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研究生:顏姿吟
論文名稱:醫師世家子女生涯抉擇歷程與代間傳遞之研究─以整合歷程系統的觀點探討
論文名稱(外文):Career choosing process and intergenerational transmission for children from a medical family---from the perspective of integrative process systems
指導教授:戴嘉南戴嘉南引用關係連廷嘉連廷嘉引用關係
學位類別:博士
校院名稱:國立高雄師範大學
系所名稱:諮商心理與復健諮商研究所
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:2014
畢業學年度:102
語文別:中文
論文頁數:365
中文關鍵詞:醫師世家生涯抉擇歷程代間傳遞整合歷程系統
外文關鍵詞:medical familycareer choosing processintergenerational transmissionintegrative process systems
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本研究目的旨從「整合系統歷程」觀點,探討醫師家庭對子女生涯抉擇與代間傳遞的影響與內涵。研究參與者是一個醫師世家的三代家庭成員,其中祖父與父親為醫師、孫子為醫學生,採用敘說研究的方法進行,運用「整體―內容」分析方式呈現個體的生涯抉擇歷程、家庭系統與生涯代間傳遞;「類別―內容」方式分析個體的生涯信念、工作價值觀,與生涯行為特質,並理解個體進行生涯抉擇與代間傳遞的意義建構、及其影響因素。結果摘要如下:

一、台灣醫師世家子女之生涯抉擇歷程是社會、時間,與空間等三維影響的結果;社會塑造醫師職業的卓越意義,搭造個體生涯抉擇範圍的舞台,家庭在認同這「社會卓越」後,塑造自律與注重學業成就的環境,限制生涯探索的範圍與時間,父親也成為生涯的楷模,讓個體隨時間成長,排除自己原先的興趣,逐漸符合社會主流的價值觀,因而努力追求,進入醫師生涯。
在生涯信念方面,包含「自我價值」、「工作抱負」與「外在取向」等三主題,這三主題信念因每一個體的生活經驗差異,從注重關係取向的自我要求,轉為注重生活中的自我需求,所以沒有代間傳遞的現象。
在工作價值觀方面,包含「個人利益」、「家族利益」與「集體利益」等三主題,其中僅「家族利益」出現代間傳遞的現象,同時良好親子關係會影響子代的價值觀,但在「個人利益」工作價值觀的影響方向上相反,並且工作價值觀也隨個體生涯發展建構工作上的意義,進而影響子代出現「集體利益」的新工作價值。
在生涯行為特質方面,包含「努力實做」與「關懷分享」等主題;「努力實做」是貫穿三代的生涯行為特質,但努力內涵從努力是個人應盡義務的美德,轉變成努力是達到目標的工具;「關懷分享」則出現在後二代的生涯行為特質。

二、台灣醫師世家存在一個包含家庭結構與家庭動力,讓家庭系統減少外在事件衝擊,維持凝聚與持續成長的穩定機制。家庭結構宛如一個漏斗,以世代間階層性與成員間接近性等二向度,形塑出漏斗的開口寬度,並運作「傳頌祖先仁醫的家庭故事」、「權衡或控制、或親密的教養方式」、「正負回饋調節訊息」、「三代成員互動靈活互補」,與「格調為衡量處事之標準」等方式過濾事件的衝擊。家庭動力包含父母聯手之引導力、祖父母次系統與子女次系統之配合力,以及子女反哺力等三力量,引導家庭前進,跟上社會變化。
三、台灣醫師世家的生涯代間傳遞是成員認同與凝聚家庭共有意義的過程,過程中生涯意義會隨角色變化不斷建構,並以迂迴且持續傳遞醫師職業的正向價值。這個生涯代間傳遞包含社會模式與親代模式等二模式相互影響:社會模式塑造卓越意義,影響父母的價值觀與子女認同,讓子女直接或間接接受醫師生涯的抉擇;並且父母在接受「社會卓越」後,孕育屬於家庭自己之助人利他的「家庭熱愛」,以影響子女、穩固子女認真學習生涯所需技能,並加速生涯抉擇的時機點。

最後,依據上述研究結果,本研究提出對諮商實務工作、以及未來相關研究之建議以供參考。

This study is aimed to investigate, from the perspectives of “integrative system process”, the effects of a medical family on its children’s career choosing and intergenerational transmission. The participants were members in a three-generation medical family in which the grandfather and father were doctors and the son was still a student currently majoring in medicine. Presented in a narrative way, the “holistic--content” analytical method was used to depict individual’s career choosing process, family system and intergenerational career transmission; The “category--content” method was used to analyze individual’s career beliefs, work values and behavioral traits in career. This study also tried to comb out the meaning constructs and the affecting factors when an individual was making career decision and conducting intergenerational transmission. The findings are as follow:
1.The career choosing process for children from Taiwan’s medical family was the consequence influenced by society, time, and environment. The society molded the prominent meanings of the doctor’s profession, and shaped up the stage for individual’s career choosing options. With the family identifying with the “social prominences “, it accordingly built a self-discipline environment that valued academic achievement, and limited simultaneously the context and time for career exploring. Father also became the career role model. With time passing, an individual ruled out his original interest, gradually conformed to the values of the social mainstream, and started to strive for the doctoral career.
Career beliefs included three themes: self value, career aspiration, and external orientation. Since each individual had disparate life experiences, ranging from the self-regulation focusing on relationship to self-needs focusing on life style, there was no intergenerational transmission among the three beliefs.
Work values included three themes: individual interest, family interest, and group interest. Only “family interest” showed intergenerational transmission, and a good parent-child relationship could affect children’s values. On the other hand, the “individual interest” showed the opposite effects. And work values could construct work meaning with individual’s career development, which in turn influenced children’s new work values “group interest.”
Career behavioral traits included striving practice, and caring share. Striving practice was the career behavioral trait throughout three generations, but the implication of striving had transformed from the virtue of individual obligation to a tool reaching one’s goal. Caring share appeared in the behavioral traits of the second and the third generations.
2. Taiwanese medical family had a stable mechanism which includes family structure and family dynamics, minimizing the impact of external incidents on the family system, maintaining its cohesion and keeping it growing. This structure was like a funnel. The two dimensions, generational hierarchy and members’ proximity, shaped the opening width of a funnel. In the meantime, there were several ways to filter the impact of incidents: “retelling the family’s story of the past medical