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研究生:張心怡
研究生(外文):Hsin-YiChang
論文名稱:社會脈絡下兒童身體虐待倖存者之療癒
論文名稱(外文):Healing from Child Physical Abuse in the Social Context
指導教授:馮瑞鶯馮瑞鶯引用關係
指導教授(外文):Jui-Ying Feng
學位類別:碩士
校院名稱:國立成功大學
系所名稱:護理學系碩博士班
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:172
中文關鍵詞:兒童身體虐待療癒紮根理論社會脈絡
外文關鍵詞:child physical abusehealinggrounded theorysocial context
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背景:兒童身體虐待對個體在生理、心理社會、發展和自我概念上造成長久且持續的影響和傷害。療癒對兒虐倖存者而言是幫助其重整創傷意義,協助他們重新回到正常生活之必要歷程。了解置身於社會脈絡中兒童身體虐待倖存者之療癒並釐清互動過程中的必要元素,才能更貼近倖存者於社會脈絡建構下之真實療癒經驗,也可提供專業助人工作者進一步規劃可行的介入措施。
目的:了解兒童身體虐待倖存者如何看待並解釋自己從受創至療癒之經驗歷程,並探究個體於過程中其自我與社會脈絡之間的建構過程與互動關係。
方法:研究設計以紮根理論(Grounded Theory)為基礎,研究對象採立意與滾雪球選樣方式,選擇 8 位 20 歲以上,兒時遭受身體虐待並自覺有療癒之經驗或正在經歷療癒者。資料蒐集方法為半結構式深度訪談,依紮根理論之開放性編碼、主軸編碼及選擇性編碼作為資料分析之依據。
結果:三個核心範疇:茁壯自我、關係與親子倫理脈絡形成兒童身體虐待療癒理論模式:掌握放風箏之藝術。茁壯自我與親子倫理脈絡皆鑲嵌在關係脈絡中,三者在歷程中持續互動與相互影響。兒虐倖存者在逐漸熟練放風箏之訣竅的過程即是茁壯自我的歷程,此歷程由內在改變動機展開,歷經因應創傷與自我賦權使療癒達到正向轉變。倖存者之療癒一方面渴望自由,又因親子倫理的存在而有所牽絆,使療癒便在一拉一放之間達到動態的平衡。
結論:台灣兒童身體虐待倖存者之療癒無法脫離關係和親子倫理脈絡。本研究結果建議相關助人工作者於協助兒虐倖存者療癒時需考量其矛盾親子關係與情感、對孝道的重視和考量,協助其分析、了解和面對兒時創傷的影響並執行有利於療癒之行動和決策,以促進其療癒之歷程。
Background: Child physical abuse severely damages survivors’ physical and psychological health and self-concept. Healing from child abuse is an essential process that helps survivors reorganize the meaning of trauma and pursue for a normal life. Trauma and healing from child physical abuse needed to be considered in the social and cultural context to reflect the circumstances that survivors experienced in the process of healing.
Purpose: The purpose of this study was to explore child physical abuse survivors’ perceptions and interpretation of their experiences and process of healing within the social context.
Method: The research design was Grounded theory. Purposive sampling and snowball sampling was used to recruit 8 survivors from childhood physical abuse and who felt experiencing healing. Individual semi-structured in-depth interviews were used to collect data. Data were analyzed by open coding, axial coding and selective coding.
Results: Healing from child physical abuse in the social context is described as mastering the art of kite-flying. Three core categories emerged from the interviews: the thriving self, relationship, and parent-child ethics. The thriving self and parent-child ethics are embedded within the context of relationship and interact with each other. Healing starts from the intrinsic drive for a change of life. Individuals achieved positive transformation from trauma to healing by coping with trauma and empowering themself in this process. Healing from child physical abuse reaches a dynamic balance between an eager for freedom and the bonding of parent-child ethics and relationship.
Conclusion: Mastering the art of kite-flying for child abuse survivors in Taiwan is an integration of thriving self, relationship and parent-child ethics. None of them can work individually for healing. The findings of this study suggest that professionals working with child abuse survivors need to recognize conflicts in parent-child relationship and the emphasis of filial piety for victims and survivors within Chinese culture. Strategies can be developed to assist survivors in coping with the impact of childhood trauma and to facilitate healing process.
中文摘要 i
英文摘要 ii
致謝 iv
目錄 vii
表目錄 xi
圖目錄 xi
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究重要性 5
第三節 研究目的與研究問題 8
第二章 文獻查證 9
第一節 兒童身體虐待創傷的影響 9
一、認知生理層面 10
二、情緒與心理層面 11
三、行為層面 13
四、人際關係層面 14
五、影響兒童虐待創傷的因素 15
第二節 兒童虐待的社會建構論述 16
一、兒童虐待的社會建構觀點 16
二、兒童身體虐待與台灣社會文化脈絡 19
第三節 兒童虐待的療癒 20
一、兒童虐待創傷療癒的相關理論與治療原則 20
二、兒童虐待療癒的特質 25
三、影響兒童虐待療癒的相關因素 28
四、社會建構觀點下兒童虐待療癒之論述 29
第三章 研究方法 32
第一節 研究方法的選擇 32
第二節 紮根理論方法論 33
一、紮根理論的理論背景 33
二、紮根理論的發展 34
三、紮根理論於研究方法上之應用 38
第三節 研究對象 41
第四節 資料蒐集方法 43
一、資料蒐集過程 43
二、資料蒐集工具 44
第五節 資料整理與分析 45
一、開放性編碼 47
二、主軸編碼 47
三、選擇性編碼 48
第六節 研究方法嚴謹度 49
一、可轉換性 49
二、確實性 50
三、可靠性 50
四、可確認性 52
第七節 研究者的背景 52
第八節 研究倫理考量 54
一、自主原則 54
二、不傷害原則 55
三、行善原則 56
第四章 結果 57
第一節 研究參與者的基本資料與兒時受虐經驗 57
第二節 兒童身體虐待倖存者療癒之理論模式 60
一、 茁壯自我 65
二、 關係 84
三、 親子倫理 93
第五章 討論 102
第一節 兒虐療癒的動態歷程 102
第二節 茁壯自我 105
一、 分辨打罵責任歸屬的重要性 106
二、 我要和父母不一樣為復原力 107
第三節 關係脈絡 108
第四節 處在親子倫理脈絡下的兒虐療癒 110
一、 兒虐倖存者的子女角色 111
二、 親職角色於兒虐療癒的意義 112
第五節 研究結果之應用 114
第六節 研究限制與建議 116
一、 研究限制 116
二、 建議與應用 117
第六章 結論 119
第七章 參考文獻 120
附件一、受試者同意書 140
附件二、訪談基本資料表 143
附件三、初步訪談大綱 144
附件四、正式訪談大綱 146
附件五、訪談筆記範例 147
附件六、研究筆記範例 150
附件七、紮根理論模式檢證歷程 151
附件七之一:訪談逐字稿檢證 151
附件七之二:開放式編碼同儕編碼檢證 152
附件七之三:紮根理論模式概念檢證歷程 154
一、 理論模式概念檢證第一版 154
二、 理論模式概念檢證第二版 156
三、 理論模式概念檢證第三版 160
四、 理論模式概念檢證第四版 162
五、 理論模式概念檢證第五版 164
六、 理論模式概念檢證第六版 165
七、 理論模式概念檢證第七版 168
附件七之四:研究參與者檢證結果 172
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