發展遲緩兒童照顧者的面子顧慮與憂鬱

Face Concern and Depression in Caregivers with Developmentally Delayed Children

目的：在亞洲人文化裡，「面子」代表一個人的社會地位，這是建立於個人在人際互動的表現上。雖然面子顧慮跟智能障礙個案照顧者的心理困擾有關，但是比較顧慮面子是否跟發展遲緩兒童照顧者的憂鬱症有關仍然不清楚。本研究的目的在探討面子顧慮與發展遲緩兒童照顧者族群憂鬱症的關係。方法：217位發展遲緩兒童的照顧者，分別測量其面子顧慮程度及照顧負荷、並以迷你國際神經精神疾病會談量表作診斷是否有憂鬱症。結果：二十六位(12.0%)照顧者罹患有憂鬱症疾患。照顧者比較顧慮面子跟罹患憂鬱疾患之間有顯著的相關性。在控制照顧者收入、教育程度、工作與否以及照顧負荷後，面子顧慮方面，患有憂鬱疾患的照顧者與沒有患有憂鬱疾患的照顧者相比，仍然有顯著的差異（p<0.05，風險性比率：1.94，95%信效區間：1.13-3.32）。進一步把面子顧慮分成兩個部分時，只有顧慮自己的面子，在控制其他變數後，患有憂鬱疾患的照顧者與沒有患有憂鬱疾患的照顧者相比，仍然有顯著的差異（p<0.01，風險性比率：2.18，95%信效區間：1.33-3.58）。結論：發展遲緩兒童照顧者面子顧慮程度與罹患有憂鬱症疾患有關。臨床工作者應留意照顧者的面子顧慮問題，給予即時的支持及提供罹患有憂鬱照顧者適當的治療。

Objective:“Face” in Asian culture refers to social position that is based on one’s performance in an interpersonal context. The face concern is associated with psychological distress among caregivers of subjects with mental retardation. But whether face concern is associated with depressive disorders for caregivers of chil-dren with developmental delay remains unclear. This study was intended to assess the association between face concern and depressive disorder in a group of caregivers of children with developmental delay. Methods:We enrolled 217 caregivers of children with developmental delay in an early intervention program in south Taiwan to this study. Each participant was asked to complete the Loss of Face Scale (LOF) to assess his/her level of face concern and the Care Burden Inventory to assess care burden. Depressive disorder was diagnosed using the Mini-Interna-tional Neuropsychiatric Interview (MINI). Results:Twenty-six (12.0%) caregivers were found to have depressive disorder. A significant relationship existed between high face concern and depressive disorders of caregivers. After controlling caregiver’s income, occupation, education, and care burden, significant difference still existed in face concern between caretakers with and without depressive disorders (p< 0.05, odds ratio (OR): 1.94, 95% confidence interval (CI): 1.13 - 3.32). With (OR) face concern being split into two domains, the significant difference only existed between caretakers with depressive disorders and those with self-face concern (p< 0.01, OR: 2.18, 95% CI: 1.33 - 3.58), but not between those with depressive disorders and those with other-face concern. Conclusion:Self-face concern had impact on the mental health of caregivers of children with develop-mental delay. Introducing a timely and supportive approach for face concern of those caregivers and giving appropriate treatment for those with depressive caregivers are important.