| Summary: | 碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 93 === Object
Depression among enlist men in national service is a widely discussed issue by general public recently. The most serious form of depression is major depression. However, in the past years, there were few researches focusing on this issue. Therefore, no proper explanation was given, nor effective preventive measures were suggested on this issue.
This study attempts to approach this issue from the perspectives of individual, family, and military, and hopes to find out risk factors for Major depression among enlist men in national service, and to suggest preventive measures, in order to decrease morbidity after recruitment into military.
Method
The sample of this study was conducted in two different groups: soldiers with major depression, and soldiers without major depression. Soldiers with major depression were sampling from hospital inpatients from Armed Forces Beitou Hospital, Tri Service General Hospital and Armed Forces Songshan Hospital. The soldiers without major depression were sampling from three military bases in Taipei. Samples were selected by purposive sampling. The survey was conducted from May 2004 to August 2004.
Various data was collected from each individual recruited into this study, including general personal background, family background, military service background, stressor inventory for enlist men, coping skill inventory for enlist men. There were seven factors in the stress inventory: “military duty, military lifestyle, military hierarchy, family concern, family event, personal affection, and personal future stress”; there were four factors in the coping skill inventory : “positive thinking, positive action, positive accommodation, and negative coping”.
General personal background, family background, military background, stress caused by 7 different factors including military duty, military lifestyle, military hierarchy, family concern, family event, personal affection, personal future, and 4 coping styles including positive thinking, positive action, positive accommodation, and negative coping, all were compared to decide if there was significant difference between enlist men of major depression group and non-major depression group. Moreover, correlation of above items and presence of major depression was investigated. Finally, a regression model was developed to predict probability of occurrence of major depression.
SPSS (10.0) was used for statistic analysis in this study. The statistic methods included: using factor analysis to determine the validity of inventories, using reliability analysis-scale to determine the reliability of inventories, using descriptive statistics to perform the descriptive analysis of major depression group and non-major depression group, using chi-square test and t-test to perform the differential analysis between major depression group and non-major depression group, and using logistic regression to explore the correlation between all variables mentioned in above paragraph and the occurrence of major depression in order to develop the regression model.
Result
182 questionnaires were distributed to the group of enlist men with major depression, and 174 of them were returned. The return rate was 95.6%. Excluding the incomplete ones, there were 155 effective questionnaires. 265 questionnaires were distributed to the non-major depression group, and 256 were returned. The return rate was 96.6%. Excluding incomplete ones, there were 274 effective questionnaires.
After analysis of complete questionnaires of both sets, the major depression group of enlist men have following characteristics compared to the non-major depression group: 1. most of them being unemployed before recruitment, 2. less interaction with family members, 3. more psychiatric history, 4. most of their parents marriage status being incomplete, 5. harsher discipline and less proper communication from father, 6. harsher discipline and less proper communication from mother, 7. less family revenue, 8. more psychiatric history among family members, 9. most just being placed at current base in the past three months, 10. perceiving more stress from military duty, 11. perceiving more stress from military lifestyle, 12. perceiving more stress from military hierarchy, 13. perceiving more stress from family concern, 14. perceiving more stress from family event, 15. perceiving more stress from personal affection, 16.perceuving more stress from personal future, 17.less positive thinking for coping, 18, less positive action for coping, 19. less positive accommodation for coping, 20. more negative coping.
The logistic regression model developed in order to predict occurrence of major depression utilizing the following eight factors: past vocational function, personal psychiatric history, discipline attitude of father, psychiatric history in family members, stress caused by military hierarchy, stress caused by family concern, positive accommodation for coping, and negative coping. The predictive accuracy is 88.9%.
Conclusion
Enlist men with major depression and non-major depression soldiers showed significant differences in the aspects of personal background, family background, military background, stressors, and coping; occurrence of major depression was affected by personal, familial, military factors. Therefore, in order to reduce the incidence of major depression, the individual, the parents and the superior officers all share the responsibility of noticing possible symptoms cooperatively to prevent major depression effectively.
Key words: solider, major depression, stressor, coping skill
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