燒傷病人憂鬱及其相關因素之探討

Factors Related to Depression among Burns Patients

本研究的目的在探討燒傷病人出院後，產生憂鬱之狀況及其相關因素，係採描述性橫斷性調查法，以立意取樣方式，選取東部某準醫學中心，五年內出院之燒傷患者96位為研究對象，研究工具包括「貝氏憂鬱量表」、「自我概念量表」、「社會支持量表」及「個人基本資料表」四部份。研究結果顯示，96位燒傷病人憂鬱量表平均得分為13.38，顯示屬輕度憂鬱；自我概念量表平均得分為1.22，顯示燒傷患者自我概念尚可。患者對社會支持滿意度平均得分為2.36，顯示患者對社會支持的滿意度尚可，而以情緒性支持平均得分最高，實質性支持平均得分為最低。此外，憂鬱與社會支持呈顯著負相關；憂鬱與自我概念亦呈顯著負相關；社會支持與自我概念呈顯著正相關。經路徑分析發現基本資料中的經濟困難、慢性病過去病史、住院天數、受傷類別，自我概念與社會支持是憂鬱的重要預測變項，可解釋總變異量70.2%，且社會支持是藉由自我概念來影響患者憂鬱情況。本研究結果可提供護理人員瞭解燒傷病人出院後的憂鬱狀況及其影響因素，提供未來照護燒傷病人時的參考依據，以增加患者的調適能力，減少其出院後的心理適應問題。

The purpose of this study was to explore the factors related to emotional disturbance among bums patients, using purposive sampling. A total of 96 subjects from an Eastern Taiwan medical center were selected. Instruments used included the ”Beck Depression Inventory”, ”Self-Concept Inventory”, ”Social Support Inventory”, and ”Demographic Data Inventory”. Results showed the average depression index score was 13.38, indicating mild depression. The average score was 1.22 for the self-concept measure, showing an acceptable self-image among burn victims. The average score for the social support scale was 2.36, indicating an acceptable level of satisfaction with social support. The highest level of social support reported was for emotional support, with an average of 2.52 points; the lowest scores reported were for material support, with an average of 2.12 points. Depression and self-concept were found to have a negative correlation. Depression and social support were also found to have a negative correlation. A positive correlation was seen between social support and self-concept. Economic difficulties, history of chronic illness, number of days hospitalized, type of injuries, self-concept and social support are major predictors of depression status, explaining 70.2% of variance in the depression. Social support has only an indirect effect on emotional disturbance through its relationship with self-concept. Nursing professionals assisting burn victims with depression and other issues should find these results useful as a guide to care provision in the future, reducing the problems of psychological adjustment and increasing patient adaptability after discharge from hospitals.