研究目的：失眠為國人常見的健康問題，造成患者夜間睡眠的痛苦，對白天生活品質也有明顯的影響，站在預防失眠慢性化的角度切入，找出情境性失眠高危險群的心理病理特性，應可為防治失眠疾患提供更積極的建議。本研究目的一即是想透過與好眠組的比較，討論壓力因應風格、持續失眠相關病因(對睡眠不適當認知、睡眠相關安全行為、身心激發程度)在失眠高危險族群及慢性失眠者的特性為何。第二個目的則想驗證失眠持續因素對失眠的影響路徑，並探討壓力因應風格在失眠持續模式中的影響性為何。
研究方法：本研究以橫斷式問卷調查法收集資料，蒐集有效問卷情境性失眠高風險群組74份、好眠組75份、與慢性失眠組62份，總共211份有效問卷。統計方法則根據不同研究目的分別採用單因子變異數分析及結構方程模型的路徑分析進行資料處理。
研究結果：慢性失眠者比好眠者與慢性失眠者有更高的睡眠不適當認知、更多睡眠相關安全行為更高的睡前激發程度。慢性失眠者與情境性失眠高危險族群在面對壓力時，也比好眠者使用較多的「社會支持、情緒調節與發洩的調解」、「逃避」、「問題解決、重釋與接受」等因應策略。此外，情境性失眠高危險族群也比好眠者用更多的睡眠相關安全行為來因應疲憊或睡不好的狀況。另外，本研究路徑分析結果發現睡眠不適當認知會透過安全行為及激發程度而影響失眠，且在考驗各個壓力因應風格對失眠持續模式之影響時，發現較一致的結果是逃避因應可能會增加個體使用更多睡眠相關安全行為而惡化失眠
研究討論：研究結果支持過去理論認為睡眠不適當認知、睡眠相關安全行為及睡前激發程度為失眠的持續因子。為預防情境性失眠高危險族群其失眠症狀慢性化，建議重點應放在睡眠的衛生教育，並且不只是教導適當因應失眠的行為，重要的是需包括增強對失眠處理的控制感、建立適當合理的藥物使用概念、矯正對失眠後果的災難化想法。最後，過去少有其他研究討論逃避因應風格與失眠的關係，建議對此有興趣的研究者可對逃避因應風格與失眠的關係做進一步的重覆驗證與探討。 / OBJECTIVE: The goals of the study are to examine (1) the differences of coping, dysfunctional beliefs and attitudes about sleep, sleep related safety behaviors and pre-sleep arousals among chronic insomniacs, normal sleepers vulnerable to stress-related sleep disturbance and good sleepers (2) the interactions of coping with other etiological factors in the model of persistent insomnia.
METHOD: The sample was composed of 211 participants. Participants were asked to complete a set of questionnaires, including the Ford Insomnia Response to Stress Test (FIRST), the Insomnia Severity Index, the Pre-Sleep Arousal Scale, the Sleep-Related Behaviour Questionnaire, the Dysfunctional beliefs and attitudes about sleep questionnaire, COPE, the Center for Epidemiologic Studies Depression Scale, the Beck Anxiety Inventory and the Pittsburgh Sleep Quality Inventory. The participants were categorized into three subgroups, 75 good sleepers, 74 normal sleepers vulnerable to stress-related sleep disturbance, and 62 chronic insomniacs, according to clinical interview and/or their scores on the FIRST.
RESULT: The results showed that chronic insomniacs reported more dysfunctional beliefs and attitudes about sleep, sleep related safety behaviors and pre-sleep arousals than the other groups. In addition, chronic insomniacs and normal sleepers vulnerable to stress-related sleep disturbance used more coping styles of “problem solving, positive reinterpretation and acceptance”, “social support, focus on and venting of emotions”, and “avoidance” than good sleepers. Also, normal sleepers vulnerable to stress-related sleep disturbance reported more safety behaviors to cope insomnia than good sleepers. Furthermore, the path analysis showed that the safety behaviors and arousal play an important mediating role between dysfunctional beliefs and attitudes about sleep and insomnia in chronic insomniacs. Finally, data showed that avoidance coping could predict the frequency of sleep related safety behaviors.
CONCLUSION: The results imply that in order to prevent normal sleepers vulnerable to stress-related sleep disturbance from becoming chronic insomniacs, sleep hygiene education program should incorporate methods that are designed to reduce maladaptive sleep beliefs and sleep related safety behaviors. The relationship found between avoidance coping and insomnia is also of interest and require replication in future researches.
| Identifer | oai:union.ndltd.org:CHENGCHI/G0093752004 |
| Creators | 林詩淳, Lin, Shih Chun |
| Publisher | 國立政治大學 |
| Source Sets | National Chengchi University Libraries |
| Language | 中文 |
| Detected Language | English |
| Type | text |
| Rights | Copyright © nccu library on behalf of the copyright holders |
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