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    題名: 鄉村型態安寧照顧者之照顧處境探究：以「居家」為視域
    Exploring the caring situatedness of family members as caregivers of terminal patients in home-based palliative care model : From the perspective of “Homelikeness”
    作者: 王雅婷
    Wang, Ya Ting
    貢獻者: 林耀盛
    Lin, Yaw Sheng
    王雅婷
    Wang, Ya Ting
    關鍵詞: 社區醫療
    現象學心理學
    棲居
    居家照顧處境
    家屬照顧者
    community medicine
    phenomenological psychology
    dwelling
    home-based caring situatedness
    family caregivers
    日期: 2017
    上傳時間: 2017-02-08 16:50:50 (UTC+8)
    摘要: 社區安寧療護的推展以「居家存有」為中心，以身心整體照顧為導向的醫療，與全然「醫療權力」視角不同。本研究嘗試探討家屬照顧者於居家安寧照顧處境下的經驗，嘗試以「倫理關係」思考居家型的照顧內涵。
    本研究透過田野參與觀察及深度訪談法，以北部某醫療院所提供之社區安寧療護服務區域為田野，訪談接受社區安寧照護之五位家屬主要照顧者。資料分析依現象學心理學分析方法（李維倫、賴憶嫺，2009）。而後，邀請兩名受訪者，對資料的組織脈絡描述及其所驅動的主題置身結構，予以交叉討論與分享，提昇質性研究可靠度的品質。
    研究結果發現，鄉村型態安寧照顧者的置身經驗中，呈現出一種「鄉村型態的寓居」混合狀態，既安居又陌生的處境。一方面，參與者經驗到的棲居地域，並不侷限於家屋建築或特定地域，更是對地方的認同與情感的依附，從而開展自我「寓居於世」的「照顧者棲居」樣態；另一方面，照顧事件的衝擊，為照顧者帶來一種既熟悉又陌生的詭譎「無居家感」（uncanny）狀態。然而，如此看似矛盾處境，反使其於居家照顧處境之倫理凝視中，啟動反身窺探自我生命，以及於居家照顧處境中與他者間關係的梳理，進一步帶出「居家照顧作為一倫理行動」，進而深刻化「照顧自己/關切他人」的倫理意涵。
    由此發現，鄉村型態居家照顧經驗之置身結構，可為與其相似處境之居家照顧者提供置身經驗之參考，並據以推動社區安寧方案的規劃。
    The goal of the home-based palliative care model is to facilitate the patients and their family to feel “being at home.” Differ from the perspective of the “power domination in medical regime,” the home-based palliative care model focuses on the ethical relationship besides the bio-psycho-social care aspects. This study aims to understand the caring situatedness of family members as caregivers in home-based palliative care model, and try to disclose the sense of homelikeness through the caring relationship. We applied the participatory observation and depth interview to collect data. Five family caregivers who agreed the informed consent were recruited from home-based palliative care service in northern Taiwan and were interviewed twice. Interviews were recorded, transcribed, and analyzed by a phenomenological psychology method. The results revealed that there is ambivalent caring experience towards “dwelling in the community-home”. The experiences they felt seemed both strange and familiar. On the one hand, the caregivers’ dwelling pattern of being-in-the-world was constructed from the perspective of human-environment comfortable relationship (sense of feeling at home); on the other hand, they are bothered and struck by the caring problem, they faced the new challenges and thrown into the situation of “uncanny.” It is an unhomelike being-in-the-world in which Da-sein takes on alien and uncanny qualities. However, the two caring modes manifested the meaning of existentiality. Immersed in this situation, caring is not only the labor work, it is also the ethical act to respond the worrisome emotion and regain the relationships with others during the caring experiences. Ethical caring is the cornerstone of relational understanding towards the human subjectivity rather than the medical positivism. By elaborating the situatedness of home-based palliative care model, further planning of the community-based palliative care model in similar situation may base on this study outcome implication.
