配偶罹癌生活經驗的初探－以南部某醫院乳癌病友團體為例

罹癌和治療過程都會對病人及其配偶的生活造成衝擊與影響。本文探討當病人被診斷證實罹患乳癌後，病人及其配偶如何面對罹癌的事實、因應治療過程的挑戰、親密關係有何變化，以及對其生活有何影響。由於國內過去有關罹患乳癌調適的研究，傳統上常以病人個人壓力和調適經驗為分析焦點，少把夫妻看為單一分析單位，同時針對夫妻雙方進行雙人調適罹癌經驗的探究。本研究採用質性研究方法，以立意取樣招募5對乳癌病人夫妻，透過半結構訪談方式進行個別訪談。研究發現在罹癌確診階段，夫妻都有強烈的負面情緒反應；夫妻面對治療的過程，病人受到社會文化因素影響，擔心治療過程身體形象改變，失去性別認同的器官；而配偶不受社會文化因素的影響，重視病人生命過於外觀的改變。病人因配偶的接納而克服自我認同的危機。在親密關係方面，因乳癌治療影響性行為，夫妻改變表達親密關係的方式。乳癌病人及配偶藉由參與病友團體來重建生活秩序，從疾病經驗分享的助人過程，找到罹癌後的生命價值與意義。本研究建議醫務社工人員提供乳癌病人關懷服務時，亦需要關心配偶照顧負荷和其身、心與社會需求；透過舉辦病友團體，作為乳癌病人及配偶疾病經驗交流和社會支持的資源。

關鍵字

乳癌；配偶照顧者；潛在案主；腫瘤社會工作

並列摘要

Cancer and its treatment have a profound effect on the lives of patients and their partners. This article explores patients that have been diagnosed with breast cancer. It investigates, in particular, how they and their partners confront and adjust to cancer, including the challenges of treatment, the changes in marital intimacy, and the impact of all this on their lives more generally. Previous academic research regarding breast cancer has been significant with regards to patients' adjustment and their personal experiences in reference to stressors. However, these studies rarely take couples as a single unit for analysis. It is this research gap that this study attempts at fulfilling. Encountering the cancer battle, both patients and their partners suffer from physical, mental, and social stressors and life challenges. Therefore, our study adopted a qualitative research method. We recruited five couples of patients with breast cancer using purposive sampling and conducted semi-structured interviews with these individuals. Studies found that the participants showed adverse solid emotional reactions during the course of their cancer diagnosis. In addition, the patients' perceptions of change regarding their body image were affected by the social culture in their respective society. The patients worried about the changes in their body image during the treatment process and the loss of organs related to gender identity. Yet, relatively speaking, the partners were less affected by this social culture. Instead, they were more concerned with the patients' lives rather than their appearance. Accordingly, the patients overcame the crisis of self-identity with the acceptance from their partners. In terms of material intimacy-since breast cancer treatment results always affect sexual behavior-the couples changed the way they expressed intimacy. Patients with breast cancer and their partners reset their lives by participating in mutual-help patient groups and by finding the value and meaning of life after cancer from sharing different disease experiences. The study thereby suggests that medical social workers need increased consideration when providing support to patients with breast cancer and their partners. The mutual-help patient groups then serve as a resource for patients with breast cancer and their partners to exchange disease experiences and social support. Thus, it is suitable for the patients and their partners to participate in mutual-help patient groups.