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研究生: 王歆韶
Wang, Hsin-Shao
論文名稱: 思覺失調症患者家庭成員知覺家庭韌力之敘事研究
A Narrative Study on Perceived Family Resilience of Family Members of Patients with Schizophrenia
指導教授: 王玉珍
Wang, Yu-Chen
口試委員: 田秀蘭
Tien, Hsiu-Lan
謝文宜
Shieh, Wen-Yi
王玉珍
Wang, Yu-Chen
口試日期: 2022/07/11
學位類別: 碩士
Master
系所名稱: 教育心理與輔導學系
Department of Educational Psychology and Counseling
論文出版年: 2022
畢業學年度: 110
語文別: 中文
論文頁數: 334
中文關鍵詞: 家庭韌力思覺失調症敘事研究
英文關鍵詞: family resilience, schizophrenia, narrative research
研究方法: 敘事分析
DOI URL: http://doi.org/10.6345/NTNU202201768
論文種類: 學術論文
相關次數: 點閱:101下載:21
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  • 本研究旨在探討思覺失調症患者家庭成員知覺家庭韌力發展之經驗,包含家庭韌力的發展歷程、家庭面對的困境與挑戰,以及家庭韌力的特質。研究採敘事研究取向,以半結構深度訪談法,針對四位思覺失調症患者家庭成員搜集資料,以「整體—內容」、「類別—內容」進行資料分析。研究結果如下:
    本研究四位研究參與者的家庭韌力發展經驗可分為五階段,分別為:困境出現、家庭韌力醞釀到形成、家庭韌力受到挑戰、家庭韌力鞏固再發展、家庭韌力帶來家庭轉化,而本研究四名研究參與者的家庭所遭遇到的困境與挑戰,分別為:精神疾病的困難照顧、沈重的家庭照顧負擔、情緒與關係的傷害、疾病污名下的家庭孤立、隱晦的表達使溝通受阻。
    本研究四名研究參與者的家庭韌力特質可歸納為四大類別共十六項家庭韌力特質,分別有(一)克服逆境的正向信念,包含對家庭的愛與認同、接受且為逆境賦予意義、迎向未來的正面展望、信仰與靈性的超越力量;(二)彈性的家庭組織,包含替代角色的功能、強而有力的領導與決策、相互支持與合作、關係的連結與凝聚、允許離家的彈性界線;及(三)積極的溝通與問題解決,包含清晰直接的溝通、坦白的情感分享、同理與接納、因應疾病的問題解決;以及(四)家庭外的資源與幫助,包含親屬與大家族成員的支援、社區鄰里與學校師長提供幫助、醫療專業與社區資源的支持。
    最後,根據研究結果,提出對於國家政策、臨床工作者與未來研究的建議。

    The aim of this study was to explore the development of family resilience by family members of schizophrenic patients, focusing on the developmental process of family resilience, the difficulties and challenges faced by families, and the traits of family resilience. This research adopts a narrative research orientation and uses semi-structured interviews to collect data from four family members of patients with schizophrenia. The data were then analyzed in terms of “holistic content” and “categorical content.” The results of this study are as follows:
    The development of family resilience for the four research participants in this study can be divided into five stages: The emergence of difficulties, the formation of family resilience, the challenges of family resilience, the consolidation and redevelopment of family resilience, and the family transformation brought out by family resilience. Difficulties and challenges encountered by the families of the four research participants in this study includes: difficulty in caring for mental illness, heavy family burdens, harmful emotions and relationships, communication barriers caused by implicit expressions, and family isolation caused by social stigma.
    The family resilience traits of the four research participants in this study can be classified into four categories with a total of 16 traits. (1) Positive beliefs: love and recognition towards family, meaning making of adversity, stimulation for a positive outlook, transcendence through religion or spirituality; (2) Flexible family structure: alternating roles, strong authoritative leadership, mutual support and cooperation, connection and cohesion, flexible boundaries for escape; (3) Active communication and problem solving: clear and direct communication, open emotional expression, empathy and acceptance, problem solving in response to illness; and (4) Social resources: support from extended family members, neighbors, school teachers, medical professionals, and community resources.
    The suggestions were based on the research results and will be provided to national policy, clinicians, and future researchers.

    謝詞 i 中文摘要 iii 英文摘要 v 目次 vii 表次 ix 圖次 xi 第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的與問題 5 第三節 名詞釋義 5 第二章 文獻探討 9 第一節 思覺失調症及其家庭 9 第二節 家庭韌力的概念與相關研究 19 第三節 思覺失調症患者家庭韌力 32 第三章 研究方法 41 第一節 敘事研究法 41 第二節 研究參與者 42 第三節 研究工具 44 第四節 研究實施程序 47 第五節 資料整理與分析 49 第六節 研究信實度 53 第七節 研究倫理 59 第四章 研究結果 63 第一節 小草長成大樹——萍兒的生命故事 63 第二節 永不放棄的愛就是家——如意的生命故事 112 第三節 突破困境後勇敢站立——小艾的生命故事 164 第四節 真實關係中有愛的力量——緋比的生命故事 209 第五節 綜合討論 273 第五章 研究結論與建議 299 第一節 研究結論 299 第二節 研究限制與建議 302 第三節 研究者的覺察與反思 305 參考文獻 307 中文部分 307 英文部分 320 附錄 327 附錄 1 訪談大綱 327 附錄 2 研究邀請函 328 附錄 3 研究參與者同意書 330 附錄 4 訪談札記 332 附錄 5 研究參與者檢核表 333

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