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研究生:林宜靜
研究生(外文):I-Ching Lin
論文名稱:臨終病人面對死亡之心理調適歷程
論文名稱(外文):The psychological adjusting process of dying patients when they face the expectable death
指導教授:蕭文蕭文引用關係
學位類別:碩士
校院名稱:國立彰化師範大學
系所名稱:輔導與諮商系
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2002
畢業學年度:90
語文別:中文
論文頁數:171
中文關鍵詞:臨終病人預期性死亡心理調適歷程
外文關鍵詞:dying patientexpectable deathpsychological adjusting process
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中 文 摘 要
本研究旨在瞭解臨終病人面對預期性死亡之心理調適歷程,並探討影響其調適的因素及有助於其調適的方法為何。本研究係採用質性研究中的深度訪談法來蒐集資料,共訪談了四位癌症病患,訪談後並針對所蒐集到的資料進行分析。研究結果除了歸納四位受訪者資料的異同點之外,並對四位受訪者之心理調適歷程做個別性的說明。研究結果發現如下:
一、病患得知病情後其心理歷程大致包含了震驚、憤怒、討價還價、沮喪及接受五個階段,有些階段是同時存在於某一時期,而有些階段在病程中則是反覆出現的。但因受訪者的個人背景、環境經驗及介入因素之不同,其調適歷程也呈現了相當的個別性。
二、在個人背景部分,病患的個性、做事及生活態度、家庭角色、宗教信仰、學習經驗、對死亡的想法等六項因素對當事人於病程中的調適發揮了正面的影響力。
三、病患過去的環境及生活經驗對其在病程中之自我調適是有影響的,這些因素包括:過去的失落經驗、過去照顧病人的經驗、長期患病的經驗、過去的醫療經驗、過去因應壓力的方式、過去的生活經驗等六大類。
四、病患面對死亡之自我調適方法包含:與疾病有關的因素、個人背景因素、過去的經驗、社會環境因素、精神有所寄託等五大類。
本研究針對上述結果加以討論,並據此結果提出若干建議以做為心理諮商專業工作者、臨終照顧者、及未來從事此方面研究者的參考。
The psychological adjusting process of
dying patients when they face the expectable death
I-Ching Lin
Abstract
The purpose of the research is to understand the psychological adjusting process of dying patients when they face the expectable death. It also explored the elements which affect and help their adjustment. This research adoptsed the qualitative research method for information collecting. It has analyzed the information which were collected by interviewing four cancer patients. The results not only concluded the common and different aspects of four interviewee, but interpreted individually how four interviewee adjust themselves.The results of this research are as follows:
1. When the patients knew the truth, they experienced the psychological process
including shock and denial, anger, bargaining, depression and acceptance phases.
Some phases co-exist in the same period, while others repeat constantly. However,
due to the different personal backgrounds, environmental experiences and various
involved elements, the adjustments showed substantial individuality.
2. As for personal backgrounds, there are six elements that influence positively to
the patients’ adjustment. These were the personality, the attituate for life and, the
attituate of dealing with things the role in the family, the religious belief, the learning experience, and the thoughts to the death.
3. The past environment and living experiences do influence the patients’ selves’ adjustment during the procedure. These elements included six categories:the past experience about loss, the past experience of taking care of patients, the past experience of having cancer, the past medical experience, the past experience of dealing with press and the past living experience.
4. The five major methods of the self-adjustment when the patients facing the death included: the elements relating to cancer, the elements relating to personal backgrounds, the past experiences, the elements relating to social-enviornment, psychological belonging(fouce on one thing to replace the anxiety of illness).
Regarding the above results, the researcher discussed the results and provided some suggestions for someone such as professional counselors, dying patients takers and the future researchers in the field as reference.
目 錄
第一章 緒論
第一節 研究動機與目的‥‥‥‥‥‥‥‥‥‥‥‥1
第二節 研究問題‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥8
第三節 名詞解釋‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥9
第二章 文獻探討
第一節 臨終病人得知病情之心理調適‥‥‥‥‥‥10
第二節 個人背景與環境、經驗因素對預期性死亡
之影響‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥21
第三節 臨終病人面對死亡之自我調適‥‥‥‥‥‥26
第三章 研究方法
第一節 研究對象‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥36
第二節 研究工具‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥39
第三節 資料蒐集過程及程序‥‥‥‥‥‥‥‥‥‥41
第四節 資料的處理與分析‥‥‥‥‥‥‥‥‥‥‥43
第四章 研究結果與討論
第一節 臨終病人得知病情後面對死亡之
自我調適歷程‥‥‥‥‥‥‥‥‥‥‥‥‥49
第二節 臨終病人的個人背景因素及環境、經驗因素
對心理調適之影響‥‥‥‥‥‥‥‥‥‥‥91
第三節 臨終病人面對死亡之自我調適的方法‥‥‥107
第四節 綜合討論‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥125
第五章 結論與建議
第一節 研究結論‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥142
第二節 研究建議‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥149
參考文獻
中文部分‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥155
英文部分‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥159
附錄
附錄一‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥168
附錄二‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥170
附錄三‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥171
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