题名

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

并列篇名

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

DOI

10.6224/JN.62.1.39

作者

陳玟伶(Wen-Ling Chen);蔡曉婷(Shiau-Ting Tsai);周汎澔(Fan-Hao Chou)

关键词

學齡期兒童 ; 注意力缺陷過動症 ; 母親憂鬱 ; 親職壓力 ; 社會支持 ; school-aged children ; attention-deficit hyperactivity disorder ; maternal depression ; parenting stress ; social support

期刊名称

護理雜誌

卷期/出版年月

62卷1期(2015 / 02 / 01)

页次

39 - 49

内容语文

繁體中文

中文摘要

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。

英文摘要

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.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Lee, M. Y.,Chen, Y. C.,Wang, H. S.,Chen, D. R.(2007).Parenting stress and related factors in parents of children with tourette syndrome.The Journal of Nursing Research,15(3),165-174.
    連結:
  2. Lin, Y. F.,Chung, H. H.(2002).Parenting stress and parents’ willingness to accept treatment in relation to behavioral problems of children with attention-deficit hyperactive disorder.The Journal of Nursing Research,10(1),43-56.
    連結:
  3. Tzang, R. F.,Chang, Y. C.,Liu, S. I.,Wu, K. H.(2007).Impact of comorbidity on parenting stress and parental symptoms in children with attention deficit-hyperactivity disorder.Taiwanese Journal of Psychiatry,21(3),196-207.
    連結:
  4. 林妃, F.(2006)。ADHD兒童的父母訓練課程及其成效。諮商與輔導,252,14-16。
    連結:
  5. 張美雲, M. Y.,林宏熾, H. C.(2007)。發展遲緩兒童家庭社會支持與賦權增能之相關研究。特殊教育學報,26,55-84。
    連結:
  6. 黃惠玲, H. L.(2008)。注意力缺陷過動疾患研究回顧。應用心理研究,40,197-219。
    連結:
  7. 黃惠玲, H. L.(2008)。注意力缺陷過動疾患研究回顧。應用心理研究,40,197-219。
    連結:
  8. 謝毅興, Y. H.,柯慧貞, H. C.,林彥鴻, Y. H.(2007)。憂鬱症、焦慮症、以及焦慮和憂鬱共病婦女對負面情緒的因應。台灣精神醫學,21(2),117-126。
    連結:
  9. Abidin, R. R.(1990).Parenting stress index.New York, NY:Psychological Assessment Resources.
  10. Aghebati, A.,Gharraee, B.,Hakim Shoshtari, M.,Gohari, M. R.(2014).Triple p-positive parenting program for mothers of ADHD children.Iranian Journal of Psychiatry and Behavioral Sciences,8(1),59-65.
  11. American Psychiatric Association、孔繁鐘(譯), F. C.(Trans.)(2007).DSM-IV-TR精神疾病診斷準則手冊.台北市=Taipei City, Taiwan, ROC:合記圖書=Ho-Chi.
  12. Beck、 A. T.,Steer, R. A.,Brown, G. K.,陳心怡(譯), S. Y.(Trans.)(2000).貝克憂鬱量表第二版(中文版)指導手冊.台北市=Taipei City, Taiwan, ROC:中國行為科學社=Chinese Behavioral Science.
  13. Byrnes, J. H. L.(2003).The emotional functioning and marital satisfaction of mother of children with attention-deficit hyperactivity disorder.Dissertation Abstracts International: Section B: The Sciences and Engineering,63,5507.
  14. Chi, T. C.,Hinshaw, S. P.(2002).Mother-child relationships of children with ADHD: The role of maternal depressive symptoms and depression-related distortions.Journal of Abnormal Child Psychology,30(4),387-400.
  15. Ercan, E.,Ercan, E. S.,Atilgan, H.,Başay, B. K.,Uysal, T.,İnci, S. B.,Ardıç, Ü. A.(2014).Predicting aggression in children with ADHD.Child and Adolescent Psychiatry and Mental Health,8,15.
  16. Gau, S. S-F.(2007).Parental and family factors for attention-deficit hyperactivity disorder in Taiwanese children.Australian and New Zealand Journal of Psychiatry,41(8),688-696.
  17. Gupta, V. B.(2007).Comparison of parenting stress in different developmental disabilities.Journal of Developmental and Physical Disabilities,19(4),417-425.
  18. Horwitz, S. M.,Briggs-Gowan, M. J.,Storfer-Isser, A.,Carter, A. S.(2007).Prevalence, correlates, and persistence of maternal depression.Journal of Women’s Health,16(5),678-691.
  19. Johnston, C.,Mash, E. J.(2001).Families of children with attention-deficit/hyperactivity disorder: Review and recommendations for future research.Clinical Child and Family Psychology Review,4(3),183-207.
  20. Lara-Cinisomo, S.,Griffin, B. A.(2007).Factors associated with major depression among mothers in Los Angeles.Women’s Health Issues,17(5),316-324.
  21. Lee, S. J.,Kwon, J. H.,Lee, Y. J.(2008).Personality characteristics of mothers of children with attention deficit hyper-activity disorder as assessed by the Minnesota multiphasic personality inventory.Psychiatry Investigation,5(4),228-231.
  22. Markowitz, J. C.(2008).Depressed mothers, depressed children.American Journal of Psychiatry,165(9),1086-1088.
