- 學位論文
輕微頭部創傷患者的壓力因應歷程研究
The Stress Coping Process of Patients with Mild Traumatic Brain Injury
摘要
輕微頭部創傷患者在受傷之後除了面臨頭部創傷直接造成的身體、認知、情緒等方面的症狀，也遭遇許多心理社會面向的問題，過去研究試圖以神經病理因素的角度瞭解這些患者傷後恢復狀況的差異，但並未能獲得充分的解釋。Kendall及Terry(1996)認為，由於頭部創傷患者的適應問題涉及不同面向，壓力因應模式是適於探討這些患者傷後適應情形的一個概念模式。本研究整合生理-心理-社會觀點以及壓力因應模式形成研究架構，以個案研究的方式深入探討兩位輕微頭部創傷患者在受傷之後的壓力因應歷程。研究收集兩位參與者的認知功能評估資料以及深度訪談資料，其中深度訪談資料以內容分析法為資料整理依據。由兩位參與者的資料中發現，輕微頭部創傷患者在受傷之後會有兩種層次的壓力因應歷程同時進行，分別是「傷後症狀及相關壓力源因應」及「受傷相關經驗意義化」。此兩層次的歷程會相互影響：傷後症狀及相關壓力源的因應結果可能影響傷者對於受傷經驗的意義化；對受傷經驗所形成的內在意義，也可能影響傷者在每個當下能否適切地因應症狀及相關壓力源。由本次研究資料也發現，傷者的身體或認知功能損傷形式以及社會支持等因素於上述適應歷程中可能扮演重要角色。
並列摘要
Except for somatic, cognitive, and emotional symptoms caused by head injury, patients with mild traumatic brain injury (mTBI) suffered from many other psychosocial problems as well. Many researchers had tried to interpret the individual differences of posttraumatic adjustment by neuropathological factors, but received unsatisfied result. Considered that problems faced by traumatic brain injury patients involved different aspects, Kendal and Terry (1996) suggested that Stress-Coping Model was an appropriated viewpoint to understand adjustments of traumatic brain injury patients. Based on bio-psycho-social perspective and Stress-Coping Model, a case study with 2 mTBI patients proceeded. The 2 patients received neuropsychological evaluation and interviews separately. Texts of interview were processed in accordance with content analysis method. Results revealed that there might be two levels of stress-coping processes presented simultaneously. The 2 levels were “coping with symptoms and other related stressors” and “making meaning out of head injury experience”. There might be some interactions between the 2 levels of processes. Besides, factors such as “patterns of physical damage and cognitive deficit” and “social support” might play important roles in those processes.