The thesis sought to explore the experience of caring for an individual with an eating disorder. It is comprised of three standalone papers. Paper one and two have been prepared for submission to a journal and in accordance with the journal guidelines. Paper one is a systematic literature review synthesising qualitative studies relating to the experience and impact of caring for, or living with an individual with an eating disorder. Databases were systematically searched and twenty studies were included in the review. Nine core themes emerged from the meta-synthesis. Eating disorders were found to have a pervasive impact on family members mediated by a number of factors. Cognitive appraisals affected the caregiving experience and responses to the individual. The experience of caregiving was continually reappraised leading to a process of adaptation over time. Paper two is a qualitative study which sought to examine caregivers’ accounts of managing Anorexia Nervosa with an emphasis on accommodation responses. Eight participants were interviewed and transcripts were analysed using a grounded theory approach. A theory of the processes by which accommodation responses operate was developed which emphasised the importance of caregivers’ emotional resources in mediating responses. Difficulty managing anorexia nervosa led to low perceived efficacy and diminished resources. Subsequently caregiving aims shifted in line with accommodation responses. Carers recognised accommodation as counterproductive to recovery and experienced internal conflict (dissonance) which was reduced using a number of cognitive and behavioural strategies. The clinical implications of the findings are discussed with reference to existing literature. Paper three is a critical review of the research process, focusing on the experience of undertaking qualitative research. Personal reflections of the process, as well as the implications of the research for the researcher’s professional practice and for the wider profession are discussed.

本論文之研究目的係為探究隔代教養祖父母承擔教養孫子女責任的原因，瞭解他們所執行的照顧項目與其扮演親職角色之經驗感受，並試圖發現可能會影響隔代教養祖父母之經驗感受的個人生命脈絡，促使社會工作者對隔代教養祖父母之生命經驗有更深入的瞭解，以作為未來擬定處置計畫及支持性福利措施或方案的參考。 本研究使用質性取向的研究方法，以半結構式的深度訪談進行資料蒐集，有效受訪對象共計15人，6名男性、9名女性，年齡介於51歲至81歲之間，平均照顧之（外）孫子女1至2人，照顧期程不等，從2年至15年均有，主要研究結果分述如下： 一、本研究之受訪者之所以承擔教養孫子女的責任，係：（1）為極小化家庭 整體照顧成本、換取自身所需酬賞而表現出之代間交換行為；（2）基於對其子女與孫子女的情感而承擔照顧之責；（3）因社會規範與文化價值所囿而將「照顧」視為家人或女性的本分。 二、隔代教養祖父母所執行之親職照顧項目大致包含：（1）照顧；（2）教與管；以及（3）情感性協助與保護等三項，且「隔代」與「身處中高齡」之特殊背景使這群承接（外）孫子女照顧之責的（外）祖父母需面對一些承擔照顧責任時的挑戰，包括：（1）需處理與中生代相關之事宜；（2）再學習照顧孫子女之相關技能：；（3）留在或重返勞動市場工作；以及（4）為死亡預做準備。 三、隔代教養祖父母在扮演其親職角色時，其經驗感受可分別由客觀與主觀負荷兩者進行呈現。首先，隔代教養（外）祖父母之客觀負荷包含：（1）照顧對祖父母之生活產生影響；（2）需因應（外）孫子女之挑戰性行為；（3）處理自身角色之轉變。再者，隔代教養祖父母之主觀負荷則包含：（1）喜悅、欣慰、陪伴等正面感受以及（2）無力、擔憂、憤怒等負面感受。 四、從受訪者之言詞分析可得，影響隔代教養祖父母之經驗感受的個人人生脈絡包括隔代教養家庭之家庭資源與家庭認知，其中，家庭資源係有：（1）照顧者個人資源與力量；（2）受照顧者之自我照顧能力、健康狀況與人數；（3）家庭互動狀況；（4）家庭整體資源與社會支持網絡；而家庭認知則指家庭集體或個別成員對隔代教養事件所賦予之意義。 根據本研究結果，研究者進一步討論發現：（1）隔代教養是私人問題和公共議題交互作用下之現象；（2）隔代教養祖父母係一群擁有獨特生命經驗的群體，其經驗感受異於傳統祖父母，且需從其整體生命歷程中之個人生命事件與所處人生脈絡來理解，但我國相較於美國係較缺乏以隔代教養祖父母為主要服務對象的組織或單位；（3）可支持隔代教養祖父母之社會資源應具備可近性、可負擔性與可接受性，並依結果分析提出對社工實務、政策與未來研究之建議。