研究限制與未來研究方向

第四章綜合討論

第四節研究限制與未來研究方向

壹、研究工具

過去與心智推論能力相關的研究較常採取多向度評估的方式推估參與者之心智推論能力，例如 Carlson、Moses 及 Breton （2002）以表面-現實作業

（appearance-reality）、錯誤信念作業做為心智推論能力之指標；Ketelaars 等人

（2010）亦以情緒歸因作業（emotional attribution）、複雜矛盾情緒測驗（mixed emotions）、情緒表達規則測試（display rules）、錯誤信念，及觀點取替測驗等結果指稱學齡前至學齡初期兒童的心智推論能力。從工具選擇上的考量，雖然上述多向度測量的方式較具多樣性，但卻較無施測時間與填答便利性之考量，故多以兒童、青少年或成年人為研究對象。本研究為顧及老年人填答之便利性與意願，

僅採用觀點取替量表推估參與者之心智推論能力，相較過去研究而言，測量向度顯得較為單一；然回顧過去與老人心智推論能力相關的研究，易發現相似問題，

或雖使用較多工具，但收集較少參與者（e.g., （Happe et al., 1998; MacPherson et al., 2002; Maylor et al., 2002; Saltzman et al., 2000）；因此，建議未來以老年人為對象之心智推論能力研究或可先建立不同向度、兼顧具良好心理計量特性與填答便利性之測量工具，以提升推估上的精確度。

貳、參與者

根據教育部於民國 98 年針對我國 65 歲以上老年人教育水準調查之結果，我國老年人受高中（職）以上教育（即受教育年數約 12 年）者佔 13.01%；反觀本研究參與者之平均教育水準為 11.59 年（標準差 = 3.98），有偏高之趨勢。全量表智商部分，本研究以短版 WAIS-III 推估參與者全量表智商之結果指出，參與者的平均智商約為 106，較一般水準稍高。以上數據顯示本研究對象之教育水準

與智力功能可能未足以反映國內老年人的平均狀況，因此建議未來從事相關研究時，可增加參與者教育水準與智商之範圍，以提升研究結果之生態效度。

參、創傷距今時間、創傷種類與創傷後壓力症狀嚴重度

過去研究雖然未明確指出個體經歷創傷事件的時間與抑制功能間的關聯，然本研究中創傷組參與者之創傷經歷多距離填答當下超過 5 年（創傷組之創傷距今時間詳見圖三），且多無明顯創傷後壓力症狀（PDS 平均得分= 5.25，嚴重度屬輕微等級），故建議日後研究可擴大創傷組參與者在創傷距今時間與創傷後壓力症狀嚴重度之範圍，以了解本研究之結果在創傷程度較嚴重者身上是否可獲得重複驗證。

此外，隨著人類文明的演進，高齡化的現象造成不少重大疾病被診斷與治療的機率日漸提高，而獲得診斷或進行手術等治療過程可能為個體帶來許多生理或心理上相關的症狀，在 DSM-IV 準則中亦將可能威脅到個體生命與存活的重大疾病列為可能的創傷事件之一，故近年來諸如癌症、心肌梗塞、心臟繞道手術等身體疾患與醫學事件可能造成創傷後壓力相關症狀也漸成相關研究者們所關注的焦點（Chung, Berger, Jones, & Rudd, 2008; Panagopoulou, Maes, Tyrodimos, &

Benos, 2008; Widows, Jacobsen, & Fields, 2000）。同時，本研究之結果亦發現，本創傷組參與者勾選之創傷種類中，與威脅生命之疾病有關的創傷事件為數頗多

（共 13 名，佔 35.1%），故建議未來相關研究可針對有重大疾病且經驗創傷的個案，以進一步以了解本研究結果在全部以此種類創傷者為對象時是否同樣存在。

另一方面，根據在台灣 921 震災後半年之研究報告，台灣災後老人患有創傷後壓力症候群之盛行率為 10.3%，同時期成年人之盛行率為 6.9%（歐陽文貞，

2004），顯示老人在天然災害後為易受傷害族群，故建議未來研究可增加收集天然災害後的創傷者，並將創傷組個體依照創傷事件的種類分組，進一步探究經歷不同種類創傷之個體在抑制功能與心智推論能力上是否有所差異。

圖四：創傷組之創傷距今時間統計

<1個月 1~3個月 3~6個月 6個月~3年 3~5年 >5年

35 97- 2815-C-002-141-H），未出版。

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在文檔中老年人創傷經驗、抑制功能與心智推論能力之關聯探討 (頁 40-52)

第四章 綜合討論

第四節 研究限制與未來研究方向

第四章綜合討論

第四節研究限制與未來研究方向