第五章 討論
第四節 研究限制與未來研究方向
研究結果的推廣性上，本研究的參與者均來自中部某醫學中心的女性乳癌患 者，研究結果是否可以推廣至全台或者華人研究，仍需保守看待。另外，乳癌是 多種癌症患者中的一類，本研究的結果是否能推估到其他癌症類型甚至所有族群 的憂鬱之風險因數反芻的研究上，有賴於進一步的研究證據累積驗證。
研究結果顯示，兩種反芻類型均與兩種因應類型呈顯著正相關，也就是說，
採用苦惱自責式反芻的患者同時較多採用趨緊因應和逃避因應，深思反省式反芻 的患者亦是如此。這與過往研究所認為的進行不適應反芻同時會採用消極的因應 的結論有所差異 (Lyubomirsky & Nolenhoeksema, 1995; Watkins & Baracaia, 2002 Abela, Vanderbilt & Rochon, 2004; Watkins & Moulds, 200; Burwell & Shirk, 2007 Marroquin et al., 2010)，或許與乳癌患者更多進行不同面向的因應而非固定單一 因應風格有關，這也有賴於今後研究的更多思考和探索。
此外，第一次將背景變項以及臨床變項納入對憂鬱的預測變項之中，結果只 有教育程度與憂鬱顯著負相關，所有變項對憂鬱的影響均不顯著，或與乳癌患者 本身的特性有關，未來其他群體的研究也可以進行更多探索，幫助更好的甄別更 具風險的個體提供協助。
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附錄一 基本資料
基本資料 病歷號碼： 研究編碼：
姓名 填寫日期 年 月 日
出生日期 民國 年 月 日 性別：
□ 女 □ 男
年齡:
歲
連絡電話 (白天) (晚上) 手機:
聯絡地址
婚姻狀態：□未婚 □已婚 □再婚 □離婚 □同居 □喪偶
教育程度：□國小及以下 □國中 □高中職 □專科 □大學及以上 診斷癌症的日期：民國 年 月
目前您癌症的期數為：
□ 零期 □ 第一期 □ 第二期 □ 第三期 □ 第四期 □ 第五期 進行手術的日期：民國 年 月
手術方式：□ 全部切除 □ 部分切除 □ 一側全部切除、一次部分切除 是否接受其他輔助治療：□ 是 □ 否
化學療法：□ 是 □ 否 放射療法：□ 是 □ 否 藥物療法：□ 是 □ 否
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附錄二 反芻反應風格量表
附錄三 因應策略量表
16. 我會放棄去處理問題……… 1 2 3 4 17. 我會從發生的事情當中找出它的正向意義……… 1 2 3 4 18. 我常用開玩笑的方式來處理問題……… 1 2 3 4 19. 我會藉著做一些事以減少去想問題的次數，
例如看電影、看電視、閱讀、做白日夢、睡覺或逛街…… 1 2 3 4 20. 我會接受事情已經發生的事實……… 1 2 3 4 21. 我會表達負向的感覺……… 1 2 3 4 22. 我會試著在我的宗教或信仰中尋求安慰……… 1 2 3 4 23. 我會尋求別人的幫助或建議……… 1 2 3 4 24. 我會學習著與事情（問題）共處……… 1 2 3 4 25. 我很認真地想下一步要怎麼做……… 1 2 3 4 26. 對於那件發生的事情，我會責怪自己……… 1 2 3 4 27. 我會禱告、冥想或拜拜、唸經……… 1 2 3 4 28. 我會讓情況變得更有樂趣……… 1 2 3 4
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