腦中風是全世界主要死因之一，在台灣位居十大死因之第三位，也是導致成人失能的主要原因，而且隨著年齡的增加，腦中風的發生率也隨之提高，其影響更造成家庭及社會沉重的負擔。腦中風分成缺血性及出血性腦中風，其中缺血性腦中風占所有腦中風約70-80%，在藥物治療方面，血栓溶解劑已被證實於3小時內用於治療急性缺血性腦中風，可以有效的降低中風病患的失能程度及預後。再者，腦中風對病患的影響包含生理及心理層面。本研究希望能透過質性研究深入訪談的方式，進一步探究初次腦中風病患的調適過程。
本研究採用扎根理論研究法，以半結構式訪談指引訪談十二位初次腦中風病患，並進行扎根理論研究法資料分析。研究發現初次中風病患的調適是一個歷時性轉變的歷程，此歷程所浮現的範疇(次範疇)分別為：初次中風的情境(中風的認知、中風的感受)，中風後身心的影響(生理的影響、心理的影響)，中風後經歷的過程(心理的調適、行為的調適、家人的支持、不成為家人的負擔)，必經的復健過程(不同的復健場域、復健的心路歷程)，而整合本研究的核心範疇為坦然面對，人生就此改變。
研究結果真實呈現初次腦中風病患的調適過程與適應的歷程的原貌，本研究結果建議專業人員應加強中風的認知及衛教之外，亦可強化病患心理上的照護。再者，家屬照顧初次中風病患期間的歷程亦可納入未來的研究方向。

Stroke is one of the leading cause death worldwide, and has been the third-leading causes of death in Taiwan. Further, it has been the main reason that contributes to adult disabilities. The incidence of stroke will increase by age. Moreover, stroke causes disability which is a heavy burden of patients’ families and the society. The stroke is divided into two broad categories of ischemic and hemorrhagic stroke, further, ischemic stroke accounting for approximately 70-80% of all strokes. Thrombolytic therapy has been proved to be a favorable approach for the treatment of acute ischemic stroke during the first 3 hours after its onset. It can effectively reduce the degree of disability in such patients. Furthermore, stroke does not only affect the patient physiologically, but also psychologically. In order to explore how patients adapt themselves through the stroke, we aim to explore the first-time stroke patients in how they get through stroke by using qualitative research in-depth interviews.
Based on grounded theory, 12 stroke participants join semi-structure interviews in this study. Then, data were analyzed through grounded theory data analysis process. This study found that how stroke patients adapt themselves after the accident is a time changing process. What involved in this process includes the following categories and subcategories: first stroke circumstance (the understanding of stroke and the feeling of stroke); the influences of stroke (physiological influences and psychological influences); virtually being in stroke process (psychological adaption, behavior adaption, family support, not being burdens of family); the must-go rehabilitation process (different rehabilitation venues and programs, internal struggles of rehabilitation). The core category in this study is: accept stroke with an open mind then life change from now and ever.
The study findings attempted to present the real progress and process in the adaptations of first time stroke patients. The study findings suggest that health care professionals might have to emphasis more on health educations to stroke patients, as well as to give them more psychological and spiritual supports. Moreover, the process of how family tried to adapt themselves in taking care of their stroke family members is recommended in the future study.

致謝 …………………………………………………………………………………………… i
中文摘要 ……………………………………………………………………………………… ii
英文摘要 ……………………………………………………………………………………… iii
目錄 …………………………………………………………………………………………… v
圖目錄 ……………………………………………………………………………………… viii
表目錄 …………………………………………………………………………………………ix
第壹章 緒論
第一節、研究背景及動機 ……………………………………………………………… 1
第二節、研究目的 ……………………………………………………………………… 2
第三節、名詞定義 ……………………………………………………………………… 2
第貳章 文獻查證
第一節、腦中風概述 …………………………………………………………………… 4
第二節、腦中風治療現況 ……………………………………………………………… 6
第三節、腦中風病患的護理照護 ……………………………………………………… 6
第四節、腦中風在急性期之病程發展及其影響 ……………………………………… 7
第五節、腦中風對病患影響之相關文獻探討 ………………………………………… 8
第叁章 研究方法
第一節、扎根理論研究法的起源 ……………………………………………………… 11
第二節、扎根理論研究法的概述 ……………………………………………………… 12
第三節、研究設計 ……………………………………………………………………… 16
第四節、嚴謹度 ………………………………………………………………………… 18
第五節、倫理考量 ……………………………………………………………………… 19
第肆章 研究結果
第一節、受訪者之基本資料簡介 ……………………………………………………… 20
第二節、初次腦中風病患之調適歷程 ………………………………………………… 22
第三節、核心範疇的浮現 ……………………………………………………………… 37
第四節、依譯碼典範詮釋 ……………………………………………………………… 39
第伍章 討論
第一節、初次中風的情境 ……………………………………………………………… 41
第二節、中風後身心的影響 …………………………………………………………… 42
第三節、中風後經歷的過程 …………………………………………………………… 43
第四節、必經的復健過程 ……………………………………………………………… 44
第五節、坦然面對，人生就此改變 …………………………………………………… 45
第陸章 結論
第一節、總結 …………………………………………………………………………… 46
第二節、建議 …………………………………………………………………………… 46
第三節、研究限制 ……………………………………………………………………… 47
參考文獻……………………………………………………………………………… 49
附件 ……………………………………………………………………………………55
附件一、巴氏量表 ………………………………………………………………………… 56
附件二、相關的不斷比較及分類的過程 ………………………………………………… 57
附件三、備忘錄範本 ……………………………………………………………………… 58
附件四、訪談指引 ………………………………………………………………………… 84
附件五、修改後訪談指引 ………………………………………………………………… 85
附件六、人體研究計畫核准書 …………………………………………………………… 86

圖目錄
圖一、初次腦中風病患之調適過程 ………………………………………………………… 38
表目錄
表一、舉例資料概念化的過程 ……………………………………………………………… 14
表二、受訪者的基本資料 …………………………………………………………………….21

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