Interactions Between Intra- and Interpersonal Emotional Competencies in the Case of Parental Burnout 父母倦怠案例中內部與人際情感能力之間的互動
Marie Bayot ^(1,2){ }^{1,2} (c), Isabelle Roskam², Laura Gallée ^(2){ }^{2}, and Moïra Mikolajczak² 瑪麗·巴約 ^(1,2){ }^{1,2} (c),伊莎貝爾·羅斯卡姆²,勞拉·加萊 ^(2){ }^{2} ,和莫伊拉·米科拉伊查克²^(1){ }^{1} Département de Médecine générale, UR Soins primaires et Santé, Université de Liège, Belgium ^(1){ }^{1} 一般醫學系,初級護理與健康,列日大學,比利時^(2){ }^{2} Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium 比利時魯汶大學天主教大學心理科學研究所,魯汶-拉-紐夫
Abstract 摘要
While emotional intelligence is generally associated with positive outcomes, little is known about the specific contribution of its intra- and interpersonal dimensions, even less about their interaction. By taking a variable that a priori involves both dimensions, that is, parenting, this study aimed to examine the possibility that intra- and interpersonal emotional competencies (EC) sometimes interact in such a way that the highest is not always the best. In this study, 842 parents ( 92%92 \% of mothers) completed self-reported measures of EC and parental burnout. Hierarchical multiple regression and moderation analyses showed that the level of intrapersonal EC mainly and negatively predicted parental burnout. On the other hand, the level of interpersonal EC positively predicted parental burnout and moderated the relation between intrapersonal EC and parental burnout. As interpersonal EC increased, the protective effect of intrapersonal EC on parental burnout decreased. Our findings therefore highlight the fact that intra- and interpersonal EC do not always work in a cumulative manner and emphasize the importance of studying intra- and interpersonal EC separately. As mothers were overrepresented in our sample, more data on fathers are needed to further generalize these findings. 儘管情緒智力通常與正面結果相關,但對其內部和人際維度的具體貢獻知之甚少,對它們之間的互動更是知之甚少。本研究以一個先驗涉及這兩個維度的變數,即育兒,旨在探討內部和人際情緒能力(EC)有時如何互動,以至於最高的能力不一定是最好的。在本研究中,842 名父母( 92%92 \% 名母親)完成了自我報告的情緒能力和父母倦怠的測量。分層多重回歸和調節分析顯示,內部情緒能力的水平主要且負向預測父母倦怠。另一方面,人際情緒能力的水平正向預測父母倦怠,並調節內部情緒能力與父母倦怠之間的關係。隨著人際情緒能力的增加,內部情緒能力對父母倦怠的保護作用減弱。因此,我們的研究結果強調內部和人際情緒能力並不總是以累積的方式運作,並強調分開研究內部和人際情緒能力的重要性。 由於母親在我們的樣本中佔比過高,因此需要更多有關父親的數據以進一步推廣這些發現。
Although we all experience and witness all sorts of emotions throughout our lives, we markedly differ in the extent to which we identify, express, understand, regulate, and use our own and others’ emotions (Mayer & Salovey, 1997; Mikolajczak et al., 2009; Petrides & Furnham, 2003). The concept of emotional competencies (EC) - embedded within the global term of “emotional intelligence” (EI) and sometimes used as synonym for the latter - has been proposed to account for this idea. According to the 3-level integrative model, EI encompasses the knowledge individuals may have about emotionally intelligent behaviors, the ability they may show to enact these behaviors, and their general propensity to use them (Mikolajczak et al., 2009). Interestingly, this model assumes a relative independence between EI levels. For example, one may be aware of emotion regulation strategies that are most functional (knowledge level) but may struggle with applying them (ability level). Similarly, one may be able to apply these emotion regulation strategies properly upon request, but may not spontaneously implement them in everyday life (trait level or trait EI). Moreover, EI can be subdivided in two dimensions: intra-personal (i.e., related to the processing of one’s own emotions) and interpersonal (i.e., related to the processing of others’ emotions). EI can be operationalized 儘管我們在生活中都會經歷和目睹各種情感,但在識別、表達、理解、調節和使用自己及他人的情感方面,我們的程度卻有顯著差異(Mayer & Salovey, 1997; Mikolajczak et al., 2009; Petrides & Furnham, 2003)。情感能力(EC)的概念——嵌入於“情感智力”(EI)這一全球術語中,有時也用作後者的同義詞——被提出來解釋這一觀點。根據三層次整合模型,情感智力包括個體對情感智力行為的知識、他們展現出來的執行這些行為的能力,以及他們使用這些行為的一般傾向(Mikolajczak et al., 2009)。有趣的是,這一模型假設情感智力的各個層次之間相對獨立。例如,一個人可能意識到最有效的情感調節策略(知識層面),但在應用這些策略時可能會遇到困難(能力層面)。同樣,一個人可能能夠在要求下正確地應用這些情感調節策略,但在日常生活中卻不會自發地實施它們(特質層面或特質情感智力)。 此外,情緒智力可以在兩個維度上進行細分:內在個人(即與處理自己情緒相關)和人際(即與處理他人情緒相關)。EI 可以被操作化
through diverse measures based on the assessment of individuals’ cognitions, emotions and/or behaviors, either directly observed (e.g., via computerized tasks and physiological indices) or self-reported (e.g., via questionnaires). EC, more specifically, can refer to the second level or, as in this study, the third level of EI. 透過多樣的措施,根據對個體的認知、情感和/或行為的評估,無論是直接觀察(例如,通過電腦化任務和生理指標)還是自我報告(例如,通過問卷)。情緒智力(EC)更具體地可以指第二層級,或如本研究所述的第三層級的情緒智力(EI)。
