中壯年癌末病人配偶照顧者之創傷後成長與壓力感受之探討

Posttraumatic Growth and Perceived Stress Among Middle-Aged Spousal Caregivers of Terminal Cancer Patients

林維君(Wei-Chun Lin) ； 謝文心(Wen-Hsin Hsieh) ； 黃文聰(Wen-Tsung Huang)

《安寧療護雜誌》 21卷1期 (2016/03) Pp. 1-15

https://doi.org/10.6537/TJHPC.2016.21(1).1

摘要

研究目的：罹患癌症及抗癌治療的歷程，對於癌症病人及其家庭來說，是一慢性的創傷性壓力源，雖帶來多層面的負面衝擊，但也可能導向正向的心理成長。創傷後成長（posttraumatic growth, 簡稱PTG）指的是個體在與極具挑戰性的生活事件奮戰之後，所產生的正向心理改變。近年有許多研究關注於癌症病人本身的PTG 經驗，對於同樣受到癌症衝擊的配偶照顧者，著墨甚少。本研究旨在了解中壯年配偶照顧者於病人癌症末期階段的壓力感受與創傷後成長間的關聯性，以及他們所展現出的PTG 樣貌，期能作為未來發展心理社會照護措施的參考。材料與方法：本研究為橫斷性量化調查，研究對象為照顧末期癌症病人，且年齡介於25 歲至64 歲的配偶照顧者，使用中文版創傷後成長量表（PTGI-C）及壓力知覺量表（PSS）進行測量。結果：研究期間共有91 名中壯年配偶照顧者完成調查，結果發現其知覺壓力與PTG呈現顯著負相關，男性受訪者以及教育程度較高的受訪者，有較高的PTG；與過去癌症相關PTG研究相比，本研究參與者在PTGI量表平均分數偏低，報告有中度以上的創傷後成長者比例也僅約三成，其中以「人生方向」向度分數最高。結論：配偶照顧者隨著時間在困境中發展出內在成長以面對壓力，其PTG樣貌與親身經驗癌症病痛的病人有所不同。癌症為一長期發展的慢性壓力源，建議未來需進行縱貫性的追蹤研究，從癌症診斷之初持續了解配偶照顧者對於癌症照顧經驗中重大壓力源的界定以及PTG的發展歷程。

關鍵字

中壯年 ； 配偶照顧者 ； 癌症末期 ； 創傷後成長

並列摘要

Objectives: Having cancer can be a stressful, and possibly traumatic, chronic stressor to the survivors and their family. Recent studies have reported that both positive and negative psychological outcomes might come from cancer diagnosis and treatment. Posttraumatic growth (PTG) indicates the positive changes resulting from struggling with challenging life events. As most researches on PTG have been conducted in cancer patients, little is known about the positive changes in spousal caregivers, especially the middle-aged ones. The purpose of this study aimed to investigate the correlation between PTG and perceived stress in middle-aged spousal caregivers, who were known as with higher risk in psychosocial health problems than other family caregivers. Methods: This cross-sectional quantitative study surveyed the spousal caregivers whose age were from 25 to 64 and who were taking care of their loved ones with terminal stages of cancer. The Chinese version of Posttraumatic Growth Inventory (PTGI-C) and Perceived Stress Scale (PSS) were used to collect information about the participants' experiences. Results: There were 91 middle-aged spousal caregivers participating in this study. Around one-third of them experienced PTG in their cancer caregiving journey, especially in the domain of ＂Life-direction.＂ As hypothesized, the perceived stress was negatively correlated with their PTG. Data analysis indicated that the male gender and the higher education level were both associated with better PTG. Conclusion: Overall, this study suggests that the spousal caregivers' PTG was developed from a long-term adversity which might alleviate their perceived stress. The phenomenon of PTG revealed in the participants was different from cancer survivors' experience. Longitudinal studies would be needed to explore how the middle-aged spousal caregivers develop PTG and how they define the major stressors in their cancer caregiving experience.

並列關鍵字

Middle-aged ； Spousal Caregivers ； terminal cancer ； posttraumatic growth ； PTG

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