慢性病患失能初期評價性自我概念之變化：以腎病末期患者為例_

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題名：	慢性病患失能初期評價性自我概念之變化：以腎病末期患者為例
書刊名：	應用心理研究
作者：	翁嘉英
作者(外文)：	Weng, Chia-ying
出版日期：	1999
卷期：	3
頁次：	頁129-161
主題關鍵詞：	失能初期；自我尊嚴；社會認定；腎病末期；Chronic disabled patients；Early adjustment stage；Self-esteem；End-stage renal disease
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(4) 博士論文(1) 專書(0) 專書論文(0) 排除自我引用:2 共同引用:3 點閱:38

　　　　　本研究關心嚴重生理功能損傷之失能性疾病（如失去重要器官或肢體殘障）患者，在失能初期驟然面對殘障的心理調適歷程。主要目的在探討患者評價性自我概念之歷時性變化，以做為臨床實務工作中提昇患者自尊感之參考。本研究將罹患腎病末期，年齡在55歲以下，接受透析治療兩年內之患者納入篩選對象，共訪談82位患者。由有多年臨床經驗之臨床心理師以結構式問卷進行訪談，內容包括病患角色認定調查表與下述變項之測量：失能前及現在之整體性自尊感高低；針對人生意義、健康狀況、活動與生涯限制、能力與才幹、社會功能與地位、家人之支持、回報能力、家庭功能等八個自我向度，在失能前、剛發病時、現在、及預期未來之自我評價的相對變化；上述八個自我評價向度在失能前、剛發病時、及現在之心理權重性相對變化。先以病患角色認定調查表，篩選17名處於抗拒階段與36名接受階段患者進行比較分析。結果顯示，兩組受試者目前之整體性自尊感得分相較於失能前皆明顯降低。在自我評價方面，接受組受試者在受訪當時，主觀上對自我的評價明顯低於失能前，同時也預期未來無法恢復到失能前的狀態。抗拒組受試者在受訪當時，主觀上認為自己的狀況比起失能前稍差但無顯著差異，同時預期未來可恢復到失能前的狀態。在心理權重性方面，接受組患者體認到失能後大部份自我向度都變得不再那麼重要，唯有「健康狀況」與「家人之態度」才是最重要的。而抗拒組受試者，即使患病時間與接受組受試者相當，但並未調整各個自我向度之心理權重性。可見，影響失能初期患者之自我尊嚴的自我評價與心理權重性皆受到其社會認定所影響。

以文找文

　　　　　The study chooses end-stage renal disease patient samples less than 55 years old who had dialysis cure within two years. We have 82 interviewees. Experienced clinical psychologists use a structured questionnaire to conduct interviews. The contents of the questionnaire include "patient role identification scale" and the relative change of self-evaluation and psychological centrality of eight self domains. 　　We use "patients role identification scale" to select 17 resistance and 36 acceptance stage patients for comparison analysis. The result indicates that present global self-esteem of the two groups compare with that of before the disease has a significant decrease. In the self-evaluation relative change scale, the acceptance stage patients drop the scale dramatically when disease onset and come back slowly but not the level as before. The resistance stage patients evaluate themselves as no significant differences than before and expect they can get well as before. In psychological centrality relative change scale, the acceptance stage patients realize that nothing is so important except "health status" and "supports from family". Even ghough the resistance stage patients have the same duration of disease they still can't adjust their psychological centrality of self domains as those patients in acceptance stage. The results indicate that the differences of self-evaluation and psychological centrality between two groups are due to social identity of patients.