Both intuitively and experimentally, EI is generally associated with positive outcomes. Indeed, an impressive body of literature indicates that the level of EI has a significant impact on psychological, social, and physical adjustment. At the psychological level, higher EI is for instance associated with greater well-being (Austin, Saklofske, & Egan, 2005) and life satisfaction (Di Fabio & Saklofske, 2014), and with decreased psychological disorders (Petrides, Pérez-González, & Furnham, 2007), stress (Mikolajczak, Roy, Luminet, Fillée, & de Timary, 2007), and burnout (Lindeman et al., 2017). At a social level, higher EI is associated with increased social support (Mikolajczak, Luminet, Leroy, & Roy, 2007) and better social and marital relationships (Malouff, Schutte, & Thorsteinsson, 2014; Petrides, Sangareau, Furnham, & Frederickson, 2006; Schutte et al., 2001). At the physical level, higher EI is linked to better physical health, both subjectively reported (Martins, Ramalho, & Morin, 2010) and objectively measured 情緒智力(EI)在直觀和實驗上通常與正面結果相關。事實上,大量文獻顯示,情緒智力的水平對心理、社會和身體調適有顯著影響。在心理層面上,較高的情緒智力與更大的幸福感(Austin, Saklofske, & Egan, 2005)和生活滿意度(Di Fabio & Saklofske, 2014)相關,並且與心理障礙(Petrides, Pérez-González, & Furnham, 2007)、壓力(Mikolajczak, Roy, Luminet, Fillée, & de Timary, 2007)和倦怠(Lindeman et al., 2017)減少相關。在社會層面上,較高的情緒智力與增加的社會支持(Mikolajczak, Luminet, Leroy, & Roy, 2007)以及更好的社交和婚姻關係(Malouff, Schutte, & Thorsteinsson, 2014;Petrides, Sangareau, Furnham, & Frederickson, 2006;Schutte et al., 2001)相關。在身體層面上,較高的情緒智力與更好的身體健康相關,無論是主觀報告(Martins, Ramalho, & Morin, 2010)還是客觀測量。
(Mikolajczak et al., 2015). Importantly, these relations appear to be causal: when EI is improved through training, psychological, social, and physical adjustment improve (Karahan & Yalcin, 2009; Kotsou, Nelis, Grégoire, & Mikolajczak, 2011; Nelis et al., 2011). (Mikolajczak 等,2015)。重要的是,這些關係似乎是因果的:當情緒智力通過訓練得到改善時,心理、社會和身體的調整也會改善(Karahan & Yalcin,2009;Kotsou、Nelis、Grégoire 和 Mikolajczak,2011;Nelis 等,2011)。
Importantly, however, little is known about the EI dimensions that contribute to those effects. For example, most of EI instruments do not make a clear distinction between self- and other-focused EC (Pekaar, Bakker, van der Linden, & Born, 2018). Interestingly, according to several studies who did take this distinction into account, (mental) health benefits associated with EI stem particularly from the intrapersonal dimensions of EI (e.g., the capacity to regulate one’s own emotional states) (Batselé, Stefaniak, & Fantini-Hauwel, 2019), whereas interpersonal EI (e.g., the capacity to assess other’s emotional states) seem to act more specifically on social outcomes (e.g., peer-rated likeability) (Baudry, Grynberg, Dassonneville, Lelorain, & Christophe, 2018; Nozaki, 2015; Nozaki & Koyasu, 2013; Szczygiel & Mikolajczak, 2018). Although beneficial for the community, socially oriented behaviors consume resources and may therefore interfere in some cases with individual well-being. For example, the attention we allocate to others’ needs, emotions, and mental representations, and the energy we use to properly respond to the latter, are not available for concurrent self-related needs and concerns. As in the case of health care professionals, parents’ other-care processes may possibly interfere with self-care processes, increasing the risk of burnout (Colville, 2018; Tei et al., 2014). As a matter of fact, the cost of being other-oriented has been observed on physical health. In their nationally representative study, Mikolajczak et al. (2015) showed that people who have the lowest health care consumption are people with high intrapersonal EC and low interpersonal EC. These pioneering results further demonstrate the need to look deeper into the interaction between EI/EC dimensions and its related outcomes. Most importantly, these data illustrate how the highest may not always be the best, even in the case of EI. For example, the downsides of emotion recognition ability (interpersonal EC) have hardly been investigated in the literature (Schlegel, 2020). Interestingly, scales such as the Profile of Emotional Competencies (PEC; Brasseur, Grégoire, Bourdu, & Mikolajczak, 2013) were purposely conceived for the investigation of trait individual differences in the identification, understanding, expression, use, and regulation of one’s own (intrapersonal EC) and others’ emotional states (interpersonal EC), and therefore allow to narrow the gap in this part of the EI literature. 然而,重要的是,對於那些影響的情緒智力(EI)維度知之甚少。例如,大多數 EI 工具並未明確區分自我導向和他人導向的情緒調節(EC)(Pekaar, Bakker, van der Linden, & Born, 2018)。有趣的是,根據幾項考慮到這一區分的研究,與 EI 相關的(心理)健康益處特別來自 EI 的內在維度(例如,調節自己情緒狀態的能力)(Batselé, Stefaniak, & Fantini-Hauwel, 2019),而人際 EI(例如,評估他人情緒狀態的能力)似乎更具體地影響社會結果(例如,同儕評價的受歡迎程度)(Baudry, Grynberg, Dassonneville, Lelorain, & Christophe, 2018;Nozaki, 2015;Nozaki & Koyasu, 2013;Szczygiel & Mikolajczak, 2018)。儘管對社區有益,社會導向的行為消耗資源,因此在某些情況下可能會干擾個體的福祉。 例如,我們分配給他人需求、情感和心理表徵的注意力,以及我們用來適當回應後者的精力,並不能同時用於自我相關的需求和關注。就像醫療保健專業人員的情況一樣,父母的他人關懷過程可能會干擾自我照顧過程,增加倦怠的風險(Colville, 2018;Tei et al., 2014)。事實上,關注他人的成本已在身體健康上有所觀察。在他們的全國代表性研究中,Mikolajczak 等(2015)顯示,健康保健消耗最低的人是具有高內在情緒能力和低人際情緒能力的人。這些開創性的結果進一步證明了深入研究情緒智力/情緒能力維度及其相關結果之間互動的必要性。最重要的是,這些數據說明了即使在情緒智力的情況下,最高的情緒能力也不一定是最好的。例如,情緒識別能力(人際情緒能力)的缺點在文獻中幾乎沒有被研究(Schlegel, 2020)。 有趣的是,情感能力概況(PEC;Brasseur、Grégoire、Bourdu 和 Mikolajczak,2013)等量表是專門設計用於研究個體在識別、理解、表達、使用和調節自己(內在情感能力)和他人情感狀態(人際情感能力)方面的特質差異,因此能夠縮小情感智力文獻中這一部分的差距。