    參考文獻: 中文文獻
    王應棠（2009）。棲居與空間：海德格空間思維的轉折。地理學報，（55），25-42。doi:10.6161/jgs.2009.55.02。
    石世明（譯）（2012）。什麼讓治療產生治療性？（原作者：Kunz, G.）。中華團體心理治療，18（2），3-17。
    汪文聖（2003）。本土精神病患照顧倫理的現象學探討。本土心理學研究，（19），65-108。doi:10.6254/2003.19.65。
    汪文聖（2007）。一葉一如來：精神病院研究個案所反映的醫護現象學意義。應用心理研究（34），113-144。
    何雪綾（2015）。社區醫療照護模式中末期患者家屬參與患者之「預立醫療計劃討論」的心理歷程特徵（博士論文）。取自華藝線上圖書館系統。（系統編號U0001-0408201500370800）。
    利翠珊（2002）。婆媳與母女：不同世代女性家庭經驗的觀點差異。女學學誌：婦女與性別研究，（13），179-218。doi:10.6255/JWGS.2002.13.179。
    李維倫（2016）。從實證心理學到實踐心理學學：現象學心理學的本土化知識之道。台灣心理諮商季刊，8（2），1-15。
    李維倫、賴憶嫺（2009）。現象學方法論：存在行動的投入。中華輔導與諮商學報（25），275-321。
    余德慧（2000）。臨終病人的事實處境：臨終的開顯。安寧療護雜誌，5（2），29-32。
    余德慧（2006）。臨終心理與陪伴研究。台北：心靈工坊文化。
    余德慧、林耀盛（2012）。生死學在台灣的文化沉思。見廖欽彬（編輯校正）「朝往東亞的生死學：台日國際硏討會特集」，頁47-63。東京：東京大學大學院人文社會系研究科。
    胡文郁（2004）。台灣文化脈絡下癌末患者之生活品質。台灣醫學，8（5），688-697。
    林秀純、徐亞瑛、姚開屏、吳淑瓊（1999）。台灣北部地區失能老人家庭照顧品質及相關因素之探討。護理研究，7，15-28。
    林維君、黃文聰、廖純真、謝玉娟、邱智鈴、夏德瑛、曹朝榮（2003）。安寧病房中家屬照顧者的資訊需求。安寧療護雜誌，8（2），161-174。
    林德祐（2016）。從沙粒到珍珠：西呂尼克與心理韌性的跨領域編織。載於謝幸芬、林德祐（譯），心理韌性的力量：從創傷中自我超越。台北：心靈工坊文化。
    林耀盛（2006）。聆聽受苦之聲：從“咱們”關係析究慢性病照顧。應用心理研究（29），183-212。
    林耀盛（2009）。逆向呈現與過度呈現之間：慢性病患者的身心受苦經驗。生死學研究，（9），1-43。
    林耀盛（2011）。精神分析取向心理病理學講稿。未發表之手稿。
    林耀盛（2012）。因應多樣性與效用性：慢性病門診病人的疾病因應方式。生死學研究，（13），83-119。
    林耀盛（2015）。放與不放間，身心千萬難？堅持與放手，一念之間。張老師月刊，455，10-14。
    林耀盛（2016a）。字化成宇：從象徵到真實。中央大學人文學報，（61），27+29-53。
    林耀盛（2016b）。實證論陰影及其超越：迂迴或直面。台灣心理諮商季刊，8（2），36-43。
    林耀盛（2016c）。坦塔洛斯的困題：思「反」心理學，批判社群革「心」。論文發表於第五十五屆臺灣心理學年會。台南：成功大學。
    林耀盛、邱子芸（2015）。臨終處境的陪伴轉化：癌末病患及其照顧者心理經驗與存在現象探究。中華心理衛生學刊，28（2），189-219。
    林耀盛、李弘毅（2016）。朝向疾病的療癒：血液透析者心理經驗之詮釋。本土心理學研究，（45），129-174。doi:10.6254/2016.45.129。
    林耀盛、吳英璋（2004）。雙重變奏曲：探究「九二一」地震「失親家毀」受創者之心理經驗現象。中華心理衛生學刊，17（2），1-41。
    林耀盛、陳玫蓉（2009）。「和而不同」的生病事件建構：以對偶關係探究腸造口癌症患者及其照顧者的心理生活經驗。本土心理學研究，（32），251-325。doi:10.6254/2009.32.251。
    林耀盛、蔡逸鈴（2012）。不可承受之重：癌末主要照顧者的心思經驗探究。教育與心理研究，35，37-66。
