醫療與我:注意力缺陷過動症大學生的自我認同

本研究旨在了解注意力缺陷過動症（簡稱ADHD）學生在醫療診斷之後對自己的認同之關係。邀請兩位注意力缺陷過動症大學生參與本研究，以敘事研究進行，透過五次結構式深度訪談ADHD大學生，再以「內容-類別」敘事分析模式，將ADHD大學生敘說之生命故事內涵，以自我調整模式(Self-regulation Model) (Leventhal, Brissette, & Leventhal, 2003)理論架構進行重述與討論。兩位研究參與者的生命故事所歸納之結果有三：一、就醫前ADHD個體的經歷影響他們對就醫的感受，與對診斷名稱與醫療的解讀。此歷程的重點在於個體的心理資產與外在因素(環境支持度及疾病汙名感受)的影響。擁有愈足夠的個人與環境資產之個體，其成就動機就愈強，承受環境衝擊的能量也愈強。環境的支持是正向外在因素，而環境對疾病的汙名則是負向因素。二、ADHD個體於醫療介入後經歷一段調適歷程，反覆經歷Leventhal等人(2003)所提出的錨定目標問題→付諸行動解決問題→獲得結果之歷程，從認知疾病到覺知疾病，最後賦予此歷程評價意義，反覆經歷認知疾病-因應-評價的歷程，逐漸深入認識自己與ADHD的關係。三、個體從「接受」自己被貼上ADHD的標籤，走向「接納」自己是個ADHD，關鍵在於醫療介入後，個體是否認知到自己因疾病的診斷而獲得前所未有的成就。本研究參與者因為對自己及ADHD有正確的認知，習得有效解決問題的方法，形成自我效能和自我認同，使他們在進入社會後更容易在工作上獲得成就感與社會的認同。　　最後，提出本研究之限制和建議。

關鍵字

ADHD ；診斷標記；藥物治療；敘事研究；大學生

並列摘要

This study utilized qualitative inquiry to develop an understanding of the meanings and consequences of a diagnosis of ADHD, and to understand how these experiences may influences the self Identity. Two college students with an ADHD diagnosis were interviewed using a semi-structured interview. The narrative life discourse of participants was collected by the guidline of topics of management of diagnosis, stimulant medication use, identity and their experiences of difficulties relating to ADHD. The categorical-content approach is used to analyze narrative data. The findings of the study are as follow： I. ADHD individuals experiences before diagnosed, Effects how they feel and how they interpret the medical diagnosis and intervention. Individuals psychological assets and those external factors, including environmental support and disease stigmatization. II. Individuals went through a period of self-regulation process after diagnosis (Leventhal et al, 2003), and will repeat: (1)Aknowledging his disorder (ADHD), (2)trying to solve problems caused by the disorder (ADHD) and gaining result, and (3) evaluate the process. From this process, individuals revised his/her recognition towared his/her disorder (ADHD) and comprehended the relationship between self and disorder catalog gradually. III. After medical intervention, whether the individual can recognize his/her improvement never before, this is the keypoint that individual can go forward from recognizing the diagnosis of ADHD to acceptance of ADHD.