published_or_final_version / Social Work / Master / Master of Social Work

本研究旨在探索香港夫婦根據他們的社會文化背景對自己在婚姻中所遇到性功能障礙的經驗詮釋和主觀視角。當生理性觀點支配我們理解整全的性行為或性經驗時，這種看法甚至於遮蔽我們在個人、關係和社會心理的向度上所表達與「性」方面有關的活動，亦逐漸令性治療的專業範疇顯得不能完善地對應需要而失效，或許更相信有效的治療方法在於去除生理醫學上的病徵，回復正常的性功能；但是，這樣未必有助於改善性生活的質素和箇中關係。因此，本研究嘗試透過被評估有性功能障礙的夫婦，去檢視他們對有關婚姻經驗的詮釋，就此探討性功能障礙在婚姻境況中的意義和重要性。本專題論文會特別考究臨床社會工作在更闊的社會文化脈絡中，要怎樣理解配偶在婚姻經驗中的詮釋，藉以拓展擴大我們對性功能障礙的現象及其呈現的選擇和可能性的理解與考察，從中由病原學的探究轉向去理解性功能障礙在具體境域中所呈現的意義和重要性。 / 本研究採用了解釋主義研究範式的取向，並著重描述性現象學和哲學詮釋學的原則，致力於人與人關係方面的知識和解構配偶在社會文化中所生成的文本。解釋主義者相信人類行為的多樣性、差異性和複雜性；而描述性現象學和哲學詮釋學的原則便提供了知識建構上的策略和理解經驗意義的四個探索向度：理解的脈絡、時間性、自我或身體的理解及與他人的關係。這亦引申到是次質性研究所涉及的概念框架預設。在研究的設計中，應用了深入面談的方式進行：八位被評估有性功能障礙的配偶及他們在異性戀婚姻中的伴侶，同意參與是次研究，詳細描述了他們在婚姻中的有關經驗和性功能障礙在婚姻中的意義及重要性。 / 研究顯示，夫婦們所描述的故事內容包括具體的婚姻生活、在婚姻中所經驗的性功能障礙和有關性功能障礙的意義及重要性的詮釋。綜合概觀八個故事，有七個重要的主題呈現出來：第一、同樣有性功能障礙的夫婦卻在婚姻關係及滿足感上各有差異；第二、夫婦都以互為主觀的看法和透過關係中的互動去描述性功能障礙的獨特意義及其重要性；第三、配偶們沒有在詮釋性功能障礙的病徵上採取生理學的看法，他們反而按社會經濟方面的理解脈絡 (例如：工作壓力、長工時、家庭財政負擔或樓房按揭)、關係上的脈絡 (例如：婚姻關係、配偶間之互動和親友的關係)、時間性的脈絡 (例如：生育的計劃、過往沮喪的經驗和有關的聯想) 去描述自身性生活的困難，較只以純粹生理性的假設更多、更複雜；第四、他們在詮釋性功能障礙的經驗中，都埋下了結構性的時間觀念，或在時間的境域上同時伸展就過去、現在和未來的意識，從而由性交生活的範圍越出到非性交生活的範圍作一連繫，這可與直線的時間觀作一比對；第五、配偶們通常會以他們的生育計劃去解釋性功能障礙在婚姻中的意義和重要性；第六、忙碌的生活或絶少空閒的生活境況往往是夫婦在家庭和社會經濟範疇上的顯著特徵；第七、除性交以外，配偶們經歷和探索了其他可以令夫婦關係和性生活滿足的選擇，例如自慰、愛撫、擁抱、親吻或甜言蜜語。 / 有關本研究的主要成果，它採取了描述性現象學和哲學詮釋學的原則作為質性研究的取向，並以此為基礎邁向一種集合生理、心理及社會性的理解樣式，有助探索關於性功能障礙在婚姻中所呈現的經驗意義，越過並擴展純粹生理學及病原學的觀點，協助建立社會工作就這方面的明確介入方向，為綜合完備的臨床實務作一基礎。此外，更對單一地了解性功能障礙在婚姻中的意義，而忽略它的多樣性現象，作一意識形態上的批判。 / This research aimed at exploring the insiders’ perspectives of the couples towards sexual dysfunctions in marriage according to their own interpretation in the socio-cultural context of Hong Kong. While the biological aspects comprise an integral part of our understanding of sexuality, it has been developing to conceal our views of the individual, relational and psychosocial dimensions of sexual expression that may eventually prove stultifying to the professional field of sex therapy. It may be increasingly effective at removing biomedical symptoms to normal sexual functioning albeit contributing little else to the improvement of sexual life quality and relations. Thus, this research attempted to investigate the marital experience of spouses, who had been assessed with sexual dysfunctions, through their interpretation, whereas the significance of sexual dysfunctions was investigated at dyadic level in marital context. Interpretation of experience in marriage for the spouses of the present study was specific to clinical social work in a wider socio-cultural context. It drove us to expand the horizon of understanding and investigation towards the phenomenon of sexual dysfunction with the concern of human alternatives or possibilities, veering round from etiology to understanding of human significance of sexual dysfunctions in contexts. / This study adopted the interpretive research paradigm with emphasis of the principles of descriptive phenomenology and philosophical hermeneutics for attention to the relational aspects of knowledge and the deconstruction of socio-cultural texts of the spouses. Interpretivists believed in multiplicity, diversity and complexity of human behavior, whereas the principles of descriptive phenomenology and philosophical hermeneutics furnished epistemological strategies for searching of meanings of the experiences in the dimensions of space (perceived context), time, self (body) and relations (others) that articulated a conceptual framework for pre-understanding of this qualitative inquiry. In this qualitative study employed with in-depth interviews, eight spouses assessed with sexual dysfunctions and their partners in heterosexual marriage had been recruited to provide personal accounts of their marital experience and perceived significance of sexual dysfunctions in marriage. / As results of the study, the stories of the couples showed through their marital life, experience of sexual dysfunctions and perceived significance of sexual dysfunction in marriage. Having examined across the eight cases, seven major themes arose from their interpretations: (a) there were diversified marital relationship and satisfaction for the spouses who had the experience of sexual dysfunctions in marriage; (b) the unique meaning and importance of sexual dysfunction in marriage was described upon the inter-subjective views of the couples through interactive perceptions; (c) the spouses did not adopt a physiological view towards the symptoms of the sexual