憂鬱症個案的運動動機、運動參與及職能平衡對生活品質之影響

研究目的：憂鬱症個案具有動機低落的特性，也常有職能失衡的問題，這可能對其生活品質產生負面影響。而運動作為一種沒有汙名問題的替代療法，個案卻可能因動機問題而導致參與度較差。有鑑於國內較少研究同時探討運動動機、運動參與、職能平衡與生活品質之間的關係，因此，本研究旨在探討門診憂鬱症個案的運動動機和運動參與程度之間的關聯性，以及運動動機、運動參與程度、職能平衡程度與生活品質狀況的關係。研究方法：本研究採用橫斷性研究（cross-sectional study）設計，招募55位臺灣中部醫院之門診成年憂鬱症個案為研究對象，受試者將填寫知情同意書及基本資料表，並填寫自填式問卷，包括中文版運動行為調節問卷（BREQ-2）、中文版國際身體活動量表長版問卷（IPAQ-LF）、中文版職能平衡問卷（OBQ11-C）、台灣簡明版世界衛生組織生活品質問卷（WHOQOL-BREF-TW）以及貝克憂鬱量表第二版（BDI-II），再由研究人員進行訪談及測量身高與體重，以瞭解他們的動機狀況、運動參與程度、職能平衡程度、生活品質狀況、憂鬱嚴重程度與基本身體狀況。資料分析採用IBM SPSS Statistic 25版統計軟體，進行描述性統計、差異檢定、相關性分析及多元線性迴歸分析。研究結果：經相關性與迴歸分析發現，自主動機與運動參與程度有顯著正向關聯，且是顯著影響因子，可解釋運動參與程度15.8%的變異量。而生活品質與自主動機、運動參與程度和職能平衡均有顯著正相關，與憂鬱嚴重程度有顯著負相關。生活品質迴歸模型顯示運動參與程度、職能平衡和憂鬱嚴重程度為顯著影響因子，可解釋生活品質76.0%的變異量。討論：本研究發現自主動機對於國內門診憂鬱症個案的運動參與程度是重要且有正向的影響，自主動機愈高的個案愈有可能維持長期運動，代表經由個案內心的認同並獲得愉悅感才能更有效地提升運動參與程度。此外，運動參與程度及職能平衡對生活品質有顯著的正向影響，個案若能規律地參與運動，並且對個人的生活安排感到滿意，對其生活品質均有益處。而自主動機對生活品質的影響未達顯著，可能待未來研究進一步驗證其角色。結論：透過本研究得知自主動機對於門診憂鬱症個案運動參與的重要性，並且提升個案的運動參與程度和職能平衡狀況，同時降低憂鬱嚴重程度皆有益於其生活品質。本研究是我們所知少數針對門診憂鬱症個案，同時探討運動動機、運動參與程度及職能平衡與生活品質之間相關性和影響力的研究。臨床工作者或研究者可將自主動機視為影響運動參與的主要因素之一，以此改善個案的運動參與狀況，同時重視職能平衡，以提升生活品質。建議未來研究可參考本研究的結果，以縱貫性研究設計進一步探討運動動機、運動參與程度、職能平衡與與生活品質之間的因果關係。

Background: People with depression often have low motivation and occupational imbalance, which may negatively influence their quality of life (QOL). Although exercise could serve as an alternative therapy for them without stigma, clients may have lower participation due to motivational problems. Given the limited research in Taiwan that simultaneously explores the relationships among exercise motivation, exercise participation, occupational balance (OB), and QOL, this study aims to investigate the correlation between exercise motivation and exercise participation for outpatient individuals with depression. Additionally, we seek to understand the relationship among exercise motivation, exercise participation, occupational balance, and QOL.Method: This study is a cross-sectional study, recruited 55 adult outpatients with depression from the psychiatric outpatient clinics located at the central Taiwan. Participants completed an informed consent and basic information form, and complete 5 self-reported questionnaires, including the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2), International Physical Activity Questionnaire-Long Form (IPAQ-LF), Occupational Balance Questionnaire11-Chinese version (OBQ11-C), World Health Organization Quality of Life-BREF-Taiwan version (WHOQOL-BREF-TW), and Beck depression inventory-II (BDI-II). Afterward, the subjects will be interviewed and measured for height and weight by the researcher, to know their motivation status, exercise participation degree, OB, QOL, depression severity, and basic physical condition. Data analysis was conducted using IBM SPSS Statistics version 25, employing descriptive statistics, difference testing, correlation analysis, and multiple linear regression analysis.Results: Correlation and regression analyses revealed a significant positive relationship between autonomous motivation and exercise participation, with autonomous motivation being a significant factor, which explained 15.8% of the variance in exercise participation. QOL showed significant positive correlations with autonomous motivation, exercise participation, and occupational balance, and a significant negative correlation with depression severity. The regression model of QOL indicated that exercise participation, occupational balance, and depression severity were significant factors that explained 76.0% of the variance in QOL.Discussion: This study found that autonomous motivation significantly and positively influences exercise participation among outpatients with depression in Taiwan. Clients with higher autonomous motivation are more likely to maintain regular exercise, indicating that inner identification and enjoyment enhance exercise participation. Moreover, exercise participation and occupational balance have a significantly positive effect on QOL. Regular exercise and satisfaction with their own daily routine benefit clients' QOL. However, the influence of autonomous motivation on QoL was not significant, suggesting the need for further research to validate its role.Conclusion: Through this study, we found the importance of autonomous motivation in promoting exercise participation among outpatients with depression. Additionally, enhancing their exercise participation and occupational balance, and reducing the severity of depression are all beneficial to their quality of life. This study represents one of the few investigations into the relationships and impacts of exercise motivation, exercise participation, occupational balance, and QOL in outpatients with depression. Clinical practitioners and researchers should consider autonomous motivation as a key factor influencing exercise participation to improve clients' exercise engagement and emphasize occupational balance to enhance QOL. It is recommended that future research could refer to the findings of this study, using a longitudinal design to further explore the causal relationships among exercise motivation, exercise participation, occupational balance, and QOL.