意外的旅程:初診斷乳癌病患之時間經驗

The time experience of patients with newly diagnosed breast cancer

吳秋玉(Chiou-Yuh Wu)

指導教授 ： 許敏桃

高雄醫學大學/護理學院/護理學系研究所/碩士(2008年)

摘要

乳癌是女性癌症第一位，就關心女性健康之立場，且就過去研究文獻得知病患於治療期間得承受身體苦痛及心理煎熬，然而卻少有人探討在診斷確立當下，在面臨生命受到威脅時，其時間經驗為何？因此本研究目的為瞭解初診斷乳癌病患之時間經驗。
本研究是採用質性研究方法以深度訪談進行資料收集，共有十位參與者，訪談次數為1-2次不等，訪談時間為45分鐘至2小時。以錄音方式錄下整個過程，資料分析以Huberman & Miles之資料分析三大要素方法來分析，研究結果顯示其歷程為「癌症即死亡即時間停止」、「時間停格與裂解」、「醫療時間的不對等」、「他人時間的不對等」及「重生的時間」五個面向。
結論：病患在罹患乳癌時之情緒反應對身體、自我及未來有不同的時間感受。然而，在醫療時，相應於不同階段治療，醫院「常規」時間與病患因發現乳房異狀所產生的內在時間產生衝突。加上，親友或專業人員常自以為是局內人而以自己認為對的方式對待患者時，卻不自覺的傷害了病患。只有相同疾病的病友們才能真正體會所承受的苦痛。故若醫護人員若能在照顧當下，可以同理病患當下情緒及瞭解時間對她們之意義，建構相關諮詢單位及轉介機制，必能助益良多。
關鍵詞：乳癌、時間經驗

關鍵字

乳癌 ； 時間經驗

並列摘要

The purpose of this study is to discover the time experience of patients with breast cancer during the treatment period. Qualitative methodology was followed by in-depth interviews and participant observations were conducted to collect data. 10 subjects were enrolled in this study. The interviews were recorded and interview texts and field notes were analyzed by Huberman & Miles’s Qualitative Data Analysis method.
Five themes emerged from the data: (1) Cancer means death and one’s time is up, (2) Time stopping and splitting, (3) Unreconciled medical time , (4) Unreconciled other’s time, (5) Reborn time.
Conclusion: The results show that patients with breast cancer will have different time perception for body, self and future. However, when medical services are applied, in the different treatment stages, there are conflicts between hospital “routine” times and the patient’s interpersonal time. In addition, relatives and specialists often think of themselves as infallible in their dealings with those concerned, who are the “Insiders” and use “The Right Way“ to treat injured patients, believing only the same kind of person can realize their feelings. Then, the nursing faculty should be made aware of recognizing patients’ worries, and providing empathy and support to reduce their anxiety, and understand their difference of time perception. Appropriate interventions based on time correlations between the patient and staff, between consultation unit and mechanisms of surgery, as well as nursing care must be developed.

並列關鍵字

Breast cancer ； Time experience

參考文獻

中文部份

王秀紅、侯明峰（1993）．乳癌患者延遲診斷的相關因素探討．高雄醫學科學雜誌，9(2)，103-112。

王惠暢、曾令民、吳秋文、雷永耀、彭芳古（2000）．乳房疾病新

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王貴霞、劉哲銘、呂志得（2005）．乳癌病患的困擾及擔憂問題．北市醫學雜誌，2(9)，71-77。