精神分裂症患者其青少年手足之生活經驗

The Lived Experience of the Schizophrenic Patients' Adolescent Siblings

高玉貞(Yu-Chen Kao)

指導教授 ： 許敏桃

高雄醫學大學/護理學院/護理學系研究所/碩士(2005年)

摘要

本研究之目的是為了瞭解當家中出現精神分裂症患者時，其青少年手足的生活經驗及可能面臨的衝擊。研究之對象取自於南部某教學醫院之青少年病房，經醫師診斷為精神分裂症者之13~18歲的手足，共有五位參與此研究。依循研究步驟，以深度訪談來收集資料，並透過訪談過程的全程錄音及訪談札記，完整的紀錄青少年的生活經驗。訪談資料經由內容分析法，共呈現出三個主題：「觀看精神疾病」、「轉變的過程」、「被他人觀看」，藉以重現青少年面對精神分裂症手足時的生活經驗。
在「觀看精神疾病」的次主題中包含有：「尋找病因並與自身區隔」及「被迫接受並面對未來」。此兩個次主題，呈現出青少年在手足罹患精神分裂症之後，一直站在他者的位置觀看，並不斷地與自身對應的經驗歷程。第二個主題「轉變的過程」之則包含兩個面向：「手足關係的改變」及「調適歷程」，主要呈現出青少年在面對手足的生病歷程時，如何找到自己的角色定位，來面對手足關係的改變---「從熟悉親近到陌生疏離」、「從衝突競爭到憐憫疼惜」。及不斷地調適自己面對「家庭重心的轉移」、「手足位階的轉換」、「被迫成長」及「猶疑在放入與區隔之間」，以維持內心的自我平衡。至於第三個主題「被他人觀看」的次主題則包含有：「擔心社會烙印」及「期待被接納」。此兩個次主題，呈現出青少年在面對社會壓力時努力做好自己的角色，以擺脫精神疾病的污名，並期待重新被他人所接受的心情。
本研究結果顯示：青少年從另一個手足開始生病，便不斷地在覺知生病手足的差異性。為了適應罹患精神分裂症的手足，青少年經常出現「不得不為」的無奈感，且因為手足疾病的慢性化而開始產生「命定」的宿命觀。面對這種家庭處境的青少年，經常會因為生病手足而放棄個人目標，進而影響未來的發展。

關鍵字

青少年 ； 精神分裂症 ； 手足 ； 生活經驗 ； 社會烙印 ； 質性研究

並列摘要

The purpose of this study is to explore the lived experience and impacts of the schizophrenic patients’ adolescent siblings. The informants were five adolescents, aged from thirteen to eighteen, whose siblings have been diagnosed as schizophrenia. After using in-depth interview with tape recording, the data were transcribed into texts to explore participate adolescents’ lived experience completely. The interview texts were analyzed by consistent content analysis method. From the findings of this study, three major themes indicated their concerns at such developmental stage are: a). the relationship with sibling -- “viewing myself with illness,” b). their efforts to adapt -- “the process of changing”, and c). the influences from other and social stigma as well -- “viewing from others with illness”. These three major themes represented the lived experience of the schizophrenic patients’ adolescent siblings.
First major theme, “Viewing myself with illness”, includes two sub-themes “using comparison to differentiate myself from my sibling”, and “being compelled to accept it”. These two sub-themes epitomize the tendency of distancing themselves from schizophrenia. The second theme, “The process of changing”, includes two sub-themes “changing relationship with patients and peer” and “coping to the illness”. These appear that how to identify oneself and to confront the changing relationship -- from intimate to stranger and from competitive to compassionate. Besides that, they also learn to elaborate themselves to the “shifting focus of the family”, “altering order among siblings”, “being propel to grow up”, and “hesitating to identify with sick siblings”. The third theme, “viewing from others with illness” includes two sub-themes “worrying about social stigma” and “expecting to be accepted”. These two sub-themes show that the adolescents do their best to put forth themselves under social stress and to get ride of social stigma.
The findings reveal that the adolescents frequently aware of the differences between themselves and their siblings and between themselves and their peer. They usually appear to be obliged for their siblings who were suffered from schizophrenia. Because of the chronic nature of schizophrenia, adolescents become more fatalism in describing their experience of living with schizophrenia. Therefore, the adolescents usually give up their dream and future to share the burden from taking care of the sick which deviate themselves from the normal development tasks at this stage.

並列關鍵字

schizophrenia ； sibling ； adolescent ； qualitative research ； social stigma ； lived experiences

參考文獻

壹、中文文獻

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