Testing a Model of Stress and Health Using Meta-Analytic Path Analysis

壓力與健康之模式驗證：統合徑路分析研究

余麗樺(Lifa Yu)；邱兆宏(Chao-Hung Chiu)；林耀盛(Yaw-Sheng Lin)；王秀紅(Hsiu-Hung Wang)；陳九五(Jew-Wu Chen)

壓力 ； 健康 ； 統合分析 ； 徑路分析 ； stress ； health ； meta-analysis ； path analysis

The Journal of Nursing Research

15卷3期（2007 / 09 / 01）

202 - 214

英文

本研究目的為應用統合徑路分析技術以評估一壓力與健康之理論模式。本研究先採用統合分析方法，結合國內於1980年1月至2003年12月間有關壓力議題之研究共477篇進行分析，所蒐尋的資料庫包括「中華民國期刊論文索引系統」、「全國博碩士論文資訊網」、「國科會科技資訊網路系統」。登錄的資訊包括壓力、健康、社會支持、因應策略和人格特質等變項，從這些經過統合分析後的資料，獲得這些變項間之相關矩陣，然後再據之進行徑路分析，以檢驗此壓力－健康之理論模式與得自實徵研究之統合分析資料間的適配程度。研究結果顯示本研究所提出之壓力－健康理論模式經修正後，與統合分析資料之間有著良好的適配。就本研究整個壓力－健康理論模式來看，主觀壓力本身對健康具有實質且重要的直接效果，而客觀壓力是需要透過主觀壓力的中介作用，才會對健康造成影響；而社會支持、因應方式、人格特質等變項，在壓力－健康歷程中，相較上不論是直接或間接，都有著較小的影響。本研究為壓力和健康間的關係呈現出一個整體性的面貌，並為未來研究和實務工作提供可參考的方向。

The goal of this study was to use meta-analytic path analysis to evaluate a theoretical model of stress and health. A meta-analysis technique was adopted to combine and re-analyze 477 studies that investigated stress-related topics between January 1980 and December 2003 in Taiwan. Databases searched included PerioPath-Index to Chinese Periodical Literature, Electronic Theses and Dissertations System, and NSC (National Science Council) Science and Technology Information System. Variables recorded included stress, health, social support, coping strategies, and personality traits. A correlation matrix of these variables was derived from meta-analytic data and then analyzed using structural path analysis to test the fitness of the hypothesized stress-health model to the observed aggregated data. Results showed the revised hypothesized model to be a reasonable, good fit to aggregated data. Based on the theoretical stress-health model developed in this study, subjective stress was found to have a substantively important and direct effect on health, whereas objective stress required the mediating function of subjective stress to exercise an influence on health. Such variables as social support, coping strategies, and personality traits had comparatively weaker influences, either direct or indirect, on the stress-health process. This study provided a holistic view on the relationship between stress and health in the context of stress and proposed a direction for future research and practice.

