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| Title: | 年輕乳癌患者的人我處境與未來感： 心理經驗轉化現象探討
Exploring the transformative felt experiences of interpersonal situatedness and future temporality of young breast cancer patients: The phenomenological psychology approach |
| Authors: | 楊子慧
Yang, Tzu Hui |
| Contributors: | 林耀盛
Lin, Yaw Sheng
楊子慧
Yang, Tzu Hui |
| Keywords: | 乳癌
創傷後成長
現象學心理學
breast cancer
posttraumatic growth
phenomenological psychology |
| Date: | 2017 |
| Issue Date: | 2017-02-08 16:40:51 (UTC+8) |
| Abstract: | 目的：本研究探討乳癌患者從受苦到經驗正向改變的轉化，以王韋婷（2014）研究為基礎進行探討。該研究於術後一日、三個月、六個月與一年，追蹤測量乳癌患者的創傷後成長（PTG），並依量表分數變化將參與者分為四種軌跡發展組別，分別為高穩定組、中間組、上升組與下降組。本研究以訪談方式進行後續追蹤。
方法：研究採取雙盲設計，抽取王韋婷（2014）研究參與者樣本，共有五位參與者，平均罹癌年齡35.6歲，接受單次訪談。資料分析以現象學心理學方法進行，並對應其受創傷成長發展軌跡組別（分別為高穩定組三位、中間組兩位），進行討論。
結果與討論：研究結果發現，參與者的主題置身結構包括：「癌症療程是溢出常態的受苦經驗」、「受苦經驗中的照顧倫理行動」、「反求諸己的受苦意涵」、「在世牽掛的流變」，並由此帶出「生活是日常與非日常的背景-前景辯證歷程」。本研究顯示PTG高穩定組的參與者，從焦慮過渡到操煩，朝向生活世界的歷程，是打開此在與生活世界、社會的交往。PTG中間組的兩位參與者，試圖領會身體限制的存在意義，仍在尋求身體的安居。只有身體的返家意識，在安居中獲得熟悉感，才能夠出發朝向世界，因此在未來的時間流變中，仍有持續邁向成長的可能性。
結論：PTG高維持組受訪者以釋放控制，帶出了「朝死而生」的本真活動，是「在己生命」開展了生活世界。PTG中間組以固守控制，將現今未能解除的困境寄望未來，是他人束縛下求全的「為己生命」。最後，提出研究限制與未來研究建議。
Objectives: The study aims to explore how the young breast cancer survivors perceived psychological growth since operation treatment, focusing on their transformative experiences of interpersonal situatedness and sense of future temporality.
Methods: Based on the dissertation by Wang (2014), the participants are recruited from Wang’s research the subjects were divided into four groups (stable high, middle stable, low increasing, and sharp decreasing) by the patterns of their posttraumatic growth(PTG) scores assessed at 1day, 3, 6, 12 months after surgery. There are five participants whose mean age 35.6 at diagnosis were interviewed and data transcribed, and analyzed by phenomenological psychology approach.
Results: Four themes emerged from the data analysis, including: (1) Enduring suffering out of daily order under cancer treatment. (2) Ethical act to care for suffering experiencing. (3) Meaning transformation of the suffering. (4) Different solicitude modes of being-in-the-world. Participants belonging to stable high group turn their state of mind from anxiety (Angst) into care (Sorge), facing the life situation and engage in life world. Participants belonging to middle stable group try to realize existential meaning and the sense of uncanny body, seeking for the dwelling of the habitual body. The ill life is an unhomelike being-in-the-world in which the lived body, the central vehicle of this being-in of Da-sein, takes on alien and uncanny qualities. Health, in contrast to this frustrating unhomelikeness, is a homelike being-in-the-world in which the lived body in most cases has a transparent quality as the point of access to the world in understanding activities.