In line with health care professions, parenting is one context in which both intrapersonal and interpersonal EC are strongly involved. On the one hand, intrapersonal EC are essential in coping with the multiple stressors that 與健康護理專業相關,育兒是一個強烈涉及內在和人際情緒智力的情境。一方面,內在情緒智力對於應對多重壓力源至關重要。
punctuate a parent’s life, including daily hassles (e.g., chores, homework, home-school-extracurricular activities journeys), acute stressors (e.g., a child choking, an adolescent running away), and chronic stressors (e.g., a child with behavioral, learning, or physical disorder). On the other hand, interpersonal EC or empathic responding plays an important role in the quality of parent-child relationship as well as child developmental and well-being outcomes (e.g., psychopathology, attachment security) (Perez-Albeniz & de Paul, 2004; Psychogiou, Daley, Thompson, & SonugaBarke, 2008; Soenens, Duriez, Vansteenkiste, & Goossens, 2007; Stern, Borelli, & Smiley, 2014). While intrapersonal EC (e.g., the capacity to regulate one’s own emotions efficiently) may protect individuals from psychological distress (Gleichgerrcht & Decety, 2013), high interpersonal EC (e.g., identification of other’s emotions) may lead to behaviors (e.g., support) that consume emotional resources and therefore make parents more vulnerable to stress. 父母的生活中充滿了各種事件,包括日常瑣事(例如,家務、功課、家庭-學校-課外活動的旅程)、急性壓力源(例如,孩子窒息、青少年出走)和慢性壓力源(例如,行為、學習或身體障礙的孩子)。另一方面,人際情感共鳴或同理心反應在親子關係的質量以及孩子的發展和福祉結果(例如,心理病理學、依附安全)中扮演著重要角色(Perez-Albeniz & de Paul, 2004; Psychogiou, Daley, Thompson, & SonugaBarke, 2008; Soenens, Duriez, Vansteenkiste, & Goossens, 2007; Stern, Borelli, & Smiley, 2014)。雖然內在情感共鳴(例如,有效調節自己情緒的能力)可能保護個體免受心理困擾(Gleichgerrcht & Decety, 2013),但高水平的人際情感共鳴(例如,識別他人情緒)可能導致消耗情感資源的行為(例如,支持),因此使父母更容易受到壓力的影響。
It has recently been shown that when stress-enhancing factors chronically outweigh stress-alleviating factors (i.e., in case of prolonged imbalance between demands and resources), parents may experience parental burnout, a syndrome encompassing three dimensions: an overwhelming exhaustion related to one’s parental role, emotional distancing from one’s children, and feelings of being fed up with one’s parental role, which all contrast with previous parental self (Roskam, Brianda, & Mikolajczak, 2018). The only study that investigated the role of trait EI in parental burnout reported a substantial association between those variables. As a matter of fact, global EI explained 20%20 \% of the variance in parental burnout ( r=-.45,p <r=-.45, p< .001) (Mikolajczak, Raes, Avalosse, & Roskam, 2018). However, these results relied on a short measure of EI. Therefore, the effect of specific EI/EC dimensions could not be examined. As regards the large effects of parental burnout on escape, suicidal ideation as well as on neglectful and violent behaviors toward children (Mikolajczak, Brianda, Avalosse, & Roskam, 2018), going deeper into the role of EC may foster the development of more targeted prevention and intervention programs. On the one hand, it is possible that interpersonal EC protect from parental burnout by helping parents to better deal with their children’s emotions. On the other hand, and according to the literature on the cost of other-oriented behaviors, it is also possible that interpersonal EC make parents more vulnerable to parental burnout. This might be specifically true for the capacity to identify other’s emotions. Indeed, it is possible that the perception of discomfort signals in others (e.g., one’s child) triggers self- and other-regulation behaviors (e.g., verbal support) that deplete emotional resources and therefore increases the risk of burning out. Finally, it is possible that intra- and inter-personal EC interact with each other and that the effect of interpersonal EC on parental burnout 最近的研究顯示,當壓力增強因素長期超過壓力緩解因素(即在需求與資源之間持續不平衡的情況下),父母可能會經歷父母倦怠,這是一種包含三個維度的綜合症:與父母角色相關的壓倒性疲憊、與孩子的情感疏離,以及對父母角色感到厭倦的感受,這些都與以往的父母自我形成對比(Roskam, Brianda, & Mikolajczak, 2018)。唯一一項研究調查了特質情緒智力在父母倦怠中的作用,報告了這些變量之間的顯著關聯。事實上,全球情緒智力解釋了父母倦怠的變異量 20%20 \% ( r=-.45,p <r=-.45, p< .001)(Mikolajczak, Raes, Avalosse, & Roskam, 2018)。然而,這些結果依賴於一個簡短的情緒智力量表。因此,無法檢驗特定情緒智力/情緒控制維度的影響。 關於父母倦怠對逃避、自殺意念以及對孩子的忽視和暴力行為的重大影響(Mikolajczak, Brianda, Avalosse, & Roskam, 2018),深入探討情緒共鳴的角色可能促進更具針對性的預防和干預計劃的發展。一方面,人際情緒共鳴可能通過幫助父母更好地處理孩子的情緒來保護他們免受父母倦怠的影響。另一方面,根據有關他人導向行為成本的文獻,人際情緒共鳴也可能使父母更容易受到父母倦怠的影響。這對於識別他人情緒的能力尤其可能成立。事實上,感知他人(例如,自己的孩子)不適信號可能會觸發自我和他人調節行為(例如,口頭支持),這會耗盡情感資源,從而增加倦怠的風險。最後,個人內部和個人之間的情感智力可能相互作用,且人際情感智力對父母倦怠的影響
partially depends on the level of intrapersonal EC (and vice versa), like Mikolajczak et al. (2015) found regarding health. In conclusion, we need to disentangle the role of both intra- and interpersonal EC dimensions in order to design efficient interventions (e.g., focusing on intrapersonal vs. interpersonal EC development) for parents in burnout, and more globally, to further investigate the role played by each dimension in the relation between EI and its (usually) positive outcomes. 部分依賴於內在情緒智力(EC)的水平(反之亦然),正如 Mikolajczak 等人(2015)在健康方面的研究所發現的。總之,我們需要釐清內在和人際情緒智力維度的角色,以便為面臨倦怠的父母設計有效的干預措施(例如,專注於內在與人際情緒智力的發展),並更廣泛地進一步研究每個維度在情緒智力與其(通常)正面結果之間關係中所扮演的角色。
