中年腦中風患者疾病適應歷程之研究

The studying in the Adaptation Experience of middle aged Patients with stroke

張雅筑(ya-Chu Chang)

指導教授 ： 童伊廸 ； 唐宜楨

中山醫學大學/醫學院/醫學社會暨社會工作學系碩士班/碩士(2016年)

摘要

本研究旨在了解中年腦中風患者疾病適應歷程，透過腦中風障礙及失能評估量表(NIHSS)篩選出六位符合研究對象之要求且願意接受訪談的患者，進行戈登人格剖析量表之施測並透過質性訪談研究方法，探索並分析患者接受醫療照護之經驗、自我概念及社會支持多元因素對中年腦中風患者疾病適應之影響。研究結果發現： 疾病適應良好與強大的社會支持及正向的人格特質有關。患者在疾病急性期時因控制感降低，對未來產生許多負向情感時，可以藉由家庭支持系統及醫療人員所提供的資訊性支持，讓受訪者穩定自己的心理狀態。進入黃金復建期時，看見自己生理狀態不如以往，親友的陪伴程度與受訪者的正負向人格特質將會影響患者如何調整自己心理狀態面對疾病造成的不便，但此階段因復原進展明顯，多數受訪者在此階段對自己的復原都還能抱持正向積極的態度。邁入慢性復原期後，因為復原進展趨緩，且一旦稍有怠惰，就需面對肌肉緊繃、僵硬退步的情況，此時期的支持系統與自我概念動態的轉變更顯重要，當受訪者不能接受自己身心狀態將會有負向適應，如社交退縮；患者如能夠接受與疾病共存的情況，會有較正向的疾病適應，如自立生活、重返職場。

關鍵字

腦中風 ； 疾病適應 ； 自我概念 ； 社會支持 ； 中年

並列摘要

The purpose of this study is to understand how middle aged Patients with stroke adaptation their own condition after illness. Research methods is screening out six patients who meets the study requirement and willing to be interviewed, then surveys GPP-I and interviews middle aged patients with stroke. And explore and analyze the test results and interview content about experiences of medical care, self concept and social support, the three aspects effects patient with stroke to adapted. The conclusion was as follow: Good adaptation and strong social support and positive personality related. When patients in the acute stage will feeling to loss control, it will have a lot of negative emotions, but they can stabilize their mental state by family support systems and the medical professional provided informational about medical message. In the prime of rehabilitation, the patients will see their physiological condition worse than before, at this time how long family and friends can keep patients company and patient’s personality traits will affect they how to adjust their psychological state to face the disability caused by the disease. But in this stage the patients will has greatly advanced, so most patients can hold positive attitude to face rehabilitation. After the rehabilitation into the chronic stage, rehabilitation will slowed down and when the patient lazy to accept the physio therapist, he will face his physiological condition deteriorates, in this time the state of support system and self-concept is more important. When patients cannot accept their physical and mental state will have a bad adaptation, such as social withdrawal. If the patient can accept sequela of stroke he will have positive adaptation, such as independent living, return to the workplace.

並列關鍵字

stroke ； adaptation experience ； Self concept ； social support ； middle aged

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