情緒調節與罹病意義對急性血癌病患因應疾病的影響：兩名女性個案之初探結果

The Effects of Emotion Regulation and Illness Meaning on Acute Leukemia Patients' Coping: Preliminary Findings of Two Female Cases

謝碧玲(Bi-Ling Shieh) ； 郭彥廷(Yen-Ting Kuo) ； 葉盈均(Ying-Chun Yeh) ； 張肇松(Chao-Sung Chang) ； 吳英璋(En-Chang Wu)

《高雄行為科學學刊》 2期 (2010/12) Pp. 147-162

https://doi.org/10.29854/TJKBS.201012.0008

摘要

自民國71年起，癌症即成為台灣十大死因之首。白血病相較其他癌症，除存活率低外，因易感染引發併發症，急性白血病病患大都需要多次住院治療，嚴重影響其生活品質與情緒適應，其需求更高。Leventhal的疾病常識模式，幾十年來在理解病患面對疾病的心理歷程與促進健康行為的處遇上，產生厚實的成果。本研究的目的為，考量新近研究文獻，以此疾病常識模式為起點，檢視病患在正／負向情緒調節、創傷後正向意義、以及生活目標重整上的表現，以利後續發展更細緻的疾病因應與情緒調適理論模式。本論文對照展現出疾病因應與情緒調適良好與不良結果的兩名女性個案之資料，包括其填寫二次的疾病知覺、癌症影響和情緒調節策略量表、以及訪視資料。研究結果顯示，良好疾病因應與情緒調適結果，除了病患有高控制感外，與增加正向情緒和低失能情緒調節策略、有罹癌正面意義、以及生活目標能重整納入醫療有關；反之，不良疾病因應與情緒調適結果，病患則有低控制感外，與紓減負向情緒和高失能情緒調節策略、無罹癌正面意義、以及生活目標未能重整納入醫療有關。研究結果顯示正／負向情緒調節、疾病正向意義、以及生活目標重整可作為後續疾病因應與情緒調適歷程研究、創傷後個案復原歷程研究、以及臨床應用上的初步方向。

關鍵字

疾病因應 ； 情緒調節 ； 創傷後成長 ； 生活目標與意義 ； 血癌

並列摘要

Since 1982, cancer has become the top of ten death causes in Taiwan. Compared with other cancers, the survival rate of Leukemia is lower. Furthermore, because they are easily infected with more complications, the patients need to be hospitalized for treatment many times, which seriously influence their quality of life and emotional adjustment.Leventhal and colleagues' common sense model of self regulation of health and illness has been the primary research model for illness coping in recent decades. The model has been productive in understanding patients' psychological process and in promoting health behaviors, and has lead to abundant research findings. The goal of the study, derived from recent literature, and Leventhal's model as the basis, was to examine the patients' positive and negative emotional regulation, positive meaning related to posttraumatic growth, and life goal reconstruction, and to provide preliminary directions for developing a more comprehensive model of illness coping and emotional adjustment.The present study compared two female cases with good and bad outcome of illness coping and emotional adjustment, using data of the illness perception, cancer influence and emotional regulation strategies scales (measured twice) as well as interviews. The results showed that good illness coping and emotional adjustment was related to, besides a sense of high self-control, increasing positive emotion and low level of ineffective emotion regulation strategies, having positive meaning related to being ill with cancer, and life goal reconstruction incorporated chemotherapy; on the contrary, bad illness coping and emotional adjustment was related to, besides a sense of low self-control, decreasing negative emotion and high level of ineffective emotion regulation strategies, no positive meaning related to being ill with cancer, and no life goal reconstruction to incorporate chemotherapy.The preliminary results indicated that positive and negative emotional regulation, positive meanings related to being ill, and life goal reconstruction were feasible directions for developing a more comprehensive model of illness coping and emotional adjustment, and exploring the posttraumatic recovery process in future research, and for clinical application as well.

並列關鍵字

Illness coping ； Emotional regulation ； Life goal & meaning ； Posttraumatic growth ； Leukemia