The aim of this study is to shed further light on the effects of EI on parental burnout, looking more deeply into the main and interactive effects of intra- and interpersonal EC. In line with the literature on EI and mental health, we expected a strong main effect of intrapersonal EC: the higher the level of intrapersonal EC, the lower the level of parental burnout. As regards the main and interactive effects of interpersonal EC, no strong hypothesis could be drawn from previous literature and the analyses were therefore exploratory. 本研究的目的是進一步探討情緒智力(EI)對父母倦怠的影響,更深入地研究內部和人際情緒調節(EC)的主要和互動效應。根據情緒智力與心理健康的文獻,我們預期內部情緒調節的主要效應會很強:內部情緒調節的水平越高,父母倦怠的水平越低。至於人際情緒調節的主要和互動效應,之前的文獻無法提出強有力的假設,因此分析將是探索性的。
Method 方法
Participants and Procedure 參與者與程序
The study protocol as well as the information and written consent documents were approved by the Université catholique de Louvain Review Board. Participants were informed about the survey through social networks, websites, schools, pediatricians, or word of mouth. In order to avoid (self-) selection bias, participants were not informed that the study was about parental burnout. The study was presented as a study about “Factors of parental well-being and exhaustion in Belgium”. Parents were eligible to participate only if they had (at least) one child still living at home. Participants were invited to complete the survey after giving informed consent. They were assured that data would remain anonymous. The questionnaire was completed online with forced answering, ensuring a dataset with no missing data. Among the 1,428 respondents, 842 answered the whole questionnaire ( M_("age ")=38.72M_{\text {age }}=38.72 years, SD_("age ")=7.21S D_{\text {age }}=7.21 years). The majority of parents in our final sample were mothers (91.9%), had two children (47.5%), lived with the father/mother of their child[ren] (78.3%), and had higher education (15 or more succeeded school years from the age of 6) (75%). 研究計劃書以及資訊和書面同意文件已獲得魯汶天主教大學審查委員會的批准。參與者通過社交網絡、網站、學校、兒科醫生或口耳相傳得知調查。為了避免(自我)選擇偏差,參與者並未被告知該研究是關於父母倦怠的。該研究被呈現為一項關於「比利時父母福祉和疲憊因素」的研究。只有在家中至少有一名孩子的父母才有資格參加。參與者在給予知情同意後被邀請完成調查。他們被保證數據將保持匿名。問卷在線完成,並要求強制回答,確保數據集沒有缺失數據。在 1,428 名受訪者中,有 842 人回答了整個問卷( M_("age ")=38.72M_{\text {age }}=38.72 年, SD_("age ")=7.21S D_{\text {age }}=7.21 年)。我們最終樣本中的大多數父母是母親(91.9%),有兩個孩子(47.5%),與孩子的父親/母親同住(78.3%),並且受過高等教育(從 6 歲起成功完成 15 年或以上的學校教育)(75%)。
Measures 措施
Demographics 人口統計
Participants were asked to indicate their age, gender, number of children (living in the same house), age of the youngest child, type of family (single parent, living with 參與者被要求指出他們的年齡、性別、子女數量(同住在同一屋簷下)、最小孩子的年齡、家庭類型(單親家庭、與...同住)
the children’s father/mother, blended family, same-sex parents, living with grand-parents/other relatives, polygamy, other), and level of education (number of succeeded school years from the age of 6). 孩子的父親/母親、重組家庭、同性父母、與祖父母/其他親戚同住、一夫多妻制、其他,以及教育程度(從 6 歲起成功完成的學校年數)。
Emotional Intelligence 情緒智力
Emotional intelligence was assessed with the Profile of Emotional Competence (PEC; Brasseur et al., 2013). This fifty, 5-point item (from 1=1= strongly disagree to 5=5= strongly agree) measure was designed to evaluate the five core emotional competencies separately, distinctly for one’s own and others’ emotions. It thus provides 10 sub-scores (identification of one’s emotions, identification of others’ emotions, understanding of one’s emotions, understanding of others’ emotions, expression of one’s emotions, listening to others’ emotions, regulation of one’s emotions, regulation of others’ emotions, use of one’s emotions, use of others’ emotions), forming 3 global scores: an intrapersonal EC score ( == mean of the five intrapersonal subscales; alpha=\alpha= .88), an interpersonal EC score ( == mean of the five interpersonal subscales; alpha=.88\alpha=.88 ), and a total EC score (= mean of intra- and inter-personal scores; alpha=.92\alpha=.92 ). All sub-scales of the PEC in the current sample showed satisfying internal consistency ( alpha_(s)\alpha_{s} between .68 and .79). Examples of items are “during an argument, I can’t identify whether I am sad or angry” and “my emotions inform me of what is important to me”. 情緒智力是通過情緒能力概況(PEC;Brasseur et al.,2013)進行評估的。這項包含五十個 5 點量表(從 1=1= 強烈不同意到 5=5= 強烈同意)的測量工具旨在分別評估五種核心情緒能力,並區分個人情緒和他人情緒。因此,它提供了 10 個子分數(識別自己的情緒、識別他人的情緒、理解自己的情緒、理解他人的情緒、表達自己的情緒、傾聽他人的情緒、調節自己的情緒、調節他人的情緒、使用自己的情緒、使用他人的情緒),形成 3 個總體分數:一個內在情緒能力分數( == 五個內在子量表的平均值; alpha=\alpha= .88),一個人際情緒能力分數( == 五個人際子量表的平均值; alpha=.88\alpha=.88 ),以及一個總情緒能力分數(=內在和人際分數的平均值; alpha=.92\alpha=.92 )。目前樣本中 PEC 的所有子量表顯示出令人滿意的內部一致性( alpha_(s)\alpha_{s} 介於.68 和.79 之間)。項目的例子包括“在爭論中,我無法確定自己是悲傷還是生氣”和“我的情緒告訴我什麼對我來說是重要的”。
Parental Burnout 父母倦怠
