洗腎病患的心理社會調適歷程

本研究旨在暸解洗腎病患所面對的生理、心理、社會議題以及其心理社會調適歷程。本研究採質性研究的敍事研究法，通過深度訪談來蒐集資料，共訪談四位洗腎超過半年以及五年以下的洗腎病患。訪談後針對所得資料進行分析，主要研究結果發現如下：一、洗腎病患所面對的生理議題為疲累、暈眩、手腳抽筋、嘔吐、廔管阻塞、氣喘。二、洗腎病患所面對的心理議題為産生負面的情緒、心情低落、想放棄或産生自殺的念頭、覺得拖累他人、覺得被看輕或歧視、感到壓力。三、洗腎病患所面對的社會議題為家人朋友遠離、失去工作及就業困難、陷入經濟困境、社交圈子受限、被歧視或誤解、飲食上的限制。四、洗腎病患的心理社會調適歷程主要分為不要去想或轉移注意力、尋求社會支持、正面積極的思考模式、宗教的力量、信念、從事有意義的活動、諮詢醫療人員、接受自己的限制、忍耐、遵從醫療人員的指示。研究者根據上述研究發現加以討論，並依據此結果對洗腎病患、專業助人者與未來的研究提出建議。

關鍵字

洗腎病患；調適歷程；敘事研究

並列摘要

The aim of this study is to understand the physical, psychological and social challenges encountered by dialysis patients and their psychosocial coping process. In this study, narrative research method is adopted and in-depth interviews were conducted with four dialysis patients who had undergone dialysis treatments for more than six months and less than five years. The main findings of the study are as follows: 1) The physical challenges faced by dialysis patients are fatigue, giddiness, cramps of limbs, vomiting, blockage of fistula and breathlessness. 2) The psychological challenges faced by dialysis patients are negative emotions, feeling down, feel like giving up or committing suicide, feel like being a burden to others, feel like being looked down or discriminated, could not find meaning in life and feeling stressed. 3) The social challenges faced by dialysis patients are deserted by family and friends, lost jobs and difficulty in finding an employment, financial difficulties, discriminated or misunderstood, restriction on foods and social limitations. 4) The psychosocial coping process of dialysis patients include stop thinking or diversion of attention, seeking social support, positive thoughts, faiths, believes, engage in meaningful activities, consult medical professionals, accept own limitations, patience and comply with medical professionals’ advice. The above findings were discussed and suggestions for dialysis patients, helping professionals and future research are provided based on the findings.