科技部專題研究計畫主持人
MOST107-2410-H-037-001-SS2
配偶罹癌與雙人調適之研究:以口腔癌和乳癌為例
A research on dyadic coping with spouses’ cancer: oral and breast cancers taken as an example
科技部
Ministry of Science and Technology
高雄醫學大學醫學社會學與社會工作學系
Department of Medical Sociology and Social Work,Kaohsiung Medical University
林東龍
Dong-Long Lin
高雄醫學大學醫學社會學與社會工作學系
Department of Medical Sociology and Social Work,Kaohsiung Medical University
蔡家瑜
研究助理
0912057207
u100566001@gmail.com
計畫執行期間起:2018-08-01
計畫執行期間迄:2020-07-31
2019-01-01
2020-05-31
口腔癌和乳癌患者及其配偶
1
001,003,004
01,夫妻
雙人調適;口腔癌;乳癌;壓力管理過程
dyadic coping;oral cancer;breast cancer;stress management process
罹患癌症不僅對患者造成嚴重衝擊,患者配偶也經常經驗相類似的壓力反應,如憂鬱、無望感、焦慮、害怕,以及不確定性等,並形成「我們生病」情形。夫妻如何能從失去信心、絕望和害怕等負面 經驗中,轉變成彼此相互支持、形成同盟共同對抗癌症的正向反應,是本研究關注重點。國外有關夫妻雙人調適配偶罹癌的議題已累積不少研究成果和實務工作方法,國內此類型研究仍相當稀少。究 竟自配偶癌症診斷後,夫妻面臨的生活挑戰和壓力源為何、彼此如何溝通和情緒支持、壓力調適的方式、對雙人調適的看法,以及採取雙人調適的阻礙與可能助益等問題,實需要進行本土經驗的探究 。如此一來,不僅可建立與國外研究成果對話的基礎、精鍊既有理論取向,也能提供國內癌症患者與配偶進行雙人調適的實務建議。 本研究以男性口腔癌和女性乳癌患者及配偶為研究對象,共成功完成181對夫妻問卷,口腔癌91對、乳癌90對。主要研究結果包括:一、不論是口腔癌患者和配偶或乳癌患者和配偶,對於自身或配偶壓 力溝通的看法,雙方都認為較少以直接、間接或暗示方式讓對方知道自己有壓力,也不會刻意讓對方不知道自己壓力,同時,大多知道如何讓對方知道自己面臨壓力,也認為對方知道自己面臨壓力;二、口腔癌患者和配偶或乳癌患者和配偶,對於自身或配偶壓力的回應方式,雙方均較常以支持的、代表的,及共有或協同的等正向方式回應對方,同時,也較少以未參與、控制的、敷衍的、敵意的反應、矛盾的支持等負向方式回應配偶;三、多數口腔癌患者和配偶或乳癌患者和配偶,均對自身與配偶一同調適罹癌壓力給予正面評價,也對夫妻關係表示滿意。 本研究建議,醫務/腫瘤社會工作者可以夫妻為單位,從中扮演重要的溝通媒介與橋樑,協助和促進罹癌夫妻有效的壓力溝通和採取正向壓力回應方式,並提升其調適罹癌壓力事件的資源。
Cancers affect not only patients but the lives of their spouses, and both of them often report similar reactions to a cancer diagnosis: feelings of hopelessness or depression,anxiety, fear, and uncertainty; consequently, it becomes a “we disease”. This study focused on how couples could transform their negative experience such as loss of confidence, hopelessness and being afraid into a positive growth that supports each other and forges an alliance to fight cancer. Many studies already explicate couples’ dyadic coping with cancer abroad and a huge number of references and practical service strategies have been accumulated, but this kind of study is still rather scarce in Taiwan. Many issues need to be studied in Taiwan, such as what the challenges and stressors are to a couple, how the couple communicate and support each other, the coping style, the attitude about dyadic coping, and the barriers and benefits of dyadic coping. When we study these issues,we could develop a dialogue with the result of referral,refine intervention theories, and provide suggestions for dyadic coping in a practical manner.This study successfully collected 91 pairs of oral cancer patients and their spouses and 90 pairs of breast cancer patients and their spouses. The main findings include 1.Whether it is oral cancer patients and their spouses or breast cancer patients and their spouses, most of them think that they are less likely to directly, indirectly, or suggestively let each other know that they are under pressure. Neither Will deliberately let their spouse not know their pressure. At the same time, most of them know how to let their spouse know that they are under pressure,and they also think that their spouse knows that they are under pressure; 2. Oral cancer patients and spouses or breast cancer patients and spouses respond to the pressure of themselves or their spouses, often react to each other in positive ways such as supportive, delegated, shared or collaborative, and less damaging practices such as uninvolved, controlling, superficial, hostile reaction,ambivalent support, etc. responding to the spouse; 3. Most oral cancer patients and spouses or breast cancer patients and spouses all give positive comments on adjusting cancer pressure with their spouses. They are also satisfied with the relationship between husband and wife.This study suggests that medical/oncology social workers can act as an essential communication bridge between husbands and wives to promote effective stress communication and positive stress response methods for couples with cancer and improve their adjustment to cancer stress events.
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