- 學位論文
植物人主要照顧者之照顧歷程
The Process of Takinng Care of Main Caregiver For Persistent Vegatative State.
摘要
本研究旨在深入瞭解植物人主要照顧者之照顧經驗及心路歷程，涵括探討主要照顧者在過去、現在、未來，三個時間向度上的整體歷程變化，作一現象主體之描述。從事件為出發點，家庭成員如何面對及因應事件的重大衝擊與失落，醫療行為及承接照顧的抉擇如何產生；嘗試從主要照顧者的照顧負荷、調適歷程、照顧困境的因應策略等面向，描繪出家庭照顧者的圖象；當主要照顧者面對植物人可能無法好轉的窘況，又該抱持著怎樣的照顧信念？對於未來的照顧安排為何？ 本研究採取質性研究，採取立意抽樣法，根據某些設定的研究對象條件作訪談，本研究共訪談了五位主要照顧者，其中兩位男性照顧者、三位女性照顧者；並以訪談所得的資料為文本加以分析。 ※ 研究結果發現： 一、事件帶來的衝擊：當家庭面臨環境的改變及重大事件壓力時，每個家庭成員都需要重新適 應新的情境，而家庭如何獲致新的平衡，將會影響後續的照顧決策。 二、返家照顧的決策：承擔照顧責任背後的因素都是出自於「親情關係」與伴隨而來的「照顧責任」；未將家人送到長期照顧機構，主要的原因多為家庭經濟狀況不允許、捨不得植物人離家、以及對機構照顧品質不放心。 三、照顧調適歷程：包括「挑戰與困境」及「調適的歷程」。前者描述照顧者進入照顧生活後遇到的適應問題，如角色衝突、生活作息、社交生活、經濟狀況等；後者則分別說明照顧者的調適方法、調適歷程中的正向回饋與負向損耗，以及照顧過程中接觸與使用資源的看法意見。 四、照顧者的生命經驗、照顧信念與照顧的意義：照顧者本身的生命經驗、個人的人格特質與價值觀，會左右照顧事件的決策及過程調適；照顧者對照顧意義有有不同的詮釋、重新構築新的角色，並且也帶來了一些正向回饋。 五、未來的照顧安排：「生命有限性」與「照顧無限性」同時存在於照顧者的擔憂裡，不同的關係角色皆有不同的想法安排，照顧者以自己有限的生命去承擔無限的責任與使命，共通點都是「願意陪他到最後」。
並列摘要
This project is for the purpose of thoroughly understanding attendance experience and the idea course of the Persistent Vegetative State (PVS)'s caregiver, include inquiring into the caregiver of passing, now and the future, three time dimensions to the whole process of changing, and make the description of one phenomenon corpus. From the event is the starting point, describe how the family member faces and with loses in accordance to the event significant impact, how the medical behavior and does the contract attendance choice produce; Try from the care burden, adjustment process of caregiver and taking care strategy of dilemma to face, describe the family caregiver's portrait; When the caregiver faces a PVS cannot turn for the better of embarrassed condition, should embrace again how of care conviction? For what is future care arrangement? This research adopts a qualitative research and adopts a purpose Purposeful Sampling and makes an interview according to research object's condition of some enactments, this research is total to interview five caregivers, two among those male caregiver, three female caregivers; and take data gained by interview as a text to originally take into to analyze. The result of study finds: (1) The affairs brings of impact: The change and major affairs pressure that takes charge of a court to face environment, each family member needs to re- adapt to a new scenario, and family how acquire new balance, will influence follow-up care decision. (2) Got home the decision-making of care: The factors that undertake care responsibility back are all come from to "natural affection relation" with chaperonage of "care responsibility"; the condition of family will influence whether their people (PVC) send to Long-term Care Center. (3) The process of caregivers’ adjustment: Includes "challenge and dilemma" and "the process of adjustment". The orientation problems that the former description caregiver meets after getting into taking care in life; the latter then explains the caregiver’s adjustment method and adjust process in of just exhaust toward the feedback and the negative. (4) The caregiver's life experience, and the faith and meaning of care: The caregiver's life experience, personal personality characteristic and value, will influence decision and process adjustment of take care the affairs. (5) Arrange the cares in the future: "Life limited" and "Care infinite" at the same time is existed to the caregiver's misgiving insides, the different relation role all has a different viewpoint arrangement, and all of something in commons are "would like to accompany him till the last".