positive leadership positively starting with secondary education. 5.Emphasize the reinforcement of positive meaning starting with elementary education. 6.Get along with the male teachers can use positive communication more often.