學齡前自閉症類群障礙兒童母親親職壓力與憂鬱、絕望感和生活品質的關係：因應行為的中介效果   免費試閱

The Mediation of Coping Behaviors in the Relationships Between Parenting Stress and Depression, Hopelessness, and Quality of Life among Mothers of Preschool Children with Autism Spectrum Disorder

本研究以5歲以下學齡前自閉症類群障礙（autism spectrum disorder, ASD）兒童之母親為對象，探究其因應行為在親職壓力與憂鬱、絕望感及生活品質的中介效果。參與者為96位ASD兒童母親，ASD兒童平均生理年齡約35個月。以親職壓力量表測量母親親職壓力，以簡明因應量表測量母親的因應行為；以貝克憂鬱量表、貝克絕望感量表和臺灣簡明版生活品質量表，分別測量母親的憂鬱、絕望感和生活品質。簡明因應量表可萃取出四個因素，包括：社會支持因應、問題焦點因應、迴避轉移因應及正向／宗教因應。社會支持因應與生活品質顯著正相關；問題焦點因應與憂鬱、絕望感顯著負相關，與生活品質顯著正相關；迴避轉移因應與憂鬱、絕望感顯著正相關；正向／宗教因應與絕望感顯著負相關，與生活品質顯著正相關。問題焦點因應，在親職壓力與生活品質間具有中介效果。本研究發現，ASD兒童母親採取問題焦點因應可緩和心理健康問題及提升生活品質；若採取逃避、分心的因應，對心理健康帶來不利的影響。本研究結果可提供ASD兒童家長與家庭服務時的參考。

This study examines mediation of coping behaviors among the relationships between parenting stress and depressive mood, hopelessness and quality of life in mothers of preschool children with autism spectrum disorder (ASD) younger than 5 years old. There were 96 mothers of preschool children with ASD with average chronological age about 35 months recruited in this study. The Parenting Stress Index (PSI) was used for measuring the parenting stress and Brief Coping Orientations to Problems Experienced Scale (B-COPE) was used to measure coping behaviors. In addition, the Beck Depression Inventory-Second Edition (BDI-Ⅱ), Beck Hopelessness Scale (BHS) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) were used for measuring the depressive mood, the feelings of hopelessness and the quality of life in mothers of preschool children with ASD, respectively. Exploratory factor analysis of B-COPE subscales identified four factors, including social support coping, problem-focused coping, avoidance distraction coping, and positive / religion coping. The social support coping correlated significantly positive with the quality of life. Additionally, the problem-focused coping correlated significantly negative with the depressive mood and feelings of hopelessness, and it also correlated significantly positive with the quality of life. Furthermore, the avoidance distraction coping correlated significantly positive with the depressive mood and feelings of hopelessness. Finally, the positive / religion coping correlated significantly negative with the feelings of hopelessness, and it also correlated significantly positive with the quality of life. The results suggested that the problem-focused coping was the partial mediation in the relationship between parenting stress and the quality of life. This study found that using the problem-focused coping could effectively buffer problems of mental health and enhance the quality of life in mothers of preschool children with ASD. In addition, using escape and distraction coping strategies has adverse effects on mental health in mothers of preschool children with ASD. The results of this study could provide implications for designing service of the mothers and family of preschool children with ASD.