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年輕思覺失調症患者及其主要照顧者主體經驗探究:關係取向觀點 / Exploring the Subjective Experiences in Young Schizophrenic Patients and Their Caregivers: From Relational Approach

本研究之目的:一為探究年輕思覺失調症患者,於荒野臨界中如何形塑其此際體態;二為探討患者主要照顧者面對精神分裂體驗,從何接應患者,如何賦予其心理照顧意義。而後,以對元結構方式,探討患者及其照顧者雙方的心理經驗。研究者將患者「生命經驗」及其主要照顧者「照顧經驗」並置於現象場脈絡中,透過深度訪談,進行現象還原,以接近患者的內在經驗,反思照顧者照顧行動意義。方法上,本研究採取立意抽樣,以年輕思覺失調症患者與其主要照顧者作為研究對象,以配對方式進行資料蒐集,共三對受訪者(6位)接受訪談,患者部分為三位男性,而雙親照顧者部分為一位男性、兩位女性。資料蒐集後,以Henri Ellenberger之現象學分析方法(林耀盛,2002)分析。研究結果發現,年輕思覺失調症患者與其雙親主要照顧者共構之置身結構經驗的定向軌跡為:(1)超常隱匿於日常偽裝之下;(2)超常現身,即特異性經驗被看見,包含病者與雙親照顧者;(3)芻思心緒,反覆思索當前之事件;(4)經驗賦義,理解所發生的事,並給出位置,將其涵容於自我之中;(5)存有的流變:希望與憂懼心思。研究貢獻為在臨床心理實務上可能的幫助:可協助狀態逐漸穩定之個案進行經驗之整理,使其看見自己的狀態,而非僅僅使其擁有病識感、願意配合醫療處遇。而對雙親做為主要照顧者,可協助其釐清對於疾病狀態的未知,及自我照顧技藝的發展。礙於現實收案狀況,難以擴大取樣具異質性的思覺失調症患者,資料豐富度較為不足,為未來研究可改善之處。 / Purpose: This study is exploring (1) how the young schizophrenic patient perceived who he/she is in “the wilderness”; (2) how their caregivers faced with the schizophrenic experiences and constructed the meaning of caring; and (3) disclosing the patients and their caregiver’s mutual situated experiences by the meta-dyadic structure.
Methods: Taking a qualitative approach grounded in phenomenological psychology, this study conducted in-depth interviews by which researchers strived to observe, analyze and understand, from their first-person perspective, how they live under such situation. The participants were recruited through purposive sampling. Three patient-caregiver dyads (three male schizophrenic patients with one male and two female caregivers) were interviewed. The analysis step is adopted by Henri Ellenberger’s existential-phenomenological method (Yaw-Sheng Lin, 2002).
Results: Five over-arching themes emerged in the analysis on the transformation of experiences of suffering and caring. (1) Camouflaging the “extra-normal” in daily life. (2) “Extra-normal” is understood through the singularity in the daily life, including the patient and caregiver can “encounter” the unique experience. (3) Ruminative reflection about what happening? (4) Make sense of schizophrenic experiences through blurry the boundary between the normal and abnormal to integrate self into life orientation. (5) Existential experience as becoming process through the state of mind of “hope” and “Angst”.
Conclusions: The outcome is implicated in clinical practice: (1) Return to young schizophrenic patients’ lifeworld beyond psychopathology comprehension to articulate the intersubjective understanding relationships. (2) Help caregiver to understand their uncanny situation and cultivate the caring ethics for self and the other. Limitation, future research agenda and suggestion are discussed and proposed.

Identiferoai:union.ndltd.org:CHENGCHI/G1017520071
Creators林孟瑤, Lin, Meng Yao
Publisher國立政治大學
Source SetsNational Chengchi University Libraries
Language中文
Detected LanguageEnglish
Typetext
RightsCopyright © nccu library on behalf of the copyright holders

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