器官移植受贈者的身心變化

Mental and Physical Changes in Organ Transplant Recipients

詹佳蓉(Chan Chia-Jung)

指導教授 ： 高美英 博士

臺北醫學大學/醫學院/醫學人文研究所/碩士(2006年)

摘要

器官移植已成了台灣器官末期疾病的治療選擇。移植手術成功後，病患除了面臨生理上、心理上、社會適應、壓力、等待死亡經歷、經濟上等等的問題，此外，自己得到器官獲得重生的同時得面臨捐贈者的死亡，其接受過程是受經驗到心理與社會層面的影響。 因此，本研究的主要目的，是試圖了解器官移植病患經歷到如何的身心變化，如何透過新器官，想像自己與捐贈者之間的關係？如何詮釋自己的器官捐贈 者?影響器官移植者構成器官受贈者的想像的因素為何?本研究採質性研究法，深度訪談11位不同器官受贈者，站在病患角度的位置來看自己的身心變化、器官與移植醫療，希望能有更多病患自己的真實想法與詮釋。 研究結果發現，身體結構上因術後因服用類固醇造成短期的外表變化，除了肝臟病患的外表變化較少外，其他約半年後變恢復原狀。「體力的恢復」是所有器官受贈者明顯感覺到移植後身體功能的改善，尤其換肝人幾乎恢復到一般人的健康狀態，「恐懼」是心與肺臟在新器官開始運作時的感覺。心臟與肺臟受贈者透過身體感覺來肯定自身移植的器官是身體最重要的器官。 移植病患的醫病關係與病友團體的互動上促進了遵醫囑行為，但對醫師的忠誠度而跨區求醫，相對付出較高的就醫社會成本。在病友互動上，移植順序關係是某些病友之間互動的影響因素，病友互動有助移植病患的心理支持，並影響其健康信念。 依照病患移植後的身心變化依改變的歸因分類為：因健康因素而改變生活習慣、因創傷事件與經驗、藉由生病的受苦經驗發現生命意義而改變人生觀、受苦經驗符合宗教意涵、歸因於器官捐贈者因素的改變。其中肝臟有不健康生活型態的隱喻，與個人行為有關。多數受贈者避而不談捐贈者，可能與醫院系統的醫療過程中所灌輸的醫學觀念有關。

關鍵字

器官受贈者 ； 身心變化 ； 身體知覺

並列摘要

In Taiwan, organ transplantation has become a choice of treatments for end-stage organ diseases. After the success of transplantation surgery, the patients must face mental and physical pressure, challenge of social adjustment, personal economic problems and even the near-death experience. Besides, the receivers have to encounter the death of the donators while getting the surviving organs. The process of receiving a new organ is deeply mentally and socially influenced. As a result, the purpose of this study is trying to understand the mental and physical changes of the receivers, and also, to realize how they recognize, through the new organs, the relationship between themselves and the donators. How do they think about their donators? What are the factors that influence the images and conception of their donators? The study used qualitative method to interview 11 receivers of different organs, and, in the viewpoint of the patients, inspected their physical and mental changes in the hope of trying to get more true thoughts and feelings of the patients themselves. The result of the study showed that the patients’ short-term appearance changes caused by steroid taken after surgery have recovered to normal in about 6 months. In addition, the “recovery of the physical power” was the prominent physical improvement confirmed by all organ receivers. Receivers of liver transplantation even reached the functional level of common healthy people. “Fear” was the major feeling of heart and lung receivers in the initial period when new organs began to work in their bodies. They affirmed that the organs they had received are the most important organ among all. Good doctor-patient relationship and the transplantation patient groups both enhanced medical compliance. Interaction between patients helps provide mental support. Regarding patients’ interaction, the sequence of transplantation surgery plays an important role. The factors influencing the patients’ mental and physical status after the transplantation surgery are as the followings: health condition (which may cause change in life style), traumatic experiences during operation, reconsideration about life meaning, attributing the whole process to religious implication, thoughts about donators. Most receivers avoided talking about their donators .Which might be caused by medical concepts imposed during medical treatment process in the hospital system.

並列關鍵字

Organ Transplant Recipients ； Mental and Physical Changes ； body image

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