dysfunctions or rather they interpreted their experience of sexual difficulties in light of socio-economic context (e.g., work stress, long work hour, burden of household finance, mortgage), relational context (e.g., relationship of marriage, interaction with spouse and relationship with friends) and temporal context (e.g., birth plan, past dreary experience and the related association), more than biological given; (d) they interpreted the experience of sexual dysfunction embedded with structural time or in a horizon of temporality stretching through past, present and future, from the sphere of coitus to the sphere beyond coitus that juxtaposed with the linear time concept; (e) the spouses usually interpreted the significance of sexual dysfunction in view of their plan of reproduction; (f) stress arisen from busy life and occupied living condition in household and socio-economic context was a prominent feature of their marital life; (g) the spouses sought alternatives for sexual and relational satisfaction apart from coitus, e.g. masturbation, caress, hug, kiss or sweet words. / For the implications of the study, it had been working towards a bio-psycho-social model with adoption of the principles of descriptive phenomenology and philosophical hermeneutics searching for meaning of the experience that surmounted physiological and etiological views of sexual dysfunctions in marriage, and shed light on social work intervention for sexual dysfunction, especially for sake of a substratum of clinical integrative practice. It also made an ideological critique on uni-mode of understanding against the sexual dysfunctions in marriage without consideration of its multifaceted phenomena. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Kwan, Ka Wing. / Thesis (Ph.D.) Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 485-537). / Abstracts also in Chinese.

Submitted by Biblioteca Central (biblioteca@unicap.br) on 2018-11-27T18:30:13Z No. of bitstreams: 2 gilclecia_oliveira_lourenço.pdf: 1198962 bytes, checksum: 14772057f1bac3dfe959da10a95f37e7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-11-27T18:30:13Z (GMT). No. of bitstreams: 2 gilclecia_oliveira_lourenço.pdf: 1198962 bytes, checksum: 14772057f1bac3dfe959da10a95f37e7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-04-04 / This study planned to understand the conjugality experience of people with mixed HIV status for HIV/AIDS. It is very important to expand knowledge of sexual-affective relational possibilities affected by the contamination with HIV/AIDS to reflect about intake practices that consider the context and demands of people living with this virus. In this sense, this study is categorized as a qualitative research in which 16 individuals were separately interviewed, 05 of them were HIV-negative and the remaining 11 were HIV-positive, all in serodiscordant relationships. In addition to the semi-structured interview, we also used a Field Journal where several experiences, observations and reflections built along the process of data production were recorded. As an analytical strategy, we used the discursive analysis inspired on Foucault. Reports of the interviewees point to a conjugality experience marked by stigmas, prejudices and conflicts on the understanding of the virus in the lives of the couples and an ongoing surveillance in their daily lives. In serodiscordant couples, sexual relations affected by discourses of risk and prevention, are experienced with fear, doubt and insecurity. Moreover, we noticed that HIV infection comprises tensions and experiences in the dynamics of the couples that cannot be reduced to aspects of sexuality, prevention and risk. The experience of serodiscordant conjugality has complex effects on the couples’ daily lives and involves the development of different strategies required for the construction and/or maintenance of the sexual-affective relationship. It is concluded that the AIDS discourse acts on the individual, producing means to relate, be a couple and be serodiscordant, in a subjectivation process determined by political, regulatory and cultural strategies. However, the experience of serodiscordant conjugality is defined as a complex phenomenon that cannot be explained by causal and simplistic explanations. The individual presented here is active in its subjectivation process, creating means of resistance and subversion that emphasize the disciplinary power of the AIDS discourse. / Este