青少年子女面對父母罹患精神疾病的觀點、經驗與壓力因應策略

The perspectives, experiences, and stress-coping strategies of adolescent children of the mental illness

紀馨雅(Sin-Ya Jih)

指導教授 ： 吳慧菁

國立臺灣大學/社會科學院/社會工作學研究所/碩士(2018年)

https://doi.org/10.6342/NTU201803962

摘要

研究動機源自研究者自身工作及實習經驗，在心理衛生社工實務中不論醫院或社區機構均以患者及成人家屬為主要服務對象，患者的親職角色與家中兒少的處境需求較缺乏被關注及服務，在國內文獻中也較缺乏重視。本研究目的在探索青少年子女經歷父母罹患精神疾病之生活經驗與觀點，並瞭解他們如何獲得資訊建構對父母的疾病認識，運用哪些資源發展因應策略來面對處境壓力的影響。本研究運用質性研究方法，採立意抽樣及深度訪談法，透過多元管道進行招募，共訪談十六位青少年受訪者，他們來自七個縣市，經歷父母生病的年數橫跨五年至十五年，因此本研究蒐集到不同病程與不同成長階段的經驗與觀點。
研究發現有以下四點：第一，父母症狀急性發作造成的家庭危機，可能造成青少年子女出現長期的壓力反應，如易驚醒、不易入睡、易做惡夢等睡眠困擾；第二，父母罹病在生活功能與親職教養的退化加上外在社會的就醫困境與歧視，可能讓青少年在心理上承受高強度情緒負荷、角色認知失調、被標籤的感覺，但青少年也會善用個人及社會資源發展有效或參考型因應策略來面對處境壓力；第三，因應過程可能讓青少年發展壓抑性格及高度自我要求的人格特質而增加日常生活的壓力感受；第四，青少年獲得正確資訊建構對父母的疾病認識，有助於增加疾病接受度以及對生病父母的接納，更有機會促進反思覺察以改善親子關係及對抗社會歧視。
研究建議強調青少年家屬需要被社工專業看見與協助，專業應主動建立關係、提供服務並發展青少年喘息服務、輔助生病家長的親職功能以減少家庭對青少年親職化的需求，並為家屬發聲倡議修法改善國內精神病人的就醫困境，最後，回應青少年倚賴網路獲得資訊的研究發現，建議發展適合青少年的精神健康網路資源，提供正確資訊及更多元的求助管道。

關鍵字

父母罹患精神疾病 ； 青少年子女 ； 生活經驗 ； 觀點 ； 壓力因應策略

並列摘要

This research was inspired by the experience of my work as a social worker and social work internship. No matter at hospital or in community, the main clients of mental health social service are the patients and their family members. There is lack of attention to the parental role of the mental illness, the demand of the patients’ children and the situation of their children, so as the social work services. In the past research, the life experiences from the mental illness’s adolescent children in Taiwan are more likely to be ignored as well.
The research purpose is to explore the life experiences of the adolescent children living with their parents with mental illness, their perspectives to the understanding of their parents’ mental illness and their coping strategies. For instance, how do they gain and to construct the information about their parental mental illness and what resources do they utilize to cope with those stressful experiences.
Qualitative design and in-depth interview were conducted. Via multiple access, 16 adolescents with parents with mental illness from seven counties and cities around Taiwan were recruited. The mental illness progress is across five to fifteen years. Therefore, the research gathered a variety of the stages of parental mental illness and the growth experience of the adolescents.
The research finding is as followed. First, the acute attack of parental mental illness may cause the adolescent children long-term stress responses, such as easy to wake up, hard to fall asleep, and having nightmares, etc. Second, the deterioration of the mental illness ‘s daily life function and parenting ability as the inner stress, and the obstacles for the mental illness to seek medical help and social discrimination as the external stress may contribute to those adolescents’ suffering from heavy emotional burden, role cognitive dissonance and feeling being stigmatized. However, the adolescents also make good use of personal and social resources to develop productive strategies and reference to other to cope with the stressful situation. Third, as the coping process progress, the adolescent develops repressed and highly self-required characteristics which increase the perceiving of daily life stresses. Last, gaining right information to their parent’s mental illness help the adolescents to construct the correct disease awareness and to grow the acceptance of mental illness and their sick parents, which makes an opportunity to initiate reflection of the adolescents. Thus, the adolescents could improve parent-child relationship and fight against the social discrimination of mental illness.
The research provides four suggestions. First, the adolescents with parent with mental illness should be noticed and be assisted by social work profession. Social work professionals should take the initiative to establish professional relationship, to provide social services for the adolescents in order to reduce their care burden. Second, to support the parents with mental illness to well operate parenting function. Accordingly, the parents with mental illness reduce rely on their adolescent children. Third, to advocate and to amend law to remove the obstacles of seeking medical help for the mental illness. Finally, responding to the research on adolescent children relying on the Internet for information, it’s suggested that the development of Internet resources about mental health suitable for adolescence can provide correct information and create more diverse helping access for the adolescents.

並列關鍵字

Parental mental illness ； adolescent children ； life experience ； perspective ； stress-coping strategy

參考文獻

網路資料

衛生福利部統計處（2015）。醫療統計年報－精神疾病患者門、住診人數統計。取自https://dep.mohw.gov.tw/DOS/cp-1921-9763-113.html

衛生福利部中央健康保險署（2017）。全民健康保險重大傷病各疾病別有效領證統計表（106年9月）。取自https://www.nhi.gov.tw/Content_List.aspx?n=D529CAC4D8F8E77B&topn=CDA985A80C0DE710

謝孟穎、陳泓儒（2017）。爸媽抓狂就在一瞬間！全台精神科就診飆260萬例，對孩子影響有多大。取自http://www.storm.mg/lifestyle/329964

貳、中文