悲悼的歧義-癌症新近喪偶者傷逝療癒歷程的建構詮釋

摘要為探究癌症新近喪偶者遭逢死亡變故「邊界處境」後，如何轉化其經驗，重返生活世界，研究者將「喪偶事件」重置於現象場脈絡下，透過多重場域、多重時間點的訪談方式，進行現象還原，以建構詮釋癌症喪偶者一年內可能存在的傷逝療癒模式。本研究採立意抽樣，以南部某教學醫院之安寧病房，病逝患者的配偶為研究對象。研究中，訪談參與者十位（男性三位、女性七位；受訪平均年齡46歲，標準差11.65歲；結婚平均年數21年，標準差11.4年；配偶平均罹病時間33個月，標準差54.16個月），每位訪談參與者將於喪偶一年四個月內接受3~4次的訪談。而後，進行資料謄寫轉錄與反覆閱讀比較，並以Moustakas(1994)所提出的現象學分析方法分析之。主要研究結果顯示，癌症新近喪偶者面對「他人之死」後，傷逝療癒的可能性徑路，是在生活世界中的「大缺席」的哀悼，即由「他者面容思念」走向「無對象性思念」倫理行動的迂迴長路。個體以身體知覺現象學為基礎，透過對「生存心態」的修補與融合，在「身體記憶的感知」、「時空慣性的裂合」、及「儀典世界的轉置」三層次中反覆流轉。進一步來看，個體對「生存心態」的修補或融合的行動，則與夫妻生前的互動模式相關。延續生前夫妻互動過程中「生活重疊性」、「情感相依性」的不同，可分為：返己性、轉他性、依場性、以及謀合性，四種療癒類型。研究指出，個體的療癒行動，應被放置在脈絡中理解，而倫理行動的產出亦需考量華人文化中「和諧」的追求。研究者認為，未來針對癌症新近喪偶者傷逝療癒歷程的關照上，或許可將末期病床陪伴互動的觀察視為基礎，拓展對生命整體性的思量，尊重適性療癒的多樣性與創造性。

關鍵字

癌症；喪偶；傷逝療癒；生活世界；倫理行動

並列摘要

Abstract To explore the Taiwanese widowers and widows who lost their loved one for cancer how to transform their “limited experience” to be back to the life world in the first year after the loss, the study was aimed to release complex “bereavement” phenomena from the emic context. In the study, we employed the multiple-site and the multiple-time procedure for depth interviews, and used the phenomenological research methods to analyze the narrative and to contruct the text. In this qualitative research, 10 subjects (in the ratio of 3 to 7 between man and women, with a mean age of 46.0±11.65 years, a mean married duration of 21±11.4 years, and a mean of 33±54.16 months for caring their spouse ) lost their spouses during the hospice care. Each subject was interviewed three or four times in the mourning period nearly during the one and half years. Then the collected data were analyzed. As the results of this research showed, the healing processes for the widows/widowers who lost spouses in hospice were complex. With time some individuals adapted to the loss and renewed their capacities for recathexis. Some kept the emotional life and symbolic relationship. The healing process was understood as an ethical act in the life world. The central task of mourning was “non-object” rather than “Other’s face”, which meant the “Absence”- to experience the dead person as living presence, with which one maintained the dialogue, would not be viewed as maladaptive. To analyze further, we found three vicissitudes of the mourning processes were named as “the awareness of body sensory “, “the holding of spatiotemporal habitus”, and “the transformation of commemoration”. Then, we found four strategiccs were adopted by the widows/widowers to reconnect or to accomplish full resolution for the “habitus”. Finally, the implications, suggestions and limitation about the study were discussed.