非法藥物施用者家庭研究

本研究探討施用非法藥物事件之壓力情境對於家庭及個別成員的意義，分析家庭與個別成員面對壓力事件的因應與調適，研究的目的在於探索家庭面臨成員施用非法藥物時之特殊生命經驗，關注家庭整體及個別成員之經驗與意義的探討與詮釋。採用滾雪球方式進行樣本蒐集，共訪談21位受訪者，19個家庭，參與者在家庭中的角色包含子女、父母、夫妻及手足等。以深度訪談的方法進行資料蒐集，透過主題分析法（Thematic Analysis）進行資料編碼、分析，形成概念與主題。研究發現與建議如下：一、非法藥物施用的壓力事件對於處於不同家庭生命歷程階段的家庭次系統，有不同的意義與反應，壓力累積的效應也影響家庭次系統中不同角色的壓力感知，感知的程度因著家庭成員在家庭角色中的份量而有差異。當家庭發生成員施用非法藥物的壓力事件時，家庭為因應壓力事件及事件的累積效應，原有的階段歷程及家庭內的成員角色功能與責任會因為因應的需要進行調整。二、家庭處於壓力事件長期的影響下，對於壓力的感知均顯得消極、負面，且家庭在因應壓力事件時所具備的資源、或所能獲得的資源也非常有限，不同的家庭角色因應壓力所選擇的策略也不相同，壓力因應結果影響家庭的調適；家庭面對壓力事件由因應走向調適再走向適應之關鍵因素或條件，力量生成的關鍵，包含家庭內部的動力、系統間的合作及時間因素。三、家庭的壓力態樣多重，除了家庭原已存在的壓力外，因壓力事件所衍生的問題也非常複雜，需要網絡合作，以連續性、系統性，從各個面向提供以案主為中心的照顧服務。施用者的家庭因處於不同生命歷程有不同的需求，家庭主要照顧度者的壓力感知也是影響服務需求的重要因素，因此對於非法藥物施用者的服務需要以個別化的服務模式，跨越標準化的服務流程，以家庭整體為中心的想像，提供符合家庭生活及文化脈絡的服務管道與服務。四、家庭雖面臨非法藥物施用所帶來的壓力與困境，但每個家庭系統仍持續運作，以他們自己的方式達到平衡的狀態，研究中也看到，家庭成員面對壓力事件時所呈現積極正面的價值觀、信念，及堅強的人格特質、家庭成員互助的凝聚力，讓家庭持續走下去。

關鍵字

家庭生命歷程；壓力；累積效應；標準化；去標準化；家庭角色

並列摘要

This research explores how the stressful situations caused by substance use disorder impact the families of the drug users. Additionally, the responses and adjustments of the family and individual members to these events were assessed. This research sought to explore their interpretation of their family members’ problematic drug use and their definitions of the specific experiences that individual family members and the families as a whole undergo. This research adopted adult of persons with drug dependence as its sample. The families recruited for this research were those of individuals who consumed Class 1 (e.g., cocaine) and Class 2 (e.g., ecstasy) drugs. The snowball sampling method was used to recruit potential research interviewees to participate in this study. In total, 21 participants, who were either the children, parents, spouses, or siblings of adult drug users, were interviewed. These participants came from 19 distinct families. Thematic analysis was used to code and analyze the data in accordance with various concepts and topics that emerged from the transcripts. The research findings and recommendations are as follows： 1. The cumulative effects of the pressure caused by problematic drug use generated multiple complex problems for the families of users. The results indicated that at different stages of their life courses, the families encountered different challenges. The stressful effects of problematic drug use impacted various family sub-systems at distinct life course stages in differing ways. The effect of stress accumulation also affected the perceptions of stress of various members of the family sub-system. Upon the occurrence of a stressful event, such as substance drug disorder by a family member, the responses of the kinsfolk to the event and its consequent cumulative effects varied based on their familial role. 2. This study found that the stressful events had a long-term impact on the families and that their perception of the stress was negative. The resources that could assist the families in coping with these difficulties or could be applied in such situations were limited. In accordance with their role, different family members chose distinct strategies in response to stress. How a family responded to stress affected their familial adjustments. The inner power of the families, their cooperation with support systems outside of the family, and time were the key factors that facilitated the generation of a positive power in response to the stress caused by family members’ illicit drug use. 3. The stress faced by persons with drug dependence and their families varied. In addition to the existing pressure in families, the problems caused by stressful events were also complex. Based on the service-user-centered concept, network cooperation is required to provide continuous and systematic resolutions in all aspects. The families of persons with substance use disorder have different needs based on the distinct positions that they occupy. The degree of stress that the main family caregivers experience is also an important factor that influences service demand. Therefore, services provided for persons with drug dependence must be customized and de-standardized. Services should be based on the needs of the family as a whole. Thus, service options should be provided in accordance with the family’s life course stages and cultural context. 4. Although the interviewed families experienced stress and difficulties as a result of their relatives’ illegal drug use, each family system continued to operate and found balance in their own ways. This research also demonstrated that when family members encounter stressful events, they utilize their positive beliefs, strong personality traits, and the support of other family members in order to persevere and overcome these challenges. In conclusion, every family develops its own strategies to facilitate its survival.