台灣東部地區青少年正向心理及健康生活型態與憂鬱症狀之相關性探討

Abstract

背景：青少年憂鬱症狀的研究較少比較居住於城市和鄉村國中生憂鬱症狀的現況和差異。另外比較不同學業競爭程度國中生憂鬱症狀差異的相關研究也較缺乏。 目的：探討北部城市和東部鄉村國中生憂鬱症狀的現況和差異，東部鄉村不同競爭程度國中生憂鬱症狀的現況和差異。比較城鄉和不同競爭程度學校國中生憂鬱症狀的影響因子。影響因子包含:基本資料(性別、年級、家庭結構)、 正向身體欣賞程度、危險健康行為(速食飲食習慣，睡眠總時數，身體活動和非活動，物質濫用，身體質量)。 方法：本研究採橫斷式、描述性相關研究設計，以北部新竹高競爭學校(N=99)與 東部花蓮三所學校(不同競爭程度:高競爭=156；中競爭=150；低競爭=174)國中學生為研究對象，採方便取樣，透過結構式問卷進行資料收集，包括「人口學基本資料」、「憂鬱症狀量表(CES-D)」、「身體欣賞量表量表（BAS）」、「健康行為量表（General health and health behaviors）」。 結果：新竹國中生與花蓮整體國中、花蓮三所不同競爭程度國中生在憂鬱症狀總分無統計上顯著差異。於憂鬱症狀的影響因子結果顯示新竹國中生與花蓮整體國中生憂鬱症狀的共同保護因子為身體欣賞，共同危險因子為有無飲用酒精性飲料以及較少的睡眠總時數。其影響因子的差異為：過去一星期有無食用微波食品為新竹國中生影響因子。自覺健康狀況程度為花蓮整體國中影響因子。花蓮三所國中身體欣賞為共同保護因子，而影響因子差異為：上課睡眠時數少為高競爭程度學校的影響因子、假日看電視程度和過去一星期有無飲用含糖飲料為中競爭程度學校的影響因子、假日網路郵件或社群聊天程度為低競爭程度學校的影響因子。 結論:不論城鄉國中生憂鬱症狀的共同保護因子為身體欣賞，有飲用酒精性飲以及較少的睡眠總時數為危險因子。鄉村國中生中，高競爭和較低競爭學校學生的危險因子分別是上課睡眠時數少和不活動程度高。本研究結果可對於城鄉和競爭程度不同學校國中生發展適合之憂鬱症防治模式。

Background：Very few studies compare the differences of the levels of depressive symptoms between adolescent population in urban and rural districts and between this population in the schools with various levels of the academic competitions. Purpose: The purposes of this study were to compare the levels of depressive sympotome and its associated factors between the junior high school students in the north city (Hsinchu) and rural region (Hualien), and between students from rural region in the schools with different levels of the academic competitions. The associated factors with depressive symptoms in this study include demographic data (gender, grade, family structure), body appreciation, and risk healthy behaviors (fast food, total sleep hours, physical activities and inactivities, substance use, and BMI). Methods：This study adopts a cross-sectional correlation design. With using convenience sampling, a total of 584 junior high school students participated in this study and they are from north city（Hsinchu）(N=99) and east rural region（Hualien) in which there were three schools with different levels of the academic competitions (high level, n=156；middle level, n=150；low level, n=174). The structured questionnaires were used to collect data including demographic questionnaire, Center for Epidemiologic Studies Depression Scale (CES-D Scale), Body Appreciation questionnaire（BAS）and Genernal health and health behavior questionnaire. Results: There were no significant differences in the levels of depressive sympotome between the junior high school students in the north city and rural region, and between students from rural region in the schools with different levels of the academic competitions. Multiple regression analysis indicated that body appreciation was the main protective factor, drink with alcohol ingredient and insufficient sleep hours were the main risk factors of depressive symptoms for all participants from city and rural regions. The differences in associated factors with depressive symptoms were for the students in city, fast food consumption was correlated with higher depressive symptoms while for the students in rural region, perceived lower general health levels were associated with higher depressive symptoms. Among rural regions with different levels of the academic competitions, for the high level of competitive school, insufficient sleep hours during weekday were related to higher depressive symptoms, for the middle level of competitive school, inactivity levels (watching television during weekend) and drink with sugar ingredient was related to higher depressive symptoms, for the low level of competitive school, inactivity levels (use a computer for surfing the web, exchanging email or participating in a chat room) were correlated with higher depressive symptoms. Conclusions：Body appreciation was the main protective factor, and risk healthy behaviors (drink with alcohol ingredient and insufficient sleep hours) were the main risk factors of depressive symptoms for all students in the city and rural regions. The risk healthy behaviors (insufficient sleep hours and inactivity levels) were the main factor of depressive symptoms for students of the high and low competitive schools in rural region. The identified risk and protective factors could be regarded as the targets for developing depression prevention program for adolescent population.