Parental burnout was measured with the Parental Burnout Assessment (PBA; Roskam et al., 2018), including 23 items rated on a 7 -point frequency scale (0=(0= never, 1=a1=a few times a year or less, 2 = once a month or less, 3=3= a few times a month, 4 = once a week, 5=5= a few times a week, 6=6= everyday), organized into four subscales: Exhaustion in one’s parental role (9 items) (e.g., “I feel completely run down by my role as a parent”), emotional distancing from one’s child(ren) (3 items) (e.g., “I do what I’m supposed to do for my child (ren), but nothing more”), feelings of being fed up with one’s parental role ( 5 items) (e.g., “I can’t stand my role as father/mother any more”), contrast with previous parental self (6 items) (e.g., “I don’t think I’m the good father/mother that I used to be to my child(ren)”), and forming a global score. The reliability of the scale in the current sample was excellent (alpha=.97)(\alpha=.97). 父母倦怠是通過父母倦怠評估(PBA;Roskam 等,2018)來測量的,包括 23 個項目,根據 7 點頻率量表進行評分 (0=(0= 從不, 1=a1=a 每年幾次或更少, 3=3= 每月一次或更少, 3=3= 每月幾次, 6=6= 每週一次, 5=5= 每週幾次, 6=6= 每天),組織成四個子量表:在父母角色中的疲憊感(9 個項目)(例如:“我感到作為父母完全精疲力竭”)、與孩子的情感疏離(3 個項目)(例如:“我為我的孩子做我應該做的事情,但沒有更多”)、對父母角色感到厭倦(5 個項目)(例如:“我再也無法忍受作為父親/母親的角色”)、與以往的父母自我對比(6 個項目)(例如:“我不認為我仍然是我曾經對我的孩子(們)那樣好的父親/母親”),並形成一個總分。在當前樣本中,該量表的可靠性非常好 (alpha=.97)(\alpha=.97) 。
Data Analyses 數據分析
After checking for significant outliers (i.e., 4 for demographic variables) and normality, we ran our analyses in four steps. First, we applied a multiple regression analysis to estimate the validity of discrete demographic variables in predicting parental burnout. Since level of education ( beta\beta 在檢查顯著的異常值(即,人口統計變數的 4 個異常值)和常態性後,我們分四個步驟進行分析。首先,我們應用了多元回歸分析來估計離散人口統計變數在預測父母倦怠方面的有效性。由於教育程度( beta\beta
DeltaR^(2) beta p-value
Model 1 .16 < .001
Level of education -0.086 .009
Number of children 0.083 .012
Age of the youngest child -0.131 < .001
Intrapersonal EC -0.387 < .001
Interpersonal EC 0.119 .002
Model 2 .001
Level of education -0.087 .008
Number of children 0.087 .008
Age of the youngest child -0.133 < .001
Intrapersonal EC -0.395 < .001
Interpersonal EC 0.130 .001
Intra xx Inter 0.109 .001
Total R^(2) < .001 | | $\Delta R^{2}$ | $\beta$ | $p$-value |
| :--- | :--- | :---: | ---: |
| Model 1 | .16 | | $<.001$ |
| Level of education | | -0.086 | .009 |
| Number of children | 0.083 | .012 | |
| Age of the youngest child | | -0.131 | $<.001$ |
| Intrapersonal EC | -0.387 | $<.001$ | |
| Interpersonal EC | | 0.119 | .002 |
| Model 2 | | | .001 |
| Level of education | | -0.087 | .008 |
| Number of children | | 0.087 | .008 |
| Age of the youngest child | | -0.133 | $<.001$ |
| Intrapersonal EC | -0.395 | $<.001$ | |
| Interpersonal EC | | 0.130 | .001 |
| Intra $\times$ Inter | | 0.109 | .001 |
| Total $R^{2}$ | | $<.001$ | |
=-0.12,p < .001)=-0.12, p<.001), number of children (beta=0.08(\beta=0.08, p=.02p=.02 ), and age of the youngest child ( beta=-0.19,p=\beta=-0.19, p= .001) significantly predicted parental burnout, they were added into the model. Second, the main and interactive effects of intra-and inter-personal EC were examined through a hierarchical multiple regression analysis (Table 1). In the first model, intrapersonal EC and interpersonal EC were included in addition to the abovementioned demographic variables. Then variables were centered and an interaction term between intra- and interpersonal EC was created (Intra xx\times Inter). The interaction term was added to the regression model (model 2). Third, in order to go deeper into the interaction, a moderation model was run using Hayes’ PROCESS macro version 3.1 (Hayes, 2018). The model was adjusted for level of education, number of children, and age of the youngest child (note that the results reported hereafter hold even when these control variables are not taken into account). Interaction was assessed by entering the variable Intra xx\times Inter with parental burnout as an outcome. We ran a stratified model at 16th, 50th, and 84th percentiles and used the Johnson-Neyman technique to identify the direction of the interaction. A twosided pp-value of < .05<.05 was considered statistically significant. Fourth, in order to assess the extent to which each sub-dimension of interpersonal EC (i.e., identification, understanding, listening, regulation, and use of/to others’ emotions) contributes to the moderation effect by interpersonal EC, we entered them in a multiple regression analysis with demographic variables and intrapersonal EC for the prediction of parental burnout. Hierarchical multiple regression (step 2) and moderation (step 3) analyses were replicated for each sub-dimension if they accounted for a significant part of the variance in parental burnout. The assumptions of non-collinearity (VIF), multivariate =-0.12,p < .001)=-0.12, p<.001) ,孩子數量 (beta=0.08(\beta=0.08 , p=.02p=.02 ),以及最小孩的年齡( beta=-0.19,p=\beta=-0.19, p= .001)顯著預測了父母的倦怠,因此被納入模型。其次,通過分層多重回歸分析(表 1)檢查了內部和外部情緒智力的主要和互動效應。在第一個模型中,除了上述的人口統計變數外,還包括了內部情緒智力和外部情緒智力。然後對變數進行中心化,並創建了內部和外部情緒智力之間的互動項(內部 xx\times 外部)。互動項被添加到回歸模型中(模型 2)。第三,為了深入探討互動,使用 Hayes 的 PROCESS 宏版本 3.1(Hayes,2018)運行了一個調節模型。該模型已根據教育水平、孩子數量和最小孩的年齡進行調整(請注意,以下報告的結果即使在不考慮這些控制變數的情況下也成立)。通過將變數內部 xx\times 外部與父母倦怠作為結果進行評估互動。 我們在第 16、第 50 和第 84 百分位數運行了一個分層模型,並使用約翰遜-奈曼技術來識別互動的方向。雙側 pp -值為 < .05<.05 被認為具有統計學意義。第四,為了評估人際情感能力(即認同、理解、傾聽、調節和對他人情感的使用)每個子維度對人際情感能力的調節效應的貢獻程度,我們將它們與人口統計變數和內在情感能力一起輸入多元回歸分析,以預測父母倦怠。如果每個子維度在父母倦怠的變異中佔據了顯著部分,則將對其進行分層多元回歸(第 2 步)和調節(第 3 步)分析的重複。非共線性假設(VIF),多變量