    林耀盛、龔卓軍（2009）。我的傷口先於我存在？從創傷的精神分析術到倫理現象學作為本土心理治療的轉化。應用心理研究，(41)，185-234。
    張維真、林耀盛（2012）。天然災害倖存者的心理現象：以八八風災災民為例。高雄行為科學學刊，（3），95-124。
    張榮哲、林耀盛（2012）。家庭醫學中的醫病關係與人性關懷。台灣醫學，16，660-666。doi:10.6320/FJM.2012.16(6).11。
    費孝通（1948）。鄉土中國。上海：觀察社。
    彭富春（譯）（1991）。詩・語言・思（原作者：Heidegger, M.）。北京：文化藝術出版社。（原著出版年：1971）。
    彭榮邦、廖婉如（譯）（2012）。好走（原作者：Singh, K. D.）。台北：心靈工坊文化。（原著出版年：2000）。
    趙可式（1997）。台灣癌症末期病患對善終意義的體認。安寧療護，5，51-61。
    衛生福利部（2012）。我國長期照顧十年計畫～101至104年中程計畫。取自https://www.gender.ey.gov.tw/GecDBGIA/Impact_GIA_PlanDBDetail.aspx?psn=FIZ6DRPt2vpNLxD/ZkTRPA==&giasn=kbvEYGuPi2RD2A09YV@@@dSA==
    衛生福利部健保署（2015）。安寧居家、社區安寧支付標準（104.02.17更新）。取自http://www.nhi.gov.tw/webdata/webdata.aspx?menu=20&menu_id=712&WD_ID=902&webdata_id=4703
    譚家瑜（譯）（2001）。醫院裡的哲學家（原作者：Zaner, R. M.）。台北：心靈工坊文化。（原著出版年：1993）。
    龔卓軍、王靜慧（譯）（2003）。空間詩學（原作者：Bachelard, G.）。台北：張老師出版社。（原著出版年：1969）。

    英文文獻
    Andrews, S. C. (2001). Caregiver burden and symptom distress in people with cancer receiving hospice care. Oncology Nursing Forum, 28, 1469-1474. Retrieved from https://onf.ons.org/
    Armstrong, D. (1990). Use of the genealogical method in the exploration of chronic illness: A research note. Social Science and Medicine, 30, 1225-1227. Retrieved from https://www.journals.elsevier.com/social-science-and-medicine/
    Barnard, S. (2002). Diachrony, tuché, and the ethical subject in Levinas and Lacan. In E. E. Gantt, & R. N. Williams (eds.). Psychology for the Other: Levinas, ethics and the practice of psychology. Pittsburgh, PA: Duquesne University Press.
    Bauman, Z. (1992). Mortality, immortality and other life strategies. Cambridge, UK: Polity Press.
    Benner, P. (2001). The phenomenon of care. In S. K. Toombs (Ed.), Handbook of Phenomenology and Medicine (pp. 351-369). Dordrecht, NL: Kluwer Academic.