以文找文

期刊論文
1.	Muhlenkamp, A. F.、Sayles, J. A.(1986)。Self-esteem, social support and positive health practices。Nursing Research，35(6)，334-338。
2.	Wichowski, H. C.、Kubsch, S. M.(1997)。The relationship of self-perception of illness and compliance with health care regimens。Journal of Advanced Nursing，25(3)，548-553。
3.	Janoff-Bulman, R.、Frieze, I. H.(1983)。A theoretical perspective for understanding reactions to victimization。Journal of Social Issue，39(2)，1-17。
4.	Marsh, H. W.(1986)。Global self-esteem: Its relation to specific facets of self-concept and their importance。Journal of Personality and Social Psychology，51(6)，1224-1236。
5.	Bachrach, L.(1992)。"The chronic patient": In search of a title。Hospital and Community Psychiatry，43，867-868。
6.	Brickman, A. L.、Yount, S. E.、Blaney, N. T.(1996)。Personality traits and long-term health status. The influence of neuroticism and conscientiousness on renal deterioration in type-1 diabetes。Psychosomatics，37，459-468。
7.	Davis, M. C.、Tucker, C. M.、Fennell, R. S.(1996)。Family behavior, adaptation, and treatment adherence of pediatric nephrology patients。Pediatric Nephrology，10，160-166。
8.	Gorman, C.、Kennedy, P.、Hamilton, L. R.(1998)。Alterations in self-perceptions following childhood onset of spinal cord injury。Spinal Cord，36，181-185。
9.	Hoge, D. R.、McCarthy, J. D.(1984)。Influence of individual and group identity salience in the global self-esteem of youth。Journal of Personality and Social Psychology，47(2)，403-414。
10.	Kelly-Powell, M. L.(1997)。Personalizing choices: patient's experience with making treatment decisions。Research in Nursing and Health，20，219-221。
11.	Kubsch, S. M.、Wichowski, H. C.(1992)。Identification and validation of a new nursing diagnosis: Sick role conflict。Nursing Diagnosis，3，141-147。
12.	Peterson-Martin, J.、Cottrell, R.(1987)。Self-concept, values and health behavior。Health Education，25(5)，6-9。
13.	Rolland, J.(1984)。Toward a psychosocial typology of chronic and life-threatening illness。Family Systems Medicine，2，245-262。
14.	Shnek, Z. M.、Foley, F. W.、LaRocca, N. G.(1997)。Helplessness, self-efficacy, cognitive distortions, and depression in multiple sclerosis and spinal cord injury。Annals of Behavioral Medicine，19，287-294。
15.	Wortman, C. B.(1983)。Coping with victimization: Conclusions and implications for future research。Journal of Social Issues，39(2)，195-221。
16.	Harter, S.(1982)。The perceived competence scale for children。Child Development，53(1)，87-97。
17.	Engel, George L.(1977)。The need for a new medical model: A challenge for biomedicine。Science，196(4286)，129-136。

會議論文
1.	翁嘉英(1998)。病痛中之自我評價向度--以血液透析患者為例。心理學2001研討會。高雄：高雄醫學院心理系。100-107。延伸查詢

學位論文
1.	翁嘉英(1997)。失能性慢性病患之自我評價歷程與自尊感對其初期因應策略的影響(博士論文)。國立臺灣大學。延伸查詢

圖書
1.	Roy, C.、Andrews, H. A.(1991)。The Roy adaptation model: the definitive statement。Norwalk, CT：Appleton & Lange。
2.	Gergen, K. J.、Greenberg, M. S.、Willis, R. H.(1980)。Social exchange: Advances in theory and research。New York：Plenum Press。
3.	Greenberg, J.、Cohen, R. L.(1982)。Equity and Justice in Social Behavior。New York：Academic Press。
4.	Coopersmith, S.(1967)。The Antecedents of Self-Esteem。San Francisco：Freeman。
5.	Campbell, R. N.(1984)。The New Science: Self-Esteem Psychology。Boston：University Press of America。
6.	Burgess, R. L.、Huston, T. H.(1979)。Social exchange in developing relationships。New York：Academic Press。
7.	Messer, B.、Harter, S.(1986)。The adult self-perception profile (manual)。Denver, CO.：University of Denver。
8.	Rosenberg, M.(1986)。Conceiving the self。New York：Basic Books, Inc.。
9.	Wells, E. L.、Marwel, G.(1976)。Self-Esteem。Beverly Hills：Sage。
10.	Wylie, R. C.(1974)。The self-concept。Lincoln：University of Nebraska Press。
11.	Rosenberg, Morris(1979)。Conceiving the Self。Basic Books。
12.	Rosenberg, Morris(1965)。Society and the Adolescent Self-image。Princeton University Press。

圖書論文
1.	Harter, S.(1986)。Processes underlying the construction, maintenance, and enhancement of the self-concept in children。Psychological perspectives on the self。Hillsdale, NJ：Erlbaum。
2.	Blascovich, J.、Tomaka, J.(1991)。Measures of self-esteem。Measures of personality and social psychological attitudes. (Vol. 1), Measures of social psychological attitude。San Diego：Academic Press, Inc.。
3.	Cohen, F.、Lazarus, R. S.(1979)。Coping with stresses of illness。Health Psychology。San Francisco：Gossey-Bass。
4.	Harter, S.(1990)。Adolescent self and identity development。At the threshold: The developing adolescent。Cambridge, Massachusetts：Harvard University Press。
5.	Harter, S.(1993)。Causes and consequences of low self-esteem in children and adolescents。Self-esteem: The puzzle of low self-regard。New York：Plenum press。
6.	Reid, D. W.(1984)。Participatory control and the chronic illness adjustment。Research with the Locus of Control Construct。Extention Limitations：Academic Press Inc.。
7.	Silver, R. C.、Wortman, C. B.(1980)。Coping with undesirable life events. helplessness: Theory and application。Human helplessness: Theory and application。New York：Academic Press。
8.	Stryker, S.(1991)。Exploring the relevance of social cognition for the relationship of self and society: Linking the cognitive perspective and the identity theory。The self-society dynamic: Cognition, emotion, and action。Cambridge, England：Cambridge University Press。
9.	Taylor, S. E.、Aspinwall, L. G.(1993)。Coping with chronic illness。Handbook of stress: Theoretical and clinical aspects。New York：Free Press。

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