A Clinical Investigation of Self-Efficacy, Outcome Expectancy, Coping Styles, and Emotional Adaptation in Diabetes Mellitus Patients

本研究探討糖尿病患在面對疾病控制壓力時，其自我效能、結果預期、及因應方式對於疾病的情緒調適結果有何影響。本研究以問卷施測之方式收集了35名糖尿病患及37名其他診斷之慢性病患者（包括高血壓、高血脂、痛風）的資料。研究結果發現，糖尿病患與其他診斷之慢性病患者在自我效能、因應方式及情緒適應結果並無顯著差異，但糖尿病患對疾病控制之結果預期顯著高於其他診斷之慢性病患者。全體受試者使用問題聚焦之因應方式比例最高，可能表示此類慢性病患疾病控制度較高，患者傾向以問題聚焦因應方式處理疾病壓力。最後，本研究針對糖尿病組進行探索性之路徑分析，結果顯示問題聚焦因應對憂鬱情緒具有顯著預測效果，而自我效能變項則對問題聚焦因應及對逃避式因應有顯著預測效果，或可推論在糖尿病患中，疾病控制的自我效能，對於病患的情緒適應仍具最主要之影響力。This study aimed to investigate the association between self-efficacy, outcome expectancy, coping style, and emotional adaptation in diabetes mellitus (DM) patients when they confronted with disease-related stress. This study used questionnaires and the subjects consisted of 35 DM patients and 37 other chronic diseases patients (including hypertension, hyperlipidemia, and gout). The results revealed that, between the DM patients and the non-DM patients, there were no significant differences in all dependent variables except for outcome expectancy, in which the DM patients were more positive than non-DM patients. Besides, all patients used problem-focused coping most frequently, this may suggest that the self-care controllability of these chronic diseases is above some level so that the patients tend to use problem-focused coping for disease-related stress. An exploratory path analysis in DM group suggested that problem-focused coping predicted depression, and problem-focused coping and avoidant coping were predicted by self-efficacy, which may be the most powerful predictor for patients’ emotional adaptation.第一章 緒論................................................................................................ 1 第一節 慢性病............................................................................................ 1 第二節 因應概念界定的歷史發展.......................................................... 6 第三節 自我效能感.................................................................................. 17 第二章 研究架構、目的及假設................................................................ 25 第一節 研究架構...................................................................................... 25 第二節 研究目的與假設.......................................................................... 26 第三章 研究方法...................................................................................... 28 第一節 受試者.......................................................................................... 28 第二節 研究工具...................................................................................... 28 第三節 研究程序...................................................................................... 33 第四章 研究結果...................................................................................... 34 第一節 自我效能、結果預期、因應方式、以及情緒適應結果之差 異分析.......................................................................................... 34 第二節 因應方式使用頻率之差異分析................................................... 40 第三節 糖尿病患者與無糖尿病患者在各變項之相關性分析............... 42 第四節 研究架構之路徑分析.................................................................. 46 第五章 討論.............................................................................................. 47 第一節 糖尿病患與其它診斷的慢性病患者的差異.............................. 47 第二節 慢性病患者的因應方式.............................................................. 48 第三節 慢性病患者自我效能、結果預期、以及因應方式之相關.......... 49 第四節 自我效能、結果預期、因應方式對情緒適應之影響.................. 50 第六章 研究限制與未來研究方向.......................................................... 52 第一節 研究限制...................................................................................... 52 第二節 未來研究方向.............................................................................. 53 參考文獻................................................................................................................ 55 附錄......................................................................................................................... 5