情緒管理團體對護專學生之憂鬱與焦慮情緒之成效分析

The effectiveness of emotion management group for depression and anxiety in nursing students

青少年憂鬱與焦慮情緒所延伸的身心症狀與行為問題日漸受到重視，認知行為取向的情緒管理方案已廣為應用在臨床憂鬱與焦慮症的患者。本研究採取世界衛生組織（WorldHealthOrganization）三級預防角度來思考心理健康議題，以期將心理介入提前至第一級和第二級預防，由校園中直接進行預防、篩選和心理介入，以降低青少年因憂鬱與焦慮情緒所延伸的身心症狀與行為問題。本研究以八名南部某醫護專科學校學生為研究對象，受試者參與為期二天共十二小時的「情緒管理團體」，團體內容以認知行為療法（cognitivebehaviortherapy）為架構，針對憂鬱與焦慮情緒進行介入。受試者在參與團體前一週由研究者進行個別會談，以瞭解其壓力來源、身心症狀，以及因應方式，並施以社會再適應量表（SocialReadjustmentRatingScale）、身心症狀評估表（PsychosomaticSymptomsRatingScale）、貝克憂鬱量表（BeckDepressionInventory-II,BDI-II）與貝克焦慮量表（BeckAnxietyInventory,BAI），在團體結束後二週再由研究者進行個別會談，並以BDI-II與BAI評估受試者憂鬱與焦慮情緒的改變情形。本研究發現，受試者壓力來源以「課業」居多（佔100%），其次為「同儕和人際關係」與「家庭互動」（各佔25%）；受試者之平均壓力分數為798.12（SD=782.66），有三分之一的受試者得分落在中度與高度壓力的危險等級。受試者在面對壓力時的因應方式以「主動想辦法解決」為最多（佔62.5%），其次為「找同學／老師／家人傾訴」和「壓抑在心裡」（均為50%）。透過「情緒管理團體」之介入，多數受試者的憂鬱程度與焦慮程度均有下降趨勢。從團體回饋分析發現受試者對「情緒管理團體」有正面評價，包括滿意團體進行方式與老師帶領方式，亦獲得情緒管理新知，同時也對自己在團體表現予以正向評價。此外，受試者亦表示透過「情緒管理團體」而學習到如何覺察自己憂鬱和焦慮情緒、辨認思考模式、學習放鬆與腹式深呼吸技巧、問題解決與情緒管理策略，同時也透過進一步自我坦露而達到自我瞭解，並因認識新朋友而獲得社會支持。因此，情緒管理團體之實施有助於學生在面對生活壓力事件與情緒困擾時，習得更多自我瞭解與情緒因應策略。建議未來可舉辦更多情緒管理團體，以協助學生因應生活壓力，並協助學生培養正向思考模式與情緒因應技巧。

In recent years, depression and anxiety intervention programs have become essential issues in Taiwan. Depression, cancer and acquired immune deficiency syndrome (AIDS) have been listed in the top three diseases in 21th century by World Health Organization (WHO). There are many depression, anxiety and stress coping problems in the teenager and become the main issues in our society. There were eight nursing students participated 12 hours emotion management program that was based on cognitive behavior therapy and focused on depression and anxiety. Subjects accepted individual interview, Social Readjustment Rating Scale, Psychosomatic Symptoms Rating Scale, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) by clinical psychologist one week before the program, and BDI/BAI two weeks after program to evaluate the improvement. The results showed that the major stressor of students was schoolwork (100%) and then interpersonal relationship and family interaction (25% and 25% respectively). The mean stress score of subjects was 798.12 (SD = 782.66), and one-third of subjects had medium to high stress risk level. For the stress coping, the subjects were using problem solving (62.5%) and talking to classmates/ teaches/ family members (50%), and keep in their mind (50%) for dealing with their stressors. After emotion management program, the depression and anxiety were decreased. The analysis of group feedback found that subjects had positive feedback for the emotion management program, such as satisfied with the program and leader, got the new ideas of emotion management and satisfied with their performance in the program. Besides, subjects reported that they learned how to self-awareness of depression and anxiety, identify their thinking processes, muscle relaxation and deep breath, problem-focus and emotion-focus strategies, and used self-disclosed for self-understanding and increased social support in this program. Therefore, emotion management program helped students how to self-understand and increased emotion coping strategies when they were suffering by negative emotion. For increasing mental health in the campus of nursing school, we suggested that there will be more emotion management programs will be hold to help students cope with their stressors, think positive, and positive coping skills when they are interrupted by the negative emotion.