疾患認知表徵、調適目標、及生活目標之關聯性－乳癌個案研究之探討

Exploration of the Relationships among Illness Representations, Goals of Illness Adaptation, and Other Life Goals — Case Study for Breast Cancer Patients

白欣宜(Hsin-Yi Pai)

指導教授 ： 吳英璋

國立臺灣大學/理學院/心理學研究所/碩士(2013年)

https://doi.org/10.6342/NTU.2013.00709

摘要

乳癌是個具威脅性的疾病，患者從懷疑罹癌開始，將面臨生理、心理、及社會多方面的威脅。因此，如何協助乳癌患者發展因應策略，以維持與自身疾患共處的平衡，將會是影響患者生存適應與提升生活品質的重要議題。因應程序的首要任務為確認目標；而根據「常識模式」，患者如何因應疾患威脅取決於患者對自身疾患的認知表徵。因此，疾患認知表徵與疾患調適目標設定之間的關聯可說是瞭解患者之疾患因應程序與行為的重要因素。此外，在處於癌症經驗下，患者的其它生活目標可能會與其疾患調適目標產生相互影響的關係，進而影響患者後續的疾患因應歷程。故本研究嘗試藉由個案研究的方式，分析兩位乳癌患者之深度訪談資料，以瞭解在疾患調適歷程中，患者的具體疾患認知表徵、疾患調適目標、和其它生活目標設定等現象特性，以及此三者之間可能的關聯性。研究結果發現，雖然患者的疾患調適目標設定會受到患者如何表徵自身疾患所影響，但當患者有其它重要的生活目標時，可能會減弱患者對疾患調適目標的投入動機，或是影響疾患調適目標的內容設定與選擇，甚至有時候患者的疾患調適目標為達成其它生活目標的途徑之一。因此，本研究認為若要完整了解患者的疾患調適經驗，除了如常識模式所述要了解患者對疾患的表徵與因應之外，尚需考量患者的生活脈絡與其它生活目標，才能協助患者成功走過疾患調適歷程。

關鍵字

乳癌 ； 疾患認知表徵 ； 目標 ； 個案研究

並列摘要

This study aims to explore the relationships among illness representations and goals of illness adaptation and other life aspects in breast cancer patients. Using the case study design, two breast cancer patients’ responses to the Illness Experiences Questionnaire and focused interviews were analyzed. Qualitative analysis was used to code interview transcriptions. Except for confirming that goal setting of illness adaptation was directed by illness representations, results showed that goals of other life aspects also played important roles in patients adaptation goal striving. When patients encountered goal conflicts between illness adaptation and other life aspects, the important goals of other life aspects determined not only how they set their goals of illness adaptation, but also how much effort they devoted to the goals. Results suggested that consideration of patients’ life goals striving cannot be overlooked when helping them to adjust to cancer.

並列關鍵字

breast cancer ； illness representation ； goal ； case study

參考文獻

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