Conclusion: Participants belonging to stable high group carry on limited lifetime and take authentic mode of being toward death, illustrating ‘being-in-itself’, and the experience of illness underlines our homeless predicament, but it can also serve as a springboard to addressing and living with existential uncertainty in a more authentic way. Participants belonging to middle stable group hold on limited lifetime and take future temporality as a hope to leave the predicament, illustrating ‘being-for-itself’, and it projects the possibilities of the future, on the basis of the care pattern of meaning constituting its past, as a means of constructing its present. In Heidegger’s words, ‘‘The totality of being of Dasein as care means: ahead-of-itself-already-being-in (a world) as being-together-with beings encountered in the world”. The outcome implication and further research agenda are discussed. |
| Reference: | 王韋婷（2014）。乳癌患者創傷後成長與心理適應的關係之長期追蹤研究─異質性發展軌跡與調節因子的探討。政治大學心理學研究所博士論文，台北市。
台北市：衛生福利部國民健康署（2016）。取自：
http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=201312230001&parentid=200712250033
台北市：財團法人全民健康基金會（2016）。取自：
http://www.twhealth.org.tw/index.php?option=com_zoo&task=item&item_id=187&Itemid=21
石世明（譯）（2004）。病床邊的溫柔（原作者：van den Berg, J. H.）。台北：心靈工坊。
朱紅文、李捷（譯）（2009）。時間社會學（原作者：Hassard, J.）。北京：北京師範大學。
李維倫 （2004）。 以置身所在做為心理研究的目標現象及其相關之方法論。應用心理研究， 22，頁 157-200。
李維倫（譯）（2004）。現象學十四講（原作者：Sokolowski, R）。台北：心靈工坊。
李維倫（2016）。從實證心理學到實踐心理學：現象學心理學的本土化知識之道。台灣心理諮商季刊，8（2），頁1-15。
李維倫、賴憶嫺（2009）。現象學方法論：存在行動的投入 。中華輔導與諮商學報，25，頁275-321。
汪文聖（2001a）。醫護倫理之存有論基礎初探－從海德格走向優納斯。哲學雜誌，37，頁4-34。
汪文聖（2001b）。精神病患之照顧存在性的現象學探討。國立政治大學哲學學報，7，頁269-306。
汪文聖（2016）。從「原初理性」生成「原初語言」來談文化的再造─從海德格早期的討論出發來看。哲學與文化，43（7），頁5-25。
吳秋玉（2008）。意外的旅程：初診斷乳癌病患之時間經驗。高雄醫學大學護理學研究所，高雄市。
吳麗敏、金繼春 （2007）。 從文化面走入癌症兒童父母的疾病思維。腫瘤護理雜誌， 7（1），頁 21-29。
余德慧、李宗燁（2002）。生命史學。台北：心靈工坊。
林俐君（2005）。未婚女性乳癌患者復原歷程之探討。東海大學社會工作系碩士論文，台中市。
林雅慧、蘇靜嫻 （2011）。 乳癌術後經產婦面臨安胎失敗之護理經驗。助產雜誌， 53，頁 72-79。
林耀盛 （2006）。 慢性病心理社會模式之探討：以癌症為例。臨床心理學刊，3（2），頁 56-67。
林耀盛 （2009）。 逆向呈現與過度呈現之間：慢性病患者的身心受苦經驗。生死學研究， 9，頁 1-43。
林耀盛 （2016）。實證論陰影及其超越：迂迴或直面。台灣心理諮商季刊，8（2），頁36-43。
林耀盛、李弘毅（2016）。朝向疾病的療癒：血液透析者心理經驗之詮釋。本土心理學研究，45，頁129-174。
林耀盛、胡至家 （2010）。 內在與外緣間異質身體：詮釋乳癌第一、二期存活者之心理經驗現象。中華心理衛生學刊， 23（2），頁 305-335。
林耀盛、胡至家 （2011）。乳癌術後婦女身體意象衡鑑量表之研發。臨床心理學刊， 5（2），頁 37-46。
林耀盛、胡至家、張娟鳳 （2009）。憂鬱傾向和親密關係對乳癌術後婦女身體意象影響之相關探討。高雄行為科學學刊， 1（1），頁 25-39。
林耀盛、陳玫蓉 （2009）。「和而不同」的生病事件建構：以對偶關係探究腸造口癌症患者及其照顧者的心理生活經驗。本土心理學研究， 32，頁 251-325。
林耀盛、蔡逸鈴（2012）。不可承受之重：癌末主要照顧者的心思經驗探究。國立政治大學教育與心理研究，35（3），頁37-66。
林耀盛、羅愔愔 （2010）。 患者與照顧者間照顧覺知落差對雙方心理與生活適應之影響：以婦癌病患為例。中華輔導與諮商學報， 27，頁 161-197。