    Beynon, T., Radcliffe, E., Child, F., Orlowska, D., Whittaker, S., Lawson, S., . . . Harding, R. (2014). What are the supportive and palliative care needs of patients with cutaneous T-cell lymphoma and their caregivers? A systematic review of the evidence. British Journal of Dermatology, 170, 599-608. doi: 10.1111/bjd.12644
    Carter, P. A. (2002). Caregivers` descriptions of sleep changes and depressive symptoms. Oncology Nursing Forum, 29, 1277-1283. Retrieved from https://onf.ons.org/
    Coutts, M. (2014). The iceberg: A memoir. Londen, UK: Atlantic Books.
    Denzin, N. K. (1978). Sociological methods: A source book (2nd ed.). New York, NY: McGraw-hill.
    Dumont, S., Turgeon, J., Allard, P., Gagnon, P., Charbonneau, C., & Vézina, L. (2006). Caring for a loved one with advanced cancer: Determinants of psychological distress in family caregivers. Journal of Palliative Medicine, 9, 912-921. doi: 10.1089/jpm.2006.9.912
    Enyert, G., & Burman, M. E. (1999). A qualitative study of self-transcendence in caregivers of terminally ill patients. American Journal of Hospice and Palliative Medicine, 16, 455-462. Retrieved from http://journals.sagepub.com/home/ajh
    Foucault, M. (1973). The birth of the clinics. London, UK: Tavistock.
    Foucault, M. (1988). Technologies of the self. In L. H. Martin, etc. (Eds.), Technologies of The Self, pp.16-49. London, UK: Tavistock.
    Foucault, M. (1993). On the genealogy of ethics: an overview of work in progress. In H. Dreyfus & P. Rabinow (Eds.), Michel Foucault: Beyond Structuralism and Hermeneutics. Chicago, IL: The University of Chicago.
    Frank, A. W. (1995). The wounded storyteller: Body, illness, and ethics. Chicago, IL: The University of Chicago.
    Frankenburg, R. (1988). “Your time or mine?”: An anthropological view of the tragic temporal contradictions of biomedical practice. International Journal of Health Services, 18, 11-34. Retrieved from http://journals.sagepub.com/home/joh
    Funk, L., Stajduhar, K., Toye, C., Aoun, S., Grande, G., & Todd, C. (2010). Part 2: Home-based family caregiving at the end of life: A comprehensive review of published qualitative research (1998-2008). Palliative Medicine, 24, 594-607. doi: 10.1177/0269216310371411
    Gantt E. E. (2000). Levinas, psychotherapy, and the ethics of suffering. Journal of Humanistic Psychology, 40(3), 9-28. Retrieved from http://journals.sagepub.com/home/jhp
    Garro, L. C. (1992). Chronic illness and the construction of narratives. In Mary-Jo D. Good., P. E. Brodwin., B. J. Good. & A. Kleiman.(Eds.), Pain as human experience: An anthropological perspective. Berkeley, CA: University of California press.
    Grunfeld, E., Coyle, D., Whelan, T., Clinch, J., Reyno, L., Earle, C. C., . . . Glossop, R. (2004). Family caregiver burden: Results of a longitudinal study of breast cancer patients and their principal caregivers. Canadian Medical Association Journal, 170, 1795-1801. Retrieved from http://www.cmaj.ca/
    Hoeller, K. (1988). Heidegger & Psychology. Seattle, WA: Review of Existential Psychology & Psychiatry.
    Kayali, T., & Iqbal, F. (2013). Depression as unhomelike being-in-the-world? Phenomenology`s challenge to our understanding of illness. Medicine, Health Care, and Philosophy, 16, 31-39. doi:10.1007/s11019-012-9409-5
    Kierkegaard, S. (1985). Fear and trembling. Harmondsworth, UK: Penguin.
    Kleinman, A., & Kleinman, J. (1991). Suffering and its professional transformation: Toward an ethnography of interpersonal experience. Culture, Medicine and Psychiatry, 15, 275-301. Retrieved from http://link.springer.com/journal/11013
    Kockelmans, J. J. (1990). Some reflections of empirical psychology: Toward an interpretive psychology. In R. Williams & Faulconer, J. (Eds.), Reconsidering psychology: Perspectives from continental philosophy. Pittsburgh, PA: Duquesne University Press.