trabalho objetivou compreender a experiência de conjugalidade de pessoas que vivem em situação de sorodiscordância para HIV/aids. Aprofundar o entendimento das possibilidades relacionais afetivas e sexuais atravessadas pelo acometimento do HIV/aids é de fundamental relevância para se pensar práticas de acolhimento que levem em consideração o contexto e as demandas das pessoas que (con)vivem com o vírus. Neste sentido, este estudo se caracteriza como uma pesquisa de natureza qualitativa em que foram entrevistadas, individualmente, dezesseis pessoas, sendo cinco participantes com sorologia negativa e outras onze pessoas soropositivas para HIV, todas em relacionamentos sorodiscordantes. Além da entrevista semidirigida, também fizemos uso de um Diário de Campo, em que foram registradas diversas vivências, observações e reflexões construídas ao longo do processo de produção dos dados. Como estratégia de análise, lançamos mão da analítica discursiva de inspiração foucaultiana. As narrativas dos sujeitos entrevistados apontam para uma experiência de conjugalidade marcada por estigmas, preconceito e conflitos sobre o entendimento da entrada do vírus na vida a dois e uma constante vigilância sobre o cotidiano. Nas díades sorodiscordantes, as práticas sexuais, atravessadas pelos discursos de risco e prevenção, são vivenciadas com medo, dúvida e insegurança. Além disso, percebemos que o acometimento pelo HIV compreende tensões e vivências na dinâmica do par, que não podem ser reduzidas aos aspectos da sexualidade, prevenção e risco. A vivência da conjugalidade sorodiscordante tem efeitos sobre o cotidiano do casal na sua mais diversa complexidade e comporta a organização de diferentes estratégias necessária à construção e/ou manutenção do relacionamento afetivo-sexual. Conclui-se que, o discurso da aids atua sobre os sujeitos, produzindo modos de se relacionar, de ser casal, de ser sorodiscordante, num processo de subjetivação agenciado por estratégias políticas, normativas e culturais. No entanto, a experiência de conjugalidade sorodiscordante se caracteriza como um fenômeno complexo e não passível de explicações causais e simplórias. O sujeito que aqui se apresenta é ativo no seu processo de subjetivação, produzindo modos de resistência e de subversão que tencionam o poder disciplinador do discurso da aids.

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Bibliography: leaves 235-261 / Queer studies have not adequately considered gay men seeking sexual exclusivity within longterm relationships. In contrast, the emphasis has been on understanding evolving queer norms. Homonormativity has been informing sexual permissiveness. In accordance, and contrasting gay men seeking sexual exclusivity, gay, male couples tended to use relationship agreements to stipulate guidelines for extradyadic sex. This study was inspired by my inability—as a counsellor of gay men seeking sexual exclusivity—to provide them with credible insights to better understand their goals. Representing an initial step in generating practical knowledge, it was anticipated that my counselling clients could benefit from an exploration of lived experiences rather than having to rely on theoretical inferences and opinions. “How” and “why” participants maintained sexual exclusivity were the main targets of discovery. Eleven gay, Canadian men aged thirty-three and older, in relationships of five years or longer, participated in semistructured interviews in-person or via video chat. Using Kleiman’s (2004) protocol for phenomenological analysis, common units of meaning were coded, from interview responses, so that distinct subthemes, contributing to six themes, were identified. These findings included content concerning “seeking positive affects,” “avoiding negative affects,” “factors supporting sexual exclusivity,” “threats to sexual exclusivity,” “rigidity in beliefs,” and “decision-making toward sexual exclusivity.” The first two themes integrated innately to form a meta-theme, “emotional optimization.” An essential insight into how participants maintained sexual exclusivity was their awareness of, and restraint in using, sexually tantalizing, visual stimuli, which was the primary risk to sexual exclusivity. Suggestions for gay men desiring sexual exclusivity included discontinued utility of pornography and cybersex. Varied implications for prospective research, clinical practice and support groups were delineated. / Psychology / D. Phil. (Psychology)