1. Cheng, H. Y.,Dai, Y. T.,Kuo, S. H.,Yao, K. P.(2000).Relationships between stress, coping strategies, and quality of life in adult asthma patients.The Journal of Nursing Research,8(6),599-613.
   連結：
2. Chu, L. C.,Kao, S. R.(2005).The moderation of meditation experience and emotional intelligence on the relationship between perceived stress and negative mental health.Chinese Journal of Psychology,47(2),157-179.
   連結：
3. Liaw, G. F.,Cheng, M. J.,Wang, Y. S.(2005).A study of negative affectivity influencing the relationships among social support, stressor of role and job burnout.Journal of Human Resource Management,5(4),155-180.
   連結：
4. Lue, B. H.,Chen, H. J.,Kao, M. Y.(2006).Perceived stress in medical students and its relationship to mental health.Journal of Medical Education,10(1),25-33.
   連結：
5. Wang, H. F.,Yeh, C. M.(2005).Stress, coping, and psychological health of vocational high school nursing students associated with a competitive entrance exam.The Journal of Nursing Research,13(2),106-116.
   連結：
6. Aneshensel, C. S.,A. V. Horwitz,T. L. Scheid (Eds.)(1999).A handbook for the study of mental health: Social contexts, theories and systems.Cambridge, UK:Cambridge University Press.
7. Bandura, A.(1986).Social foundations of thought and action: A social cognitive theory.Englewood Cliffs, NJ:Prentice Hall.
8. Borenstein, M.,Hedges, L.,Higgins, J.,Rothstein, H.(2005).Comprehensive meta-analysis: A computer program for research synthesis.Englewood, NJ:Biostat.
9. Chiou, W. B.(2001).The coping effect of social support: A critical review.Proceedings of the National Science Council: Humanities and Social Science,11(4),311-330.
10. Cohen, S.,Wills, T. A.(1985).Stress, social support, and the buffering hypothesis.Psychological Bulletin,98(2),310-357.
11. Cox, T.(1978).Stress.Baltimore, MD:University Park Press.
12. Dahlin, M.,Joneborg, N.,Runeson, B.(2005).Stress and depression among medical students: A cross-sectional study.Medical Education,39,594-604.
13. Ding, L.(2003).The effect of the personality traits of MIS professionals to job stress.National Kaohsiung Hai Yuan Journal,18,211-225.
14. Diong, S. M.,Bishop, G. D.,Enkelmann, H. C.,Tong, E. M. W.,Why, Y. P.,Ang, J. C. H.(2005).Anger, stress, coping, social support and health: Modeling the relationships.Psychology & Health,20(4),467-495.
15. Folkman, S.,Moskowitz, J. T.(2004).Coping: Pitfalls and promise.Annual Review of Psychology,55,745-774.
16. French, J.(2005).Work locus of control as a moderating influence on the quality of work life for radiation therapists.Canadian Journal of Medical Radiation Technology,36(1),12-16.
17. Friedman, H. S.(2002).Health psychology.Upper Saddle River, NJ:Prentice Hall.
18. Gerrig, R. J.,Zimbardo, P. G.(2005).Psychology and life.Boston:Allyn & Bacon.
19. Hammer, T. H.,Saksvik, P. O.,Nytro, K.,Torvatn, H.,Bayazit, M.(2004).Expanding the psychosocial work environment: Workplace norms and work-family conflict as correlates of stress and health.Journal of Occupational Health Psychology,9(1),83-97.
20. Hedges, L. V.,Olkin, I.(1985).Statistical method for meta-analysis.Orlando, FL:Academic Press.
21. Hu, L. T.,Bentler, P. M.(1999).Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives.Structural Equation Modeling,6(1),1-55.
22. Huang, H. C.,Pai, L.(1992).A study on stress perception of adult life events.Proceedings of Medical Research of the Tri-Service Hospital,15,933-952.
23. Hunter, J. E.,Schmidt, F. L.(2004).Methods of meta-analysis: Correcting errors and biases in research findings.Thousand Oaks, CA:Sage.
24. Jiang, C. X.(1991).Taipei,National Taiwan Normal University.
25. Jöreskog, K. G.,Sörbom, D.(2004).LISREL 8.7: Computer software.Lincolnwood, IL:Scientific Software International.