涂佩瓊（2013）。初診斷乳癌患者的心理沮喪發展軌跡與資源變化、因應風格之關係探討。政治大學心理學研究所博士論文，台北市。
張純純、陳月枝、胡文郁、楊志新 （2011）。罹癌母親親子互動之經驗歷程。安寧療護雜誌， 16（3），頁 326-337。
郭雅君，楊雅婷（譯）（2002）。乳房聖經（原作者：Love, S.&Lindsey K.）台灣：天下生活。
陳清香（2003）。疑似乳癌婦女未確立診斷前之心理狀態與照護需求初探。台北醫學大學護理學研究所，台北市。
許禮安（2005）。病情世界的多重現象分析。東華大學族群關係與文化研究所碩士論文，花蓮縣。
程巍（譯）（2012）。疾病的隱喻（原作者：Susan Sontag）台北：麥田。
馬雨沛（2001）與癌症共舞─３２歲的馬雨沛對抗乳癌歷程。台北：原水。
楊婉萍、趙可式、龔卓軍、賴維淑 （2012）。 癌症病人生病經驗之時間性議題。應用心理研究， 54，頁 53-73。
楊婉儀（2016）。過度與開端─從萊維納斯觀點探問《存在與時間》之此在與存有論意涵。哲學與文化，43（7），頁65-82。
劉千美（譯）（1988）。自我實現與人格成熟（原作者：Maslow, A. H.）。台北：光啟。
劉嘉雯、魯宓（譯）（2007）。道德的重量：不安年代的希望與救贖。（原作者：Kleinman, A.）。台北：心靈工坊。
鄧旗明（2003）。雙峰患者生命意義之探討。南華大學生死學研究所，嘉義縣。
蘇英華、黃美智、駱麗華、張財旺 （2009）。父母罹患癌症對其學齡期子女的衝擊：成功大學新進教師專題研究計劃成果報告。
譚家瑜（譯）（2001）：醫院裡的哲學家（原作者：Zaner, R.M.）。台北：心靈工坊。
龔卓軍 （2003）。生病詮釋現象學：從生病經驗的詮釋到醫病關係的倫理基礎。生死學研究， 1，頁 57-75。
Adams, E., McCann, L., Armes, J., Richardson, A., Stark, D., Watson, E., & Hubbard, G. (2011). The experiences, needs and concerns of younger women with breast cancer: a meta-ethnography. Psychooncology, 20(8), 851-861. doi: 10.1002/pon.1792
Aldwin, C. M., & Levenson, M. R. (2004). Posttraumatic growth : A developmental perspective. Psychological Inquiry, 15(1), 19-21.
Allen, J. D., Savadatti, S., & Levy, A. G. (2009). The transition from breast cancer `patient` to `survivor`. Psychooncology, 18(1), 71-78. doi: 10.1002/pon.1380
Aujoulat, I., Marcolongo, R., Bonadiman, L., & Deccache, A. (2008). Reconsidering patient empowerment in chronic illness: A critique of models of self-efficacy and bodily control. Social Science and Medicine, 66, 1228-1239.
Bonanno, G. A. (2004). Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? Am Psychol, 59(1), 20-28. doi: 10.1037/0003-066X.59.1.20
Bouknight, R. R., Bradley, C. J., & Luo, Z. (2006). Correlates of return to work for breast cancer survivors. Journal of Clinical Oncology, 24(3), 345-353. doi: 10.1200/JCO.2004.00.4929
Brunet, J., McDonough, M. H., Hadd, V., Crocker, P. R., & Sabiston, C. M. (2010). The Posttraumatic Growth Inventory: An examination of the factor structure and invariance among breast cancer survivors. Psycho‐Oncology, 19(8), 830-838.
Caruth, C. (1996). Unclaimed Experience: Trauma, Narrative and History. Maryland: Johns Hopkins University Press.
Carver, C. S., Pozo-Kaderman, C., Price, A. A., Noriega, V., Harris, S. D., Derhagopian, R. P. R., D. S., & Moffatt, F. L. (1998). Concern about aspects of body image and adjustment to early stage breast cancer. psychosomatic medicine, 60(2), 168-174.
Cohen, M. Z., Kahn, D. L., & Steeves, R. H. (2000). Hermeneutic phenomenological research: A practical guide for nurse researchers. CA: Sage: Thousand Oaks.