normality, independence of residuals (Durbin-Watson test), and homoscedasticity were respected in linear regression analyses. Descriptive data for trait variables and their correlation with relevant demographic variables are displayed in Electronic Supplementary Material, ESM 1. 常態性、殘差獨立性(德賓-沃森檢驗)和同方差性在線性回歸分析中得到了遵守。特徵變數的描述性數據及其與相關人口統計變數的相關性顯示在電子補充材料 ESM 1 中。
Results 結果
Main Effects of Intrapersonal and Interpersonal EC 內部與外部情緒智力的主要影響
As shown in Table 1, both intrapersonal EC and interpersonal EC had a significant main effect on parental burnout. These effects nonetheless varied in size and direction. As expected, intrapersonal EC had a large negative effect on parental burnout. On the contrary, interpersonal EC had a small positive effect on parental burnout. 如表 1 所示,內在情緒調節和人際情緒調節對父母倦怠均有顯著的主要影響。然而,這些影響的大小和方向有所不同。正如預期的那樣,內在情緒調節對父母倦怠有很大的負面影響。相反,人際情緒調節對父母倦怠有小的正面影響。
Interaction Between Intrapersonal and Interpersonal EC 內在與人際情感智力之間的互動
As shown in Table 1, intrapersonal and interpersonal EC also significantly interacted to predict parental burnout. Process outputs showed that the part of parental burnout variance explained by moderated multiple regression ( R^(2)=.171,F(6,780)=26.91,p < .0001R^{2}=.171, F(6,780)=26.91, p<.0001 ) was significantly greater than multiple regression (DeltaR^(2)=.011,Delta F(1,780)=:}\left(\Delta R^{2}=.011, \Delta F(1,780)=\right. 11.105, p < .001p<.001 ), further confirming the added-value of the interaction term Intra xx\times Inter in our model. Coefficients from our model indicated that when the level of interpersonal EC was held constant (mean value), intrapersonal EC had a negative effect on parental burnout ( beta=-19.91\beta=-19.91+-1.962,p < .0001,CI[-23.761,-16.058]\pm 1.962, p<.0001, \mathrm{CI}[-23.761,-16.058] ). Inversely, when the level of intrapersonal EC was held constant (mean value), interpersonal EC had a positive effect on parental burnout ( beta=7.377+-2.193,p=.0008\beta=7.377 \pm 2.193, p=.0008, CI [3.072, 11.682]). As regards the interaction term, when the level of interpersonal EC increased by one unit, the simple effect of intrapersonal EC on parental burnout increased by 9.677 ( beta+-\beta \pm 2.193, p=.0009p=.0009, CI [3.976, 15.377]), therefore leaning toward zero. A detailed moderation analysis with the Johnson-Neyman technique showed that when the level of interpersonal EC was the highest, the protective effect of intrapersonal EC on parental burnout became non significant. Put differently, when intrapersonal EC were low, parents with high, moderate, or low levels of interpersonal EC showed the same high risk to experience parental burnout, whereas when intrapersonal EC were high, parents with high levels of interpersonal EC showed more risk to experience parental burnout than parents with moderate and low levels of interpersonal EC (Figure 1). 如表 1 所示,內在和人際情緒智力(EC)顯著互動以預測父母倦怠。過程輸出顯示,通過調節多重回歸解釋的父母倦怠變異部分( R^(2)=.171,F(6,780)=26.91,p < .0001R^{2}=.171, F(6,780)=26.91, p<.0001 )顯著大於多重回歸( (DeltaR^(2)=.011,Delta F(1,780)=:}\left(\Delta R^{2}=.011, \Delta F(1,780)=\right. 11.105, p < .001p<.001 ),進一步確認了我們模型中互動項 Intra xx\times Inter 的附加價值。我們模型的係數顯示,當人際 EC 的水平保持不變(平均值)時,內在 EC 對父母倦怠有負面影響( beta=-19.91\beta=-19.91+-1.962,p < .0001,CI[-23.761,-16.058]\pm 1.962, p<.0001, \mathrm{CI}[-23.761,-16.058] )。相反,當內在 EC 的水平保持不變(平均值)時,人際 EC 對父母倦怠有正面影響( beta=7.377+-2.193,p=.0008\beta=7.377 \pm 2.193, p=.0008 ,CI [3.072, 11.682])。至於互動項,當人際 EC 的水平增加一個單位時,內在 EC 對父母倦怠的簡單效應增加了 9.677( beta+-\beta \pm 2.193, p=.0009p=.0009 ,CI [3.976, 15.377]),因此趨向於零。 一項使用約翰遜-奈曼技術的詳細調節分析顯示,當人際情感智力的水平達到最高時,內在情感智力對父母倦怠的保護作用變得不顯著。換句話說,當內在情感智力較低時,無論人際情感智力的水平是高、中或低,父母經歷父母倦怠的風險都是相同的;而當內在情感智力較高時,擁有高水平人際情感智力的父母經歷父母倦怠的風險比擁有中等和低水平人際情感智力的父母更高(見圖 1)。
Complementary analyses run to identify which interpersonal EC dimensions contributed most to the abovementioned effect revealed that the dimension “identification of others’ emotions” (IOE) was the only one to remain significant in the presence of the others ( beta=0.13,p=.007\beta=0.13, p=.007 ). Results from hierarchical multiple regression and moderation analysis (R^(2)=.171,F(6,780)=26.99,p < .0001)\left(R^{2}=.171, F(6,780)=26.99, p<.0001\right) with the interaction term Intra xx\times IOE yielded similar results as Intra xx\times Inter. 補充分析顯示,識別他人情緒(IOE)這一維度在其他維度存在的情況下仍然是唯一顯著的維度。來自分層多重回歸和調節分析的結果顯示,內部 IOE 的交互項與內部 Inter 的結果相似。
Discussion 討論
In a nutshell, the current findings suggest that (1) selfreported intrapersonal EC have a strong protective effect vis-à-vis parental burnout, (2) self-reported interpersonal EC slightly increase the vulnerability vis-à-vis parental burnout, (3) the protective effect of self-reported intrapersonal EC on parental burnout is hampered by self-reported interpersonal EC. Parents with low intrapersonal EC have the highest parental burnout levels, independently of their interpersonal EC. When intrapersonal EC are high, parents with high levels of interpersonal EC show more risk to experience parental burnout than parents with moderate and low levels of interpersonal EC. Analyses by sub-dimensions of interpersonal EC show that the capacity to identify others’ emotions is responsible for this moderation effect. 簡而言之,目前的研究結果表明:(1) 自我報告的內在情緒智力對父母倦怠有強大的保護作用,(2) 自我報告的外在情緒智力略微增加了父母倦怠的脆弱性,(3) 自我報告的內在情緒智力對父母倦怠的保護作用受到自我報告的外在情緒智力的阻礙。內在情緒智力低的父母,其父母倦怠水平最高,與他們的外在情緒智力無關。當內在情緒智力高時,擁有高水平外在情緒智力的父母比擁有中等和低水平外在情緒智力的父母更容易經歷父母倦怠。對外在情緒智力的子維度分析顯示,識別他人情緒的能力是這一調節效應的原因。
