當癌症來敲我們的家門──非癌末患者的家庭系統運作經驗之探究

Abstract

本研究目的在探討非癌末患者與其家庭成員在面對癌症經驗的心理變化歷程、因應經驗以及家庭系統運作經驗歷程。採取質性研究取向，以半結構訪談方式蒐集資料，包括家庭訪談、個別訪談、田野觀察方式探究被醫生診斷為非末期癌症患者的全體家庭成員（非癌末患者複合有器質性腦傷診斷），並以主題分析方式之詮釋循環探究非癌末患者的家庭對此經驗歷程的理解與意義。研究結果討論與結論如下： 一、 非癌末患者與其家庭成員在面對癌症經驗的心理變化歷程 （一）聽聞癌症診斷，患者與家庭成員迅速抉擇切除手術面對生命存活議題。 （二）患者面對癌症事實的心理感受，是與其日常生活所關注焦點相互關聯。 （三）自動形成的病人與健康家屬圈。 （四）把焦點放在生活此刻危機，對存活率的非即刻危機較不過度擔心。 二、 非癌末患者與其家庭成員在面對癌症經驗的因應經驗 （一）患者在面對癌症的因應經驗，相應其原本生活信念與自我概念之展現。 （二）子女在因應父親罹癌經驗更傾向在身體照顧面向、較非情緒處理面向。 （三）伴侶需要重整彈性與尋求家庭內外部支持以達「我們」共同生活目標。 （四）家庭用更積極行動去因應癌症帶來的資訊層面不確定感挑戰。 （五）因應經驗歷程中運用心理諮商協助自己抒發情緒。 三、 非癌末患者與其家庭系統運作經驗歷程 （一）面對家有患者的狀況，家庭成員需要成為一個系統共同討論與運作。 （二）家庭中嘗試照顧好對方與自己的生活，但隱藏溝通成為另一挑戰。 （三）家人間彼此體諒與肯定對方付出。 最後，根據研究結果以及研究者在研究歷程的省思，對於未來相關助人工作者以及相關研究提出建議。

This research aims at exploring the mentality change process, coping experience, and family system operation experience of non-terminal cancer patients and their families. Main research method is qualitative research approach; data collect by semi-structural interviews, including family interview, individual interview, and field studies on interviewing all family members of the non-terminal cancer patients (the cancer patient is with the complication of organic brain syndrome) diagnosed by doctors. Hermeneutic circles of thematic analyses are exploited to probe into the understanding and meaning of this process from the non-terminal cancer patient’s family. The research results and conclusions are as follow: 1. The mentality change process of the non-terminal cancer patients and their families: (1)On knowing the diagnosis, the family makes a quick decision of removal and deal with the survival issue. (2)The feelings towards the fact of suffering from cancer relate to his/her daily life foci. (3)The automatically-formed patient and healthy family circle. (4)Focus on the present crisis in the life instead of the future crisis of survival rate. 2. The coping experience of non terminal cancer patients and their families: (1)The coping experience of the patient corresponds to the representations of his/her life philosophies and self concepts. (2)In dealing with the experience, children need more support on the physical-caring aspect instead of emotional-caring aspect. (3)His/her mate needs the flexibility to reform and seek the support from both inside and outside of the family to achieve the mutual life goals. (4)The family will act more actively to face the challenge brought by the feelings of uncertainties in information. (5)In the process of coping experience, counseling techniques are used to help letting emotions out. 3. The family system operation experience process of non-terminal cancer patients and their family systems: (1)Facing the patient situation, the family members need to work as a system to discuss and move together. (2)The family should try to take care of each other’s life while taking care of one’s own. Hidden communications could well be another challenge. (3)Being considerate to each other and approving others’ efforts. Last, suggestions for future help-providers and related researches are stated based on the research results and the reflections from the researcher in the process.