研究背景：乳癌患者常伴隨憂鬱症狀，而反芻是癌症患者憂鬱情形的重要預測因 數。過往研究指出苦惱自責式反芻增加憂鬱的效果得到較一致的結果，而深思反 省式反芻對於憂鬱影響的結果則不太一致。深思反省式反芻意在解決問題，過程 中患者採用不同因應策略可能對其憂鬱會有不同影響，但過去較少研究探討乳癌 患者的因應如何調節深思反省式反芻對患者憂鬱變化的影響。
研究目的：探究苦惱自責式反芻與深思反省式反芻如何影響乳癌患者的憂鬱，逃 避與趨近這兩種因應方式是否在深思反省式反芻影響憂鬱的過程中有調節作用。
研究方法：本研究採用長期追蹤之研究方法，對平均年齡為 48 歲的 359 位乳癌 患者，於手術後三個月、六個月、一年和兩年四個時間點，測量其苦惱自責式反 芻、深思反省式反芻，趨近、逃避等因應模式及憂鬱狀況後進行分析。為了探索 考個體內和個體間變項的影響，包含臨床背景資料對憂鬱的預測效果，研究擬採 用階層線性模型（HLM）之方法進行統計分析。
研究結果：苦惱自責式反芻正向預測乳癌患者憂鬱情形，深思反省式反芻對憂鬱 的預測效果則受到趨近因應的調節，趨近因應越高，深思反省式反芻越能負向預 測憂鬱情形。依此結果可知對於乳癌患者而言，苦惱自責式反芻為不適應的反芻 類型，會增加乳癌患者的憂鬱情形，而深思反省式反芻的適應性僅存在於更多使 用趨近因應的患者之中。 / Background: Depressive symptoms occur frequently with breast cancer. Rumination is a major risk factor of depression. Numerous research evidence shows that brooding, the maladaptive subtype of rumination, increases depression while the effect of reflective pondering, the other subtype, remain inconsistent. Individuals who reflective ponder mean to solve the problem they face, but there is little research to explore what role coping plays in the process that reflective pondering contribute to or eliminate depression.
Purpose: To examine how two subtypes of rumination predict the depression of women with breast cancer, and whether the moderating effect of two different coping strategies, approach and avoidance, exists and how it works.
Method: Longitudinal data of rumination, coping, and depression at Time 1 (3 months after surgery), Time 2 (6 months after surgery), Time 3 (1year after surgery), and Time 4 (2 years after surgery) among 359 women with breast cancer whose mean age was 48 was collected to explore the prediction of rumination and the moderating effect of coping. To address the effect of both with- and between- subject variables including background materials and disease-related information, HLM is adopted as the analysis method.
Results: Brooding predicts the increase of depressive symptoms and acts as the maladaptive subtype of rumination. In addition, reflective pondering’ prediction to decreased depression only appears with the interaction of approach coping, which means that patients who reflective ponder more and take more approach coping at the meanwhile will experience more recovery from the depressive symptoms.
| Identifer | oai:union.ndltd.org:CHENGCHI/G0104752025 |
| Creators | 程燕敏, Cheng, Yan Min |
| 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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