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| 題名: | 精神官能症病患死亡態度之研究 |
| 其他題名: | Attitudes toward death in neurotic patients |
| 作者: | 周士雍
Chou, Shih-Yong |
| 貢獻者: | 生死學研究所
文榮光 |
| 關鍵詞: | 死亡態度 |
| 日期: | 2001 |
| 上傳時間: | 2015-05-13 10:56:37 (UTC+8) |
| 摘要: | 精神官能症屬輕型之精神疾病，常見如焦慮症、恐慌症、強迫症、慮病症、輕鬱症等屬之，關於精神官能症之病因大致可由生理-心理-社會等三個角度來探討。臨床上，我們可以感覺到患者對死亡感到特別焦慮，或是特別恐懼死亡。本研究將由瞭解精神官能症患者的死亡態度切入，來看精神官能症之成因及治療。方法是由高雄長庚醫院精神科門診隨機抽樣選取一百名精神官能症患者為實驗組，並以其條件及背景類似之正常人一百名為對照組，以填寫結構式「死亡態度問卷」（內含「死亡恐懼」、「死亡逃避」、「死亡接受」三個向度，死亡接受又再細分為「趨近接受」、「中性接受」、「解脫接受」等三類）之方式，來瞭解精神官能症患者的死亡態度與一般正常人有何不同。研究並以病患自填之「中國人健康問卷」及「台灣人憂鬱問卷」來幫助瞭解病人最近之病況，以作者針對本研究設計的「心理治療需求問卷」來了解病人對其自身死亡態度的看法及對心理治療的需求。 研究結果發現精神官能症患者與正常人對照組在死亡態度上的確有所不同，精神官能症患者在「死亡恐懼」與死亡接受中之「解脫接受」等二項分數高於正常人對照組。而背景資料變項方面，發現有：一、男性患者之「死亡焦慮」及「死亡逃避」高於女性，而正常人對照組則無此現象；二、正常人對照組中西方宗教（含天主教及基督教）信仰者，其「趨近接受」高於無信仰者；三、其他變項如年齡、教育程度、婚姻狀況、宗教信仰、信仰虔誠度、自覺健康程度等則未見與死亡態度顯著相關。精神官能症患者之「中國人健康問卷」得分高低與「死亡恐懼」及「解脫接受」有顯著的正相關，而「台灣人憂鬱問卷」得分則與「解脫接受」有極顯著之正相關。可見精神官能症症狀較多者有較高之「死亡恐懼」，而憂鬱症狀嚴重者有較高之「解脫接受」。心理治療需求方面，則以「死亡恐懼」得分高者，有較高之心理治療需求。 作者依研究觀察所得，推論出一套「心理病理-死亡態度-精神治療」理論，提出一種以調整「死亡態度」為指標的「生理-心理-社會」治療模式，並建議以此作為精神官能症藥物及心理治療之參考。
Neuroses are minor psychiatric disorders of various types. They include the following clinical syndromes: anxiety disorder, panic disorders, obsession-compulsion neurosis, hypochondriasis and minor depression. Neuroses are caused by various factors and can be broadly classified into biological, psychological, and social types. In clinical practice, some of neurotic patients are anxious about death, or particularly afraid of death. This study attempted to understand the neurotic patient’s attitudes toward death. One hundred neurotic patients were enrolled through random sampling of patients at Kaohsiung Changgung Memorial Hospital's outpatient mental health clinic. The control group of 100 normal subjects was matched for demographic data and social characteristics. Each patient and subject filled out a structured questionnaire, the ＂Death Attitude Profile-Revised＂ (DAP-R), which included three scales: fear of death, death avoidance, and death acceptance. Death acceptance was further divided into approach acceptance, neutral acceptance and escape acceptance. The results of this questionnaire were used to determine whether there existed any difference in attitudes toward death between the two groups. These two groups patients also completed the ＂Chinese Health Questionnaire＂ and the ＂Taiwanese Depression Questionnaire＂to assist in the assessment of their recent status. The ＂Psychotherapy Needs Questionnaire＂ designed by the authors was used to understand the subjects' views on their attitudes toward death and their needs for psychotherapy. Our results showed a significant difference in attitudes toward death between patients and the control subjects, with patients scoring significantly higher than the control group on ＂fear of death＂ and ＂escape acceptance＂ categories of the acceptance of death measure. In the neurotic group, males scored higher than females on ＂fear of death＂ and ＂death avoidance＂, whereas no difference was evident between males and females in the control group. Individuals in the control group with western religions (including Christian and Catholic) had higher approach acceptance toward death than those without religion beliefs. Other independent variables (age, educational level, marital status, religious belief, sincerity of belief, and self-perceived health) were unrelated to attitude toward death. Neurotic patients showed a positive correlation between scores on the ＂Chinese Health Questionnaire＂, ＂fear of death＂ and ＂escape acceptance＂; measures. Scores on the ＂Taiwanese Depression Questionnaire＂; showed a high correlation with scores on ＂escape avoidance＂. It implied that the patients with more neurotic symptoms had a greater ＂fear of death＂, and those with more serious depression had a higher ＂escape avoidance＂. In terms of request for psychotherapy, those patients with higher scores on ＂fear of death＂ showed a higher need for psychotherapy. Based on the results of this investigation, the authors developed a ＂psychopathology--death attitude─psychiatric treatment＂ theory and proposed a ＂biological-psychological-social＂ treatment model using the ＂attitudes toward death＂ as an index, and suggest that this model may be useful as a reference in medical treatment and psychotherapy for neurotic patients. |
| 顯示於類別: | [生死學系(生死學系碩士班,哲學與生命教育碩士班)] 博碩士論文-生死學系碩士班
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