The finding that parental burnout is most strongly predicted by self-reported intrapersonal EC than self-reported interpersonal EC is consistent with the EI literature. Indeed, in studies where intra- and interpersonal EC were both considered, depression, stress, anxiety, and job burnout (Batselé et al., 2019; Cejudo, Rodrigo-Ruiz, López-Delgado, & 父母倦怠最強烈的預測因素是自我報告的內在情緒能力,而非自我報告的外在情緒能力,這一發現與情緒智力文獻一致。事實上,在考慮內在和外在情緒能力的研究中,抑鬱、壓力、焦慮和工作倦怠(Batselé et al., 2019; Cejudo, Rodrigo-Ruiz, López-Delgado, &
Figure 1. Graphic representation of the interaction between intra- and interpersonal EC in predicting parental burnout based on Process moderation analysis. 圖 1. 根據過程調節分析,內部與人際情緒智力在預測父母倦怠中的互動圖形表示。
Losada, 2018; Görgens-Ekermans & Brand, 2012; Weng et al., 2011) were only predicted by intrapersonal EC. The association between the intrapersonal dimension of EI and parental burnout makes perfect sense in the parenting context too. Even if our data do not allow to draw any causal inference, one can imagine that the capacity to identify one’s own emotions may allow detecting when personal limits (emotional or physical) in parent-child interactions are surpassed and offers the opportunity to act in a sense that preserves psychological balance of the parent (e.g., calmly expressing one’s own emotions to child). Similarly, the capacity to regulate one’s own emotions can easily be considered as a resource when parents are emotionally aroused by their child’s behavior (e.g., feelings of anger when the child disobeys) or their child’s experience (e.g., feelings of distress as regards a situation of social rejection at school). 洛薩達,2018;戈根斯-埃克曼斯與布蘭德,2012;翁等,2011)僅由內在情緒智力的個人層面預測。在育兒的背景下,情緒智力的內在維度與父母倦怠之間的關聯也顯得非常合理。即使我們的數據無法得出任何因果推論,但可以想像,識別自己情緒的能力可能有助於發現父母與孩子互動中個人極限(情感或身體)被超越的時刻,並提供機會以保護父母的心理平衡(例如,冷靜地向孩子表達自己的情緒)。同樣,調節自己情緒的能力在父母因孩子的行為(例如,孩子不服從時的憤怒感)或孩子的經歷(例如,對學校社交拒絕情況的困擾感)而情緒激動時,也可以被視為一種資源。
Interestingly, our data do not show an absence of effect of interpersonal EC. Self-reported interpersonal EC also influence the likelihood of experiencing exhaustion and emotional distress in parenting. The novelty of our finding is that interpersonal EC, albeit comprised in the broadly adaptive notion of EI, are not associated with positive outcomes but rather appear as a risk factor. A study of nearly 10,000 subjects already showed that, when intrapersonal EC was held constant, presenting good interpersonal EC was deleterious for health (Mikolajczak et al., 2015). Our data dovetail with these findings and support the hypothesis that having good interpersonal EC can be a disadvantage in some contexts and for some outcomes. While high interpersonal EC seem to be functional regarding a number of social outcomes (Nozaki, 2015; Nozaki & Koyasu, 2013), our results and those of Mikolajczak et al. (2015) show that there might also be costs (for the self) of being 有趣的是,我們的數據並未顯示人際情緒智力(EC)缺乏效果。自我報告的人際情緒智力也影響在育兒中經歷疲憊和情緒困擾的可能性。我們發現的創新之處在於,人際情緒智力雖然包含在廣泛適應的情緒智力概念中,但並不與正面結果相關,反而似乎是一種風險因素。一項針對近 10,000 名受試者的研究已經顯示,當控制內在情緒智力時,良好的人際情緒智力對健康是有害的(Mikolajczak et al., 2015)。我們的數據與這些發現相吻合,並支持這一假設:在某些情境和某些結果中,擁有良好的人際情緒智力可能是一種劣勢。雖然高的人際情緒智力似乎在許多社會結果上是功能性的(Nozaki, 2015; Nozaki & Koyasu, 2013),但我們的結果以及 Mikolajczak et al.(2015)的結果顯示,擁有良好的人際情緒智力可能也會對自我造成成本。
“other-oriented.” Moreover, the self-reported capacity to identify others’ emotions tends to weaken the negative relation between intrapersonal EC and parental burnout. One way to understand this moderation effect is to think of the fact that when parents perceive changes in their children’s emotional state, they may feel prompted to act in a sense that will respond to their children’s underlying need and restore their children’s emotional balance (Preston & de Waal, 2002). As this regulation process consumes emotional resources, parents’ capacity to regulate their own emotions cannot fully compensate for the related cost. As underlined above, this interactive effect might be moderated by other individual differences. For example, parental perfectionism (e.g., expressed by a fear of missing out on children’s emotions and/or a feeling of urgency in responding to these), which is particularly at stake in parental burnout (Mikolajczak, Raes, et al., 2018), might underlie the relation we observed between interpersonal EC and parental burnout. Anyway, future research needs to go deeper into these findings through experimental designs that allow to disentangle the direction of causality between EC and parental burnout, and more generally, would benefit from systematically performing sub-dimension analyses when investigating this issue. “以他人為導向。”此外,自我報告的識別他人情緒的能力往往會削弱人際情緒智力與父母倦怠之間的負相關。理解這一調節效應的一種方式是考慮到當父母察覺到孩子情緒狀態的變化時,他們可能會感到有必要以某種方式行動,以回應孩子潛在的需求並恢復孩子的情緒平衡(Preston & de Waal, 2002)。由於這一調節過程消耗情感資源,父母調節自己情緒的能力無法完全彌補相關的成本。如上所述,這一互動效應可能會受到其他個體差異的調節。例如,父母的完美主義(例如,表現為對孩子情緒的錯過感到恐懼和/或在回應這些情緒時感到緊迫),在父母倦怠中尤其突出(Mikolajczak, Raes, et al., 2018),可能是我們觀察到的人際情緒智力與父母倦怠之間關係的根源。 無論如何,未來的研究需要通過實驗設計深入探討這些發現,以釐清情緒調節能力與父母倦怠之間的因果關係,並且在調查這一問題時,系統性地進行子維度分析將更具益處。