  23. Narkunam, N.,Hashim, A. H.,Sachdev, M. K.,Pillai, S. K.,Ng, C. G.(2014).Stress among parents of children with attention deficit hyperactivity disorder, a Malaysian experience.Asia-Pacific Psychiatry,6(2),207-216.
  24. Peters, K.,Jackson, D.(2009).Mother’s experiences of parenting a child with attention deficit hyperactivity disorder.Journal of Advanced Nursing,65(1),62-71.
  25. Pimentel, M. J.,Vieira-Santos, S.,Santos, V.,Vale, M. C.(2011).Mothers of children with attention deficit/hyper-activity disorder: Relationship among parenting stress, parental practices and child behavior.Attention Deficit and Hyperactivity Disorders,3(1),61-68.
  26. Psychogiou, L.,Daley, D. M.,Thompson, M. J.,Sonuga-Barke, E. J. S.(2007).Mothers’ expressed emotion toward their school-aged sons: Associations with child and maternal symptoms of psychopathology.Journal of European Child & Adolescent Psychiatry,16(7),458-464.
  27. Rosner, B.(2006).Fundamentals of biostatistics.Belmont, CA:Thomson.
  28. Schub, T., & Engelke, Z. (2014). Parent teaching: Parenting skills -- Parents of school-age children (ages 6 to 11 years). Retrieved from Cinahl Information Systems website: http://web.a.ebscohost.com.ezproxy.kmu.edu.tw:2048/nrc/detail?vid=3&sid=9d934514-dfcc-479e-8843-fc2524200e10%40sessionmgr4005&hid=4206&bdata=Jmxhbmc9emgtdHcmc2l0ZT1ucmMtb-Gl2ZQ%3d%3d#db=nrc&AN=T705066
  29. Shin, H. S.,Kim, J. M.(2010).Analysis of relationships between parenting stress, maternal depression, and behavioral problems in children at risk for attention deficit hyperactive disorder.Journal of Korean Academy Nursing,40(3),453-461.
  30. Silver, E. J.,Heneghan, A. M.,Bauman, L. J.,Stein, R. K.(2006).The relationship of depressive symptoms to parenting competence and social support in inner-city mothers of young children.Maternal and Child Health Journal,10(1),105-112.
  31. Swartz, H. A.,Frank, E.,Zuckoff, A.,Cyranowski, J. M.,Houck, P. R.,Cheng, Y.,Shear, M. K.(2008).Brief interpersonal psychotherapy for depressed mothers whose children are receiving psychiatric treatment.American Journal of Psychiatry,165(9),1155-1162.
  32. van der Oord, S.,Prins, P. J. M.,Oosterlaan, J.,Emmelkamp, P. M. G.(2006).The association between parenting stress, depressed mood and informant agreement in ADHD and ODD.Behaviour Research and Therapy,44(11),1585-1595.
  33. van Steijn, D. J.,Oerlemans, A. M.,van Aken, M. A. G.,Buitelaar, J. K.,Rommelse, N. N. J.(2014).The reciprocal relationship of ASD, ADHD, depressive symptoms and stress in parents of children with ASD and/or ADHD.Journal of Autism and Developmental Disorders,44(5),1064-1076.
  34. Wood, L. J.,Sherman, E. M. S.,Hamiwka, L. D.,Blackman, M. A.,Wirrell, E. C.(2008).Maternal depression: The cost of caring for a child with intractable epilepsy.Pediatric Neurology,39(6),418-422.
  35. Yang, P.,Jong, Y. J.,Hsu, H. Y.,Tsai, J. H.(2007).Psychiatric features and parenting stress profiles of subtypes of attention deficit/hyperactivity disorder: Results from a clinically referred Taiwanese sample.Journal of Developmental and Behavioral Pediatrics,28(5),369-375.
  36. 行政院主計總處(2013,1月2日).薪資及生產力統計資料查詢系統.取自http://win.dgbas.gov.tw/dgbas04/bc5/EarningAndProductivity/Default.aspx [Directorate-General of Budget, Accounting and Statistics, Executive Yuan, Taiwan, ROC. (2013, January 2). Statistics on earnings and productivity. Retrieved from http://win.dgbas.gov.tw/dgbas04/bc5/EarningAndProductivity/Default.aspx]
  37. 吳佳賢, C. H.(2002)。南投縣=Nantao County, Taiwan, ROC.,國立暨南國際大學社會政策與社會工作研究所=National Chi Na University。
  38. 侯伯勳, P. H.,林志堅, C. C.,遲景上, C. S.,陳展航, C. H.(2003)。臺中地區某國小低年級學童注意力不足過動症候群盛行率初探。慈濟醫學雜誌,15(3),163-167。
  39. 翁毓秀, B. H.(2003).親職壓力量表指導手冊.台北市=Taipei City, Taiwan, ROC:心理=Psychological.
  40. 曾資蓉, T. J.,周傳姜, C. C.(2006)。氣喘孩童母親的親職壓力及因應行為。護理雜誌,53(4),31-40。
  41. 湯麗玉, L. Y.,毛家舲, C. L.,周照芳, C. F.,陳榮基, R. C.,劉秀枝, H. C.(1992)。痴呆症老人照顧者的負荷及其相關因素之探討。護理雜誌,39(3),89-98。
  42. 黃隆正, L. C.,李明濱, M. B.(2003)。憂鬱症與自殺。台灣醫學,7(6),929-934。
被引用次数
  1. 古思潔(2016)。家庭復原力與父母身心健康狀況之相關研究:以發展遲緩兒童家庭為例。長榮大學社會工作學系(所)學位論文。2016。1-101。