中途視障者家庭關係變化之研究

The change of family relationship to adventitious blindness

莊惠鈞(Hui-Chun Chuang)

指導教授 ： 許雅惠

國立暨南國際大學/人文學院/社會政策與社會工作學系/碩士(2009年)

https://doi.org/10.6837/NCNU.2009.00044

摘要

本研究主要之目的為探討：（一）青壯年致障事件帶給視障者家庭的壓力事件與影響；（二）青壯年致障事件對於視障者家庭系統變化的影響；（三）影響視障者致障後家庭系統變化的內、外部因素。研究中透過導引式訪談，瞭解致障事件帶給中途視障者家庭的壓力程度、家庭系統的變化，及內、外部因素對於視障者家庭壓力、系統變化的相互影響等。總共訪問了三個中途視障者家庭，分別針對視障者、配偶及子女一名進行個別訪談，其中僅一個家庭的兩位女兒一同進行訪談，共計訪談十人。本研究結果歸納如下：

一、致障事件所帶來之壓力，衝擊的不是只有中途視障者一個人，也包含了家庭其他成員及親友，特別是同住的視障者配偶及子女受影響最深。
二、致障事件對於家庭系統的影響：
1.家庭成員受視障者致障初期情緒的起伏影響很深，再加上家庭生活、經濟、照顧負荷的壓力，導致視障者與家人之間容易發生爭執、衝突。
2.家庭成員需配合視障者調整原來的生活模式，例如：習慣於用餐前先詢問視障者要吃哪些菜、外出時習慣引導視障者行走等。
3.在家庭角色部分，視障者由於視力因素無法繼續勝任原工作，通常由配偶擔任起家中主要經濟負擔者，直到視障者重建服務結束再就業時，視障者會重新扮演家中主要經濟來源者的角色。
4.致障初期，因為視障者對於自己感到自卑，及外出需要家人協助，使得家庭的社交生活逐漸封閉，原社會支持網絡解體；在經過重建後，視障者的自信心慢慢恢復，獨立自主能力提升，社會支持網絡才重新建構、恢復。
三、影響家庭系統變化之內、外部因素：
（一）內部因素
1.中途視障者如何適應視力退化後的生活，關係著整個家庭系統的變化；而視障者是否能順利接受重建服務，以家庭支持系統的影響最劇，家人們願意給予視障者情緒支持和鼓勵，有助於提升視障者接受重建服務的意願和動力。
2.子女處於學齡階段的家庭，在經濟負擔及生活照顧負荷的壓力較大，所以，當致障事件導致視障者失業，經濟負擔和照顧責任全部由視障者配偶承擔時，容易導致夫妻互動關係變差，間接地也影響了親子關係。
（二）外部因素
1.中途視障者家庭與外界社會環境互動時，接觸過程所產生的正、負面感受，影響著中途視障者家庭和他人建立關係、互動的意願。
2.中、南部視障服務資源分配不均和訊息不普及，且許多的專業人員對於視障者認識有限，使得視障者家庭尋求協助時困難度增加。
3.重建服務有助於中途視障者恢復原有的生活能力，減少家人的照顧負擔與壓力，更進一步地改善家人和視障者之間的互動關係。
4.在重建過程中，視障者得到同儕的同理與支持，有助於視障者接納自己的狀態，提升家庭與他人互動的意願。

關鍵字

中途視障者 ； 視障者 ； 家庭關係

並列摘要

This research aims to picture the life events happened to adventitious blindness families and also looks at the dynamics of family relations, pressure and its various impacts on families, especially when the adventitious blindness is happened to the middle-aged male breadwinner. The changes of family system and its internal and external factors on changes are also examined. Intensive interview is used as a method of data collecting on three families with adventitious blindness, in total 10 persons are interviewed, including men with visual impairments, their wives and children.

There are three main findings as below:
Firstly, the adventitious events bring pressure not only to the adults with visual impairments, but also to the other members of family as well as relatives. Especially, the impacts happened severely to the spouse and children living together with the adult who are visually impaired。

Secondly, the impacts of adventitious events on family system show differently in different stages:
1. In the initial stage, the up and down of emotional expression of the adults with visual impairments impacts the family members severely. Moreover, there are some issues between the life struggles, economical burden and caring burden, which may cause conflicts in their daily family life.
2. The members of family need to change their original lifestyle. For example, they need to learn, to inquire, and to take care of the adults with visual impairments, eg. what and how to eat a meal and to guild him when they go outside.
3. As for role adaption, when the adults lose their sight and they could not stay with his original job, their spouse sustain great responsibilities on economical burden. After completing rehabilitation services, the adults with visual impairments would hold an important position again.
4. In the initial stage, the adults who are visually impaired feel inferior to themselves and they need great support and practical help from family members, or their social life is dead. However, after rehabilitating, they regain self-confidence little by little, their self-independence reappear, as well as their social support network rebuild again.

Third, there are several internal and external impact factors on change of family system.
1. Internal impact factors
(1) How to cope with difficulties of visionless is related to the change of family system. Decision of accepting rehabilitation services or not depends on family support system. If family members give more emotional support and encouragement to the adults with visual impairments, it will promote inclination and motives of the adults who are visually impaired to accept the rehabilitation services.
(2) The economical and caring burdens are relatively heavy when the children are in the school age. When the adults lose their sight and are unemployed, their spouse sustain great responsibilities on economical and caring burdens. Finally, the relationship between husband and wife might become worse, and it will also have impact on parent-children relationship.
2. External impact factors
(1) Family needs to interact with other people, however, it is found that the positive and negative feeling of approach process will influence the capacity the person with visual impairments and their family to build relationship with other people.
(2) Service resources distribution is unbalanced and service information is lacked in the central and southern part of Taiwan. Most of professionals know little about the nature of client’s lives and it is difficult for the adventitious blindness family to search assistance.
(3) The rehabilitation services are designed to help the adventitious blindness to reach the original living standard, to release the caring burden of the family, and to improve the relationship between the family members and the adults who are visually impaired.
(4) During the rehabilitation course, the adults who are visually impaired might receive great support from peers and friends, which will help them to accept their own status, and to promote the family to interact with other people.

並列關鍵字

the adventitious blindness ； a person who is visually impaired / a person with visual impairments ； family relationship

參考文獻

林淑錦、白明奇（2006）。失智症病患主要照顧者的壓力－以家庭生態觀點論之。長期照護雜誌，10，412-425。

利翠珊（2005）。身心障礙兒童家庭中夫妻的壓力、付出與恩情。中華心理衛生學刊，18（2），25-54。

利翠珊（1999）。家庭心理學的系統觀點與研究。應用心理研究，2，21-40。

中文部分

內政部統計處（2009）。身心障礙者人數統計。Web address：http://www.moi.gov.tw/stat/