Beyond contributing to the field of EI, our results bring new questions to the parenting literature. Most evidencebased parenting programs mainly focus on child and family’s outcomes rather than on parental outcomes (Barlow, Smailagic, Huband, Roloff, & Bennett, 2014; Duncan, Coatsworth, & Greenberg, 2009), hence tend to promote parents’ interpersonal EC for the sake of children’s wellbeing (Psychogiou et al., 2008; Stern et al., 2014). As a matter of fact, parental empathy increases perceived maternal support and warmth (Soenens et al., 2007) but might also deplete parents’ resources in the face of parenting-related stressors. Our results indeed show that the capacity to identify others’ emotions - as beneficial for interpersonal outcomes as it can be (Baudry et al., 2018) - is positively related to parents’ emotional exhaustion. Therefore, future research on the direction of causality between these variables might yield new clinical guidelines for the prevention and treatment of parental burnout. 超越對情緒智力領域的貢獻,我們的結果為育兒文獻帶來了新的問題。大多數基於證據的育兒計劃主要關注兒童和家庭的結果,而不是父母的結果(Barlow, Smailagic, Huband, Roloff, & Bennett, 2014; Duncan, Coatsworth, & Greenberg, 2009),因此往往促進父母的社交情緒能力,以促進兒童的福祉(Psychogiou et al., 2008; Stern et al., 2014)。事實上,父母的同理心增加了感知到的母親支持和溫暖(Soenens et al., 2007),但在面對與育兒相關的壓力源時,可能也會耗盡父母的資源。我們的結果確實顯示,識別他人情緒的能力——對於人際結果的益處(Baudry et al., 2018)——與父母的情感耗竭呈正相關。因此,未來對這些變數之間因果關係方向的研究可能會產生新的臨床指導方針,以預防和治療父母的倦怠。
In spite of its contributions to the fields of both EI and parental burnout, this study bears several limitations that should be taken into account in future studies. Firstly, although this study highlighted a strong link between EC and parental burnout and even if intervention studies have already shown that EI plays a causal role in burnout (Karahan & Yalcin, 2009), the cross-sectional nature of the current study precludes formal conclusions regarding causation direction. Secondly, fathers were poorly represented within our sample (8%). Therefore, the current results may not generalize to fathers. Future studies with 儘管本研究對情緒智力和父母倦怠領域做出了貢獻,但仍存在幾個限制,未來的研究應予以考慮。首先,儘管本研究強調了情緒調節與父母倦怠之間的強烈聯繫,並且干預研究已經顯示情緒智力在倦怠中扮演了因果角色(Karahan & Yalcin, 2009),但目前研究的橫斷面性質使得無法對因果方向做出正式結論。其次,我們的樣本中父親的代表性較差(8%)。因此,目前的結果可能無法推廣到父親身上。未來的研究應該考慮到這一點。
a larger sample of fathers are needed to draw any conclusion on the role of EC in parental burnout experienced by fathers. Although we find no evidence of gender differences in the relation between EI and parental burnout in the literature, these results should be interpreted cautiously as regard to fathers. Thirdly, where EI was only measured via self-assessment, it is possible that EI ability measured by tasks (e.g., facial emotion categorization) would yield different results and draw a different association between intrapersonal EC, interpersonal EC and parental burnout. Therefore, more research is needed in order to investigate whether high interpersonal EC increase the vulnerability to parental burnout in the same way as empathy triggers caregivers’ burnout (Tei et al., 2014). Indeed, the cost of caring, which has been extensively studied among health care professionals, remains relatively understudied in the parallel domain of parenting (Roskam, Raes, & Mikolajczak, 2017). More globally, futures studies should aim at disentangling the specific effects of intra- and interpersonal EC on psychological functioning and health variables in order to enrich the EI literature. 需要更大樣本的父親來對父親經歷的父母倦怠中情緒智力的角色進行任何結論。儘管我們在文獻中未發現情緒智力與父母倦怠之間存在性別差異的證據,但這些結果在解釋父親的情況時應謹慎對待。第三,情緒智力僅通過自我評估進行測量的情況下,通過任務(例如,面部情緒分類)測量的情緒智力能力可能會產生不同的結果,並在內在情緒能力、外在情緒能力和父母倦怠之間建立不同的聯繫。因此,需要更多的研究來調查高外在情緒能力是否以與同理心觸發照顧者倦怠相同的方式增加父母倦怠的脆弱性(Tei et al., 2014)。事實上,照顧的成本在醫療專業人員中已被廣泛研究,但在育兒這一平行領域中仍然相對缺乏研究(Roskam, Raes, & Mikolajczak, 2017)。更廣泛地說,未來的研究應旨在釐清內在和外在情緒能力對心理功能和健康變數的具體影響,以豐富情緒智力的文獻。
Electronic Supplementary Material 電子補充材料
The electronic supplementary material is available with the online version of the article at https://doi.org/ 10.1027/1614-0001/a000324 電子補充材料可在文章的在線版本中獲得,網址為 https://doi.org/ 10.1027/1614-0001/a000324
ESM 1. Means, standard deviations, skewness and kurtosis indices, and bivariate Pearson correlations of trait variables with relevant demographic variables ESM 1. 特質變數與相關人口統計變數的均值、標準差、偏度和峰度指數,以及雙變量皮爾森相關係數
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History 歷史
Received July 25, 2019 收到日期:2019 年 7 月 25 日
Revision received April 16, 2020 修訂於 2020 年 4 月 16 日收到
Accepted April 17, 2020 接受於 2020 年 4 月 17 日
Published online June 3, 2020 於 2020 年 6 月 3 日在線發佈
Conflict of Interest 利益衝突
The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. 作者聲明在本研究、作者身份和/或本文章的發表方面沒有潛在的利益衝突。