- 學位論文
女性乳癌患者婚姻中親密關係轉變之研究－以曾接受乳房切除手術者 為例
A Study on the Transformation of Marital Intimacy in Female Breast Cancer Patients: The Illustration of Patients with Mastectomy
摘要
本研究旨在了解曾接受乳房切除手術之女性乳癌患者其婚姻中親密關係轉變。本研究根據質性研究方法之精神與原則，以立意取樣法徵詢研究參與者，邀請四位女性乳癌患者（年齡41 至68歲）進入正式訪談，並以開放編碼之方式進行分析。本研究之研究結果與討論共分為三部份： 一、 個別女性乳癌患者婚姻中親密關係之整體經驗：依照時間序呈現每位參與者在抗癌過程及婚姻中親密關係之經驗。 二、 罹患與治療乳癌過程對女性乳癌患者婚姻中親密關係影響之經驗歷程：說明參與者罹患與治療乳癌過程經驗中各階段的重要經驗、重要事件或現象、所造成的結果或影響。 三、 女性乳癌患者婚姻中親密關係轉變歷程之分析：亦分為三部份。 （一） 女性乳癌患者婚姻中親密關係轉變歷程之重要現象： 1. 乳癌夫妻獲知罹患乳癌當下強烈的情緒反應。 2. 乳癌夫妻間相互持續的高情緒張力狀態，透過接納與包容而舒緩。 3. 乳癌夫妻彈性調整角色分工失衡，有助降低壓力與維繫功能。 4. 先生的正向反應顛覆扭轉乳癌患者對夫妻關係之恐懼不安。 5. 乳癌夫妻共度生命逆境與因應危機深具意義。 6. 乳癌夫妻調整出契合的生命價值及生活哲學。 （二） 女性乳癌患者婚姻中親密關係各向度之轉變歷程： 1. 「溝通與分享」及「衝突解決與效應」兩因素之轉變：因性格或互動模式之改變，提升溝通品質，並降低衝突發生頻率。 2. 「情感」因素之轉變：夫妻間更增感激與欣賞，但情感表達方式存在差異。 3. 「承諾」因素之轉變：深刻體認生命伴侶之意義，出現珍惜此刻的共識。 4. 「性」因素之轉變：遭遇強大衝擊，因不離不棄、互相配合而重拾信心。 5. 「娛樂」因素之轉變：價值觀調整與經濟條件改善促使其更能共享娛樂。 6. 「自主」及「社會」因素之轉變：個人能力之展現與投入社會服務之經驗，有助夫妻共同成長，或因此改善相處氣氛、激發夫妻情感。 7. 「靈性」因素之轉變：共同宗教信仰有助於因應苦難及尋求詮釋。 （三） 女性乳癌患者之婚姻中親密關係轉變歷程之階段性特色：分就「風暴之前：發 現罹患乳癌前之時期」、「晴天霹靂：面臨乳癌的婚姻初期時期」、「共度潮起潮落：夫妻面對乳癌與治療時期」、「浮現新象：婚姻中親密關係各向度明顯轉變時期」等時期呈現婚姻中親密關係狀態不同階段性特色。 最後，研究者依據研究結果與討論，針對乳癌夫妻、乳癌夫妻之親友、相關病友團體及專業人士，及未來研究者提出建議。
並列摘要
The purpose of this study was to investigate the transformation of marital intimacy in female breast cancer patients who had undergone a mastectomy. A qualitative research method, purposive sampling was used in this study. Four female breast cancer patients were invited as participants in this study, and then the collected data was analyzed using Open-Coding method. The results and discussions of this study were threefold: 1. The experience of marital intimacy of each individual female breast cancer patient: The experience of coping with cancer and marital intimacy of each participant was investigated in time intervals. 2. The effect and related-experience of medical treatment on marital intimacy in female breast cancer patients: During the period from being diagnosed with breast cancer and to being medically treated, the important events, phenomena and the experiences of participants were described. 3. Analysis for the transformation of marital intimacy in female breast cancer patients. There were three subcategories in this section. （1.）Important phenomena occurred during the transformation: A. The strong emotional reaction of being diagnosed with breast cancer B. Continuous-interactive emotional pressure between the couples was alleviated through acceptance and inclusion. C. Re-adjustment of the roles in the marital relationship helped reduce the pressure and maintain family function. D. Positive reaction from the husband could help the wife feel no fear of marital relationship problems. E. The profound meaning of helping each other through the difficulties of life. F. The couples found a new value to life after going through the emotionally and physically painful experience of having breast cancer. （2.）The alteration of nine factors in marital intimacy is listed below. A. The alteration of “Communication”, and “Conflict resolution and effect”: Due to the change of personality and interactive behavior, communication improved, and the frequency of conflict was reduced. B. The alteration of “Affection”: The couples appreciated and admired each other more, while differences existed in the ways how they expressed their emotions. C. The alteration of “Commitment”: The meaning of spouse was deeply realized, and the couples cherished each other at this moment in time. D. The alteration of “Sex”: The couples’ sex life was heavily impacted by the disease; however the confidence was retrieved by coordination. E. The alteration of “Recreation”: The adjustment of values and improved finance helped them appreciate quality time together. F. The alteration of “Autonomy” and “Social”: The illustration of personal capability and social service experiences helped the couples advance together, and improve both the atmosphere and the relationship. G. The alteration of “Spirit”: Having the same religious belief assisted in suffering through disease and seeking mental support. （3.）The characteristics of different phases in the transformation: Those characteristics are organized into four phases as follows Phase 1: Before being diagnosed breast cancer. Phase 2: The marital situation after being diagnosed breast cancer. Phase 3: Coping with breast cancer and medical treatment together. Phase 4: The alteration of each factor in marital intimacy. Finally, based on the research results, suggestions are proposed for breast cancer couples, friends, relatives, related group, professionals and future researchers.