陳韻玲Yun-Ling Chen劉康琪LAO HONG KEI職能治療學系碩士班2026-03-242024/2/1920242024/1/25https://handle.ncl.edu.tw/11296/q63528https://scholars.csmu.edu.tw/handle/123456789/6486研究背景：近年來青少年罹患憂鬱症的人數不斷攀升，患者不僅身心受創，因憂鬱所導致的職能失衡造成生活品質下降，甚至成為自殺原因，使青少年的精神健康成為了全球社會關注的議題。研究發現正念認知治療有效降低憂鬱症者的憂鬱程度，但較少運用在大學生族群中，故本研究旨在發展以正念認知為導向的團體介入方案，主要探討其對大學生的憂鬱、因應策略及生活品質的成效，次要目的為探討職能平衡的改善程度。研究方法：本研究採用單組前後測的類實驗研究方法，於中部一所醫學大學透過進班宣傳、派發傳單及在學校社團的社群媒體網絡上宣傳的方式，招募了74位在讀學生報名，其中16位因無法聯繫、聯絡時表示已無研究意願或曾參與其他正念相關的研究而未參加研究說明，58位出席填寫參加者基本資料表、聖路易大學心智狀態量表、貝克憂鬱量表第二版和褚氏注意力測驗。從中篩選出憂鬱嚴重程度為輕度或以上，且認知能力正常、能以國語流利溝通之大學部或研究所學生，另排除有中度或以上注意力障礙、自殺意念、重大生理或心理疾病、現正服用精神科憂鬱症藥物或接受心理治療者，最後共19位報名者符合條件，隨報名時間分別組成第一梯次的10位及第二梯次的9位，兩個梯次均會接受4週相同的以正念認知為導向的團體介入方案。但在第二梯次中，有1位在第一週團體後缺席之後所有的介入及測量，因此最後為18位參加者納入分析，流失率僅5.3%。介入方案由研究者經過相關課程、閱讀眾多文獻所編製適合大學生之內容。團體介入成效以貝克憂鬱量表第二版、簡式因應策略量表、臺灣簡明版世界衛生組織生活品質問卷、職能平衡問卷測量，在介入前、介入後及一個月追蹤進行測量。採用SPSS26.0統計軟體進行Friedman檢定，與Wilcoxon signed rank test事後檢定。本研究通過中山醫學大學附設醫院第一人體研究倫理審查委員會的許可，證號為CS1-22140。研究結果：研究發現參加者憂鬱嚴重程度在後測及追蹤都顯著低於前測的分數，另外生活品質中的心理範疇及職能平衡方面，後測分數亦顯著優於前測分數。但因應策略與生活品質的生理、社會及環境範疇則未見統計上的顯著差異。 討論：以正念認知為導向的團體介入方案在參加者的考試期間仍顯著降低其憂鬱嚴重程度、提高生活品質中的心理範疇及職能平衡的分數，根據質性的回饋，第一梯次全部參加者和第二梯次81%參加者分別認為團體帶來正向成效以及有效減輕考試壓力與焦慮感，推測是降低了負面情緒反應、建立正確認知、情緒調節能力和職能勝任感有所提升所致。然而因應策略、生活品質的生理、社會和環境範疇也許是受身體疼痛、固定的環境及方案針對性不夠強的因素，導致結果未能顯著。結論：透過本研究證實了4週以正念認知為導向的團體介入方案能為大學生的憂鬱、心理健康和職能平衡帶來正面的影響。建議未來研究可循著方案的完善度、延伸性及針對性進行加強，利用大學課堂上或課後的時間進行每週一次的團體。透過4週的正念認知團體以達到預防大學生憂鬱、改善職能平衡與心理健康程度的成效。Background:In recent years, the number of adolescents suffering from depression has been continuously increasing. These patients not only experience physical and mental distress, but the functional imbalance caused by depression also leads to a decrease in the quality of life. In some cases, it even becomes a contributing factor to suicide. The mental health of adolescents has become a globally recognized issue.Research has found that mindfulness cognitive therapy effectively reduces the severity of depression in sufferers. However, it has been less commonly applied to the college student population. Therefore, this study aims to investigate the effectiveness of mindfulness-cognitive oriented group intervention program on depression, coping strategies and quality of life in college students. A secondary outcome is to explore the improvement in occupational balance.Methods:This study utilized a quasi-experimental pretest-posttest single-group design. 74 students were recruited from a medical university in Taichung through class announcements, flyers, and promotion on the social media platforms of college associations. Among 74 students, 16 applicants were excluded due to inability to contact, lack of interest, or prior participation in other mindfulness studies. 58 applicants attended and completed the baseline information form, the Saint Louis University Mental Status Exam, the Beck Depression Inventory-II, and the Chu's Attention Test. Participants who (1) had mild or above depression severity levels, (2) normal cognitive abilities, (3) fluent Mandarin communication skills, and (4) were undergraduate or graduate students were selected. Exclusion criteria included (1) moderate or above attention deficit, (2) suicidal ideation, (3) major physiological or psychological illnesses, (4) current use of psychiatric medications for depression, or undergoing psychological therapy. Finally, 19 participants met the criteria were enrolled. The participants were divided into two groups based on the time of enrollment: the first group comprised 10 participants, and the second group comprised 9 participants. However, a participant in the second group was absent from all interventions and measures after the first week of program. Therefore, only 18 participants were included in analysis. The dropout rate was only 5.3%. Both groups received a 4-week mindfulness-cognitive oriented group intervention program developed by the researcher based on relevant courses and literature review tailored to college students. The effectiveness of the intervention program was analyzed using the Beck Depression Inventory-II, the Brief Coping Orientations to Problems Experienced Scale, the WHOQOL-BREF-TW, and the Occupational Balance Questionnaire at pretest, posttest, and one-month follow-up. Statistical analysis was performed using Friedman test and Wilcoxon signed rank test with SPSS 26.0 software. This study was approved by the Institutional Review Board of Chung Shan Medical University Hospital with approval number CS1-22140.Results:The study revealed that participants' depression significantly decreased in both posttest and follow-up measurements compared to the pretest scores. Additionally, there were significant within-group differences in the psychological domain of quality of life and occupational balance between pretest and posttest scores. However, no statistically significant differences were observed in coping strategies and the physical, social, and environmental domains of quality of life.Discussion:A 4-week mindfulness-cognitive oriented group intervention program demonstrated significant reductions in participants' depression and improvements in the psychological domain of quality of life and occupational balance scores during their examination periods. According to qualitative data, all participants in the first group and 81% of participants in the second group perceived positive effects of the program. Participants believed mindfulness can effectively relieve exam-related stress and anxiety. These suggest the program may result in a reduction in negative emotional responses, the establishment of correct cognition, improved emotional regulation, and an enhanced sense of occupational competence. However, the lack of significant improvement in coping strategies and the physiological, social, and environmental domains of quality of life might be influenced by factors such as physical pain, the fixed environment, and insufficient specificity of the program, leading to inconclusive results in these areas.Conclusion:This research has confirmed that the 4-week mindfulness-cognitive oriented group intervention program has an influence on the depression, mental health, and occupational balance for college students positively. It suggests that future researches should focus on enhancing the completeness, extensibility, and specificity, and perhaps by utilizing the program weekly during or after classes. Through a 4-week mindfulness-cognitive oriented group intervention program, it may effectively prevent depression, improve occupational balance, and enhance mental health for college students.大學生正念認知生活品質因應策略憂鬱college studentscoping strategiesdepressionmindfulness cognitivequality of lifethesis