慢性病患者病後生活變動、罹病情緒、預期控制、自我照顧與憂鬱的關係：疾病調適雙路徑探討

Illness life change, illness-related distress, perceived control, self-care behaviors, and depression in chronic patients: A dual illness adaptation path

慢性病患者在疾病調適中有一定比例需面臨憂鬱的議題，而此一議題在近期漸漸受到重視，本研究主要目的即在探討慢性病患者在多元疾病調適歷程中影響憂鬱的相關因素。研究邀請兩類門診慢性病患者，包括高血壓患者110名與糖尿病患者117名，共227，男性121位，女性106位，平均年齡為60.94歲。經由研究邀請同意後請參與研究者填寫五份問卷：病後生活變動量表、預期健康控制量表、罹病情緒量表、自我照顧行為量表及貝克憂鬱量表第二版。結果證實研究路徑模式直接效果與間接效果部分成立|其中病後的生活變動透過罹病情緒間接影響憂鬱，預期控制透過自我照顧間接影響憂鬱，雙路徑中介效果成立。研究討論疾病調適憂鬱路徑的意義，並提出臨床服務的應用與建議，最後亦針對研究限制進行討論。

Depression is the key issue of patients with chronic disease that has received the most attention. The purpose of this study was to examine the influence of chronic disease patient on suffered depression how through the multiple components influenced complex process from illness adaptation. The participants comprised 227 clinic patients, 110 patients with hypertension and 117 patients with type 2 diabetes and male 121, female 106. The mean age is 60.94. Five scales were conducted by invited inform consent procedure, the scales including illness life change scale, expectancy health control scale, chronic illness-related distress scale, self-care behaviors scale and Beck Depression II scale. The results show that the research hypotheses are partially supported by the significant direct effects and indirect effects in our path model. The relationship between the illness life change and depression may mediate by illness-related distress, and self-care play mediating role between expectancy control and depression. We discussed the contributions and implications of the bi-route mediating model of illness adaptation affecting depression as well as the clinical applications and future research suggestions. Finally we also discussed the limitations of the study.