    Lacan, J. (1981). The four fundamental concepts of psychoanalysis. (A. Sheridan, Trans.). New York, NY: W. W. Norton & Company.
    Laurence, M. (1975). The diviners. Toronto, CA: Bantam.
    Levinas, E. (2012). Totality and infinity: An essay on exteriority. (A. Lingis, Trans.). Pittsburgh, PA: Duquesne University Press. (Original work published 1961).
    Levine, C. (2014). Living in the land of limbo: Fiction and poetry about family caregiving. Nashville, TN: Vanderbilt University Press.
    MacLeod, A., Skinner, M. W., & Low, E. (2012). Supporting hospice volunteers and caregivers through community-based participatory research. Health and Social Care in the Community, 20, 190-198. doi: 10.1111/j.1365-2524.2011.01030.x
    Meier, D. E. (2011). Increased access to palliative care and hospice services: Opportunities to improve value in health care. Milbank Quarterly, 89(3), 343-380. doi:10.1111/j.1468-0009.2011.00632.x
    Minty, J. (1982). (From the diary of) Judith Minty. September 19, 1972. In L. Lifshin (Ed.), Ariadne’s threat: A collection of contemporary women’s journals (pp. 215-219). New York, NY: Harper & Row.
    Paley, J. (2001). An archeology of caring knowledge. Journal of Advancing Nursing, 36(2), 188-198. doi:10.1046/j.1365-2648.2001.01959.x
    Polkinghorne, D. E. (1990). Language and qualitative research. Theoretical and Philosophical Psychology, 10(2), 3-24. doi:10.1037/h0091495
    Rabow, M. W., Hauser, J. M., & Adams, J. (2004). Supporting family caregivers at the end of life: "They don`t know what they don`t know". Journal of the American Medical Association, 291(4), 483-491. Retrieved from http://jamanetwork.com/journals/jama
    Ricoeur, P. (1992). Oneself as another. Chicago, IL: University of Chicago Press.
    Royse, D., Thyer, B. A., Padgett, D. K., & Logan, T. K. (2006). Program evaluation: An introduction. Belmont, CA: Thomson Brooks/Cole.
    Sinding, C. (2003). Disarmed complaints: Unpacking satisfaction with end-of-life care. Social Science & Medicine, 57, 1375-1385. Retrieved from https://www.journals.elsevier.com/social-science-and-medicine/
    Svenaeus, P. (2001). The phenomenology of health and illness. In S. K. Toombs (ed), Handbook of phenomenology and medicine. Dordrecht, NL: Kluwer Academic Publishes.
    Smith, M. C., Ellgring, H., & Oertel, W. H. (1997). Sleep disturbances in Parkinson`s disease patients and spouses. Journal of the American Geriatrics Society, 45(2), 194-199. Retrieved from http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1532-5415
    van Manen, M. (2002). Care-as-worry, or "don`t worry, be happy". Qualitative Health Research, 12, 262. Retrieved from http://journals.sagepub.com/home/qhr
    Von Peter, S. (2010). The temporality of “chronic” mental illness. Culture, Medicine & Psychiatry, 34, 13-28. doi:10.1007/s11013-009-9159-x
    Walsh, R. D. (2005). Beyond therapy: Levinas and ethical therapeutics. European Journal of Psychotherapy & Counselling, 7, 29-35. doi:10.1080/13642530500087294
    Williams, A.-L., & McCorkle, R. (2011). Cancer family caregivers during the palliative, hospice, and bereavement phases: A review of the descriptive psychosocial literature. Palliat Support Care, 9, 315-325. doi: 10.1017/S1478951511000265
    描述: 碩士
    國立政治大學
    輔導與諮商碩士學位學程(MPCG)
    102172003
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    顯示於類別:[輔導與諮商碩士學位學程] 學位論文

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