26. Karlin, W. A.,Brondolo, E.,Schwartz, J.(2003).Workplace social support and ambulatory cardiovascular activity in New York City traffic agents.Psychosomatic Medicine,65,167-176.
27. Lazarus, R. S.,Folkman, S.(1984).Stress, appraisal, and coping.New York:Springer.
28. Li, S. H.(2000).Taipei,National Yang Ming University.
29. Lipsey, M. W.,Wilson, D. B.(2001).Practical meta-analysis.Thousand Oaks, CA:Sage.
30. Lu, L.(1997).The process of work stress: A dialogue between theory and research.Formosa Journal of Mental Health,10(4),19-51.
31. Matthews, G.,Emo, A. K.,Funke, G.,Zeidner, M.,Roberts, R. D.,Costa, P. T.(2006).Emotional intelligence, personality, and task-induced stress.Journal of Experimental Psychology: Applied,12(2),96-107.
32. Mills, L. J.(2000).Oklahoma,University of Tulsa.
33. Mullen, B.,Suls, J.(1982).The effectiveness of attention and rejection as coping styles: A meta-analysis of temporal differences.Journal of Psychosomatic Research,26(1),43-49.
34. Ng, D. M.,Jeffery, R. W.(2006).Relationships between perceived stress and health behaviors in a sample of working adults.Health Psychology,22(6),638-642.
35. Ogden, J.(2004).Health psychology: A textbook.Buckingham Philadelphia:Open University Press.
36. Park, C. L.,Armeli, S.,Tennen, H.(2004).Appraisal-coping goodness of fit: A daily internet study.Personality and Social Psychology Bulletin,30(5),558-569.
37. Pearlin, L. I.,A. V. Horwitz,T. L. Scheid (Eds.)(1999).A handbook for the study of mental health: Social contexts, theories and systems.Cambridge, UK:Cambridge University Press.
38. Pervin, L. A.,Cervone, D.,John, O. P.(2005).Personality: Theory and research.New York:John Wiley & Sons.
39. Rintala, D. H.,Robinson-Whelen, S.,Matamoros, R.(2005).Subjective stress in male veterans with spinal cord injury.Journal of Rehabilitation Research & Development,42(3),291-304.
40. Rotter, J. B.(1966).Generalized expectancies for the internal versus external control of reinforcement.Psychological Monographs,90(1),1-28.
41. Sarafino, E. P.(2006).Health psychology: Biopsychosocial interactions.New York:John Wiley & Sons.
42. Smith, J. A.(1981).The idea of health: A philosophical inquiry.Advances in Nursing Science,3,43-50.
43. Suls, J.,Wan, C. K.(1989).The relation between Type A behavior and chronic emotional distress: A meta-analysis.Journal of Personality and Social Psychology,57(3),503-512.
44. Takaki, J.,Yano, E.(2006).Possible gender differences in the relationships of self-efficacy and the internal locus of control with compliance in hemodialysis patients.Behavioral Medicine,32(1),5-11.
45. Viswesvaran, C.,Ones, D. S.(1995).Theory testing: Combining psychometric meta-analysis and structural equation modeling.Personnel Psychology,48,865-885.
46. Wang, H. H.,Wu, S. Z.,Liu, Y. Y.(2003).Association between social support and health outcomes: A meta-analysis.Kaohsiung Journal of Medical Sciences,19(7),345-351.
47. Wasylkiw, L.,Fekken, G. C.(2002).Personality and self-reported health: Matching predictors and criteria.Personality and Individual Differences,33(4),607-620.
48. Weng, C. C.(2003).A study of emotional exhaustion among local government accountants.The National Chi Nan University Journal,6(2),1-28.
49. Wheaton, B.,A. V. Horwitz,T. L. Scheid (Eds.)(1999).A handbook for the study of mental health: Social contexts, theories and systems.Cambridge, UK:Cambridge University Press.
50. Zakowski, S. G.,Hall, M. H.,Klein, L. C.,Baum, A.(2001).Appraisal control, coping, and stress in a community sample: A test of the goodness-of-fit hypothesis.Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine,23(3),158-165.

1. 陳瑋婷(2013)。學生壓力、因應策略與性別關聯性之後設分析。中華心理衛生學刊，26(3)，347-369。
2. 高舒、林耀盛(2018)。哀悼時刻：照顧者從臨床陪伴到「後臨終」情感現象的心理轉化經驗。中華心理衛生學刊，31(3)，275-301。
3. 謝進昌、陳敏瑜(2011)。國內教育、心理後設分析研究出版偏誤檢定之實徵分析。測驗學刊，58(2)，391-422。