Danhauer, S. C., Case, L. D., Tedeschi, R., Russell, G., Vishnevsky, T., Triplett, K., . . . Avis, N. E. (2013). Predictors of posttraumatic growth in women with breast cancer. Psycho-Oncology, 22(12), 2676–2683. doi:10.1002/pon.3298
Deleuze, Gilles & Felix Guattari (1987). A Thousand Plateaus: Capitalism and Schizophrenia (trans. Brian Massumi). Minneapolis: University of Minnesota Press.
Ehrenreich, B. (2009). Smile or die. How positive thinking fooled America & the world. London: Granta Publications.
Fernandes-Taylor, S., & Bloom, J. R. (2011). Post-treatment regret among young breast cancer survivors. Psychooncology, 20(5), 506-516. doi: 10.1002/pon.1749
Fobair, P., Stewart, S. L., Chang, S., D`Onofrio, C., Banks, P. J., & Bloom, J. R. (2006). Body image and sexual problems in young women with breast cancer. Psychooncology, 15(7), 579-594. doi: 10.1002/pon.991
Frank, A. W.(1995). The wounded storyteller: Body, illness, and ethics. Chicago and London: The University of Chicago.
Heidegger, M. (1990). Being and time (J. Macquarrie & E. Robinson, Trans.). Blackwell: Oxford.
Helgeson, V. S., Snyder, P., & Seltman, H. (2004). Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Health Psychol, 23(1), 3-15. doi: 10.1037/0278-6133.23.1.3
Ives, A., Saunders, C., Bulsara, M., & Semmens, J. (2007). Pregnancy after breast cancer: population based study. British Medical Journal, 334(7586), 194. doi: 10.1136/bmj.39035.667176.55
Janoff-Bulman, R.(1992) Shattered assumptions: Towards a new psychology of trauma. New York: Free Press.
Jordan. H. (2000) No Such things as a bad day. Atlanta, GA: Longstreet.
Joseph, S., & Linley, P. A. (2006). Positive adjustment to threatening events: An organismic valuing theory of growth through adversity. Review of General Psychology, 9(3), 262-280.
Kavanagh, A. M., & Broom, D. H.(1998)Embodied risk: My body, myself ? Social Science and Medicine, 46(3),437-444.
Kagawa-Singer, M. (1993) Redefining health: living with cancer. Soc. Sci. Med. 37, 295–304.
Kelly, M. P. & Field, D.(1996). Medical sociology, chronic illness and the body. Sociology of Health and Illness,18(2),241-257.
Kennedy, F., Haslam, C., Munir, F., & Pryce, J. (2007). Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer. European Journal of Cancer Care, 16, 17-25.
Kleinman, A. (1980). Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry (Vol. 3). Univ of California Press.
Kleinman, A. & Kleinman, J.(1991) Suffering and its professional transformation. Culture, Medicine and Psychiatry, 15(3), 275-301.
Knobf, M. T. (2011). Clinical update: psychosocial responses in breast cancer survivors. Semin Oncol Nurs, 27(3), e1-e14. doi: 10.1016/j.soncn.2011.05.001
Lam, W. W., Bonanno, G. A., Mancini, A. D., Ho, S., Chan, M., Hung, W. K., . . . Fielding, R. (2010). Trajectories of psychological distress among Chinese women diagnosed with breast cancer. Psychooncology, 19(10), 1044-1051. doi: 10.1002/pon.1658
Lebel, S., Rosberger, Z., Edgar, L., & Devins, G. M. (2007). Comparison of four common stressors across the breast cancer trajectory. J Psychosom Res, 63(3), 225-232. doi: 10.1016/j.jpsychores.2007.02.002
Leder, D. (1990). The absent body. Chicago: University of Chicago Press.
Martin, L. L.,& Tesser, A. (1996) Clarifying our thoughts. In R. S. Wyer (Ed.). Ruminative thoughts: Advances in social cognition (Vol.9, pp.189-209) Mahwah, NJ: Lawrence Erlbaum Associate, Inc.
Maslow, A. H. (1968) Toward a psychology of being. New York : Van Nostrand.
Maunsell, E., Brisson, C., Dubois, L., Lauzier, S., & Fraser, A. (1999). Work problems after breast cancer: An exploratory qualitative study. Psychooncology, 8, 467-473.
Mols, F., Vingerhoets, A. J., Coebergh, J. W. W., & van de Poll-Franse, L. V. (2009). Well-being, posttraumatic growth and benefit finding in long-term breast cancer survivors. Psychology and Health, 24(5), 583-595.
