學齡期注意力缺陷過動症兒童之母親憂鬱及其相關因素之探討

Depression and Related Factors in Mothers of School-Aged Children with Attention-Deficit Hyperactivity Disorder

背景：注意力缺陷過動症兒童因疾病特性，其母親容易產生精疲力竭、壓力及憂鬱，而母親憂鬱不僅危害本身，同時對家庭和社會亦造成負面影響。目的：探討學齡期注意力缺陷過動症兒童之母親的憂鬱及其相關因素。方法　採橫斷式相關性研究，方便取樣100位學齡期注意力缺陷過動症兒童的母親為研究對象；使用親職壓力量表、社會支持量表及貝克憂鬱量表進行資料收集，並以皮爾森積差相關、逐步複迴歸等進行統計分析。結果　本研究發現學齡期注意力缺陷過動症兒童之母親近四成有憂鬱情形，將近五成親職壓力偏高，其中34%的母親有高度親職壓力需進一步轉介給專業人員。在相關性方面，本研究發現親職壓力越大，母親越容易憂鬱(r=.647, p＜.001)；社會支持越高，母親的憂鬱會降低(r=-.327, p＜.01)。「親職壓力」及「家庭每月收入40,000元（含）以下」為學齡期注意力缺陷過動症兒童之母親憂鬱的重要預測因子，而「親職壓力」為最重要之預測因子(R^2 change=41.9%)。結論　面對高親職壓力之學齡期注意力缺陷過動症兒童的母親，護理人員須注意病童母親憂鬱情形，適時提供親職管教策略，增加其社會支持，以預防或減少母親憂鬱對個人及家庭的傷害。

Background: The mothers of children with attention-deficit hyperactivity disorder tend to experience depression at higher levels because of the poor social interaction and deviant behaviors of their children. These depressed mothers often harm themselves and negatively impact their family and community. Purpose: This study examines maternal depression and its related factors in the mothers of school-aged children with attention-deficit hyperactivity disorder. Methods: A cross-sectional study with a purposive sampling of 100 mothers of school-age children with attention- deficit hyperactivity disorder was developed. Data were collected using a structured questionnaire that included the Parenting Stress Index (PSI), social support scale, and the Beck Depression Inventory (BDI). The Pearson product moment correlation and stepwise multiple regression were used to analyze data. Results: The findings showed that almost half of the mothers with school-aged ADHD children suffered higher parenting stress and that 34% required professional psychiatry referral. In addition, 40% of the participants suffered from depression. Higher levels of parenting stress were associated with a higher incidence of depression (r=.647, p＜.001). Participants with better social support had lower depression levels (r=-.327, p＜.01). 'Parenting stress' and having a monthly total household income of ≤ NT$40,000 were significant predictors of maternal depression. 'Maternal stress' was the most significant predictor, with a total explained variance of 41.9% (R^2 change=41.9%). Conclusions: The results of this study are intended to help medical staff better care for the mothers of school-aged children with ADHD. These results will assist in the evaluation of maternal depression, parenting stress, and levels of required social support. It will especially help in the evaluation of maternal depression symptoms of those mothers of low socioeconomic status with high parenting stress. Providing these mothers with parental training, education on effective parenting and discipline strategies, and better social support may effectively reduce maternal depression, which will help minimize the negative impacts of this depression on the family and the community.