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| Title: | 初探癌末病人疾病調適歷程之正向經驗
Exploring Positive Experiences in The Process of Adjustment to Illness in Advanced Cancer Patients |
| Authors: | 王郁
Wang, Yu |
| Contributors: | 吳治勳
Wu, Chih-Hsun
王郁
Wang, Yu |
| Keywords: | 癌末
正向經驗
正向轉變
疾病調適
主題分析
Advanced cancer
Positive experience
Transformation
Illness adjustment
Thematic Analysis |
| Date: | 2023 |
| Issue Date: | 2023-07-06 16:57:36 (UTC+8) |
| Abstract: | 研究背景：癌症病人自罹癌便面臨一連串生理、心理、社會、與靈性困擾。過往癌末研究多聚焦於疾病對於癌末病人的負面影響，也因此癌末病人研究幾乎等同於受苦的研究。然而，亦有過往研究指出，個體即便在高度疾病壓力狀況下，正向與負向的心理狀態仍可能同時發生。有鑑於目前國內對於癌末病人疾病正向經驗的討論仍相對缺乏，本研究旨在進一步探索癌末病人正向經驗內涵，及其與身心調適間的關聯與意義，期能增進對癌末病人臨終經驗與適應歷程的豐富理解。
研究方法：本研究於北部某醫學中心安寧緩和醫療單位進行收案，一共訪問22位門診或住院之癌末病人。研究採半結構式晤談方法進行錄音訪談，過程中鼓勵病人自由談論與癌症經驗有關的想法與感受，錄音檔後續轉錄為逐字稿進行主題分析 (thematic analysis) ，並以資料為導向，歸納出癌末正向經驗重要主題內涵。
結果：本研究透過主題分析歸納出癌末病人正向經驗四大主題與十個次主題。四大主題包含 (1) 「順應生命自然秩序」：此主題下再分三項次主題「生老病死是必經之路」、「盡人事聽天命」、「生命是禍福相依，有失有得」。 (2) 「生活秩序的建立」：此主題下的次主題分別為「與疾病共處」、「重新分辨輕重緩急」。 (3) 「正向的人我關係」：此主題下有「深化家人連結」、「良好醫病關係」兩項次主題。 (4) 「當下與來世的盼望」：此主題下有「活在他人心中」、「來世的寄望」，以及「細緻的身心感受」三項次主題。
討論：本研究所歸納出之癌末正向經驗主題具有經驗相對性、時間有限性，以及主動因應下的被動性等特徵，同時指出正向經驗亦為轉化經驗，個體從困厄中獲得心理成長的契機。個別主題之內涵亦反映癌末病人透過不同因應策略來面對臨終處境。最後，本研究亦就訪談中所觀察到癌末病人笑容的行為表現，與其臨床意義進行初步討論。
Background: Cancer patients face multiple bio-psycho-social-spiritual issues ever since their diagnosis and throughout the entire disease process, hence a large body of research literature has focused on negative impacts on patients with advanced cancer. However, past studies also indicated that positive and negative experiences or emotions co-exist even when people are in a stressful situation. Given that the positive side of the illness experience is rarely discussed in this population, this study aims to explore the positive experience as well as its possible adaptive functions, in an effort to enrich the understanding of end-of-life experiences and the process of adjustment to illness in advanced cancer patients.
Method: A total of 22 end-stage cancer patients were interviewed and recorded in a hospice care setting, including outpatients and hospitalized patients. This study adopted a semi-structure interview in which the interviewees were encouraged to talk about their thoughts and feelings related to cancer experiences. The recorded interviews were later transcribed for a bottom-up inductive approach thematic analysis.
Results: 4 main themes and 10 sub-themes of positive experiences in advanced cancer patients were developed from the collected data. The 4 main themes included (1) “Adapt to The Natural Order of Life” subsumed with “ Life Path that Everyone Must Go Through”, “ Do the Best and Leave It To the Fate”, and “Misfortune and Blessings Are Interconnected In Life”. (2) “The Establishment of Life Order” subsumed with “ Living With the Illness” and “Reassessing Priorities”. (3) “Positive Interpersonal Relationships” subsumed with “Deepening Family Bonds” and “ A Good Doctor-Patient Relationship”. (4) “Hope For The Present and Afterlife” subsumed with “ Delicate Sensory and Living Experience of The Body”, “ Believing In The Afterlife” and “ Living In The Hearts of Others”.
Conclusion: The inductive themes illustrated the relativeness, time-limitedness, and the passivity under active coping of cancer patients’ end-of-life positive experiences. This study then further indicated that advanced cancer patients’ positive experience is also a transformation process, that gives rise to the possible psychological growth of an individual in adversity. Each theme reflects how patients use different coping strategies to better adjust to the near-death situation. Finally, a preliminary observation of patients’ laughter/smile behavior is also discussed in this study. |
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| Description: | 碩士
國立政治大學
心理學系
108752003 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0108752003 |
| Data Type: | thesis |
| Appears in Collections: | [心理學系] 學位論文
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Files in This Item:
| File |
Description |
Size | Format | |
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| 200301.pdf | | 2290Kb | Adobe PDF2 | 0 | View/Open |
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