Morse, J. M. (2001). Toward a praxis theory of suffering. Advances in Nursing Science, 24(1), 47-59.
Nolen-Hoeksema, S., & Davis, C. G. (2004). Theoretical and methodological issues in the assessment and interpretation of posttraumatic growth. Psychological Inquiry, 15(1), 60-64.
Park, C. L. (2009). Medical Illness and Positive Life Change : Can Crisis lead to personal transformation? In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Overview of theoretical perspectives. (pp. 11-30). Washington, DC: APA.
Partridge, A. H., Gelber, S., Peppercorn, J., Sampson, E., Knudsen, K., Laufer, M., . . . Winer, E. P. (2004). Web-based survey of fertility issues in young women with breast cancer. Journal of Clinical Oncology, 22(20), 4174-4183. doi: 10.1200/JCO.2004.01.159
Rasmussen, D. M., & Elverdam, B. (2008). The meaning of work and working life after cancer: an interview study. Psychooncology, 17(12), 1232-1238. doi: 10.1002/pon.1354
Rowland, J. H., Holland, J. C., Chaglassian, T., & Kinne, D. (1993). Psychological response to breast reconstruction expectations for and impact on post mastectomy functioning. psychosomatics, 34(3), 241-250.
Ryan, R. M., & Deci, E. L. (2001). On happiness and human potentials: A review of research on hedonic and eudaimonic well- being. Annual Review Psychology, 52, 141-166.
Schover, L. R. (1991). The impact of breast cancer on sexuality, body image, and intimate relationship CA: a cancer journal for clinicians, 41(2), 112-120.
Schover, L. R. (1993). Sexuality and body image in younger women with breast cancer. Journal of the National Cancer Institute, 16, 177-182.
Sevenaeus, P.(2001). The phenomenology of health and illness. In S. K. Toombs(ed.), Handbook of phenomenology and medicine. Dordrecht: Kluwer Academic Publishes
Sharf, R. S.(2004). Theories of psychotherapy and counseling: Concept and cases (3rd.) Australia: Brooks/Cole.
Skinner, E. A., Edge, K., Altman, J., & Sherwood, H. (2003). Searching for the structure of coping: a review and critique of category systems for classifying ways of coping. Psychological bulletin, 129(2), 216.
Stacey, J. (1997). Teratologies: A cultural study of cancer. London: Routledge.
Takahashi, M., & Kai, I. (2005). Sexuality after breast cancer treatment: changes and coping strategies among Japanese survivors. Soc Sci Med, 61(6), 1278-1290. doi: 10.1016/j.socscimed.2005.01.013
Tedeschi, R. G., & Calhoun, L. G. (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455-471.
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual Foundations and Empirical Evidence. Psychological Inquiry, 15(1), 1-18.
Thewes, B., Meiser, B., Rickard, J., & Friedlander, M. (2003). The fertility- and menopause-related information needs of younger women with a diagnosis of breast cancer: a qualitative study. Psychooncology, 12(5), 500-511. doi: 10.1002/pon.685
Tomich, P. L., Helgeson, V. S., & Nowak Vache, E. J. (2005). Perceived growth and decline following breast cancer: a comparison to age‐matched controls 5‐years later. Psycho‐Oncology, 14(12), 1018-1029.
Toombs, S.K. (1992/1999). The meaning of illness :a phenomenological account of the different perspectives of physician and patient.
Van Manen, M. (2002). Care-as-worry, or “don’t worry, be happy”. Qualitative Health Research, 12(2), 262-278.
Williams, S. J. (1996). Medical sociology, chronic illness and the body: a rejoinder to Michael Kelly and David Field. Sociology of Health & Illness, 18(5), 699-709.
Willig, C. (2008). Discourse Analysis. In J. A. Smith (Ed.), Qualitative Psychology: A Practical Guide to Research Methods (pp. 160-187). London: SAGE.
Wilmoth, M. C. (2001). The aftermath of breast cancer: an altered sexual self. Cancer Nurs, 24(4), 278-286.
Yurek, D., Farrar, W., & Andersen, B. L. (2000). Breast cancer surgery: Comparing surgical groups and determining individual differences in postoperative sexuality and body change stress. Journal of consulting and clinical psychology, 68(4), 697.
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| Description: | 碩士
國立政治大學
心理學系
102752017 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0102752017 |
| Data Type: | thesis |
| Appears in Collections: | [心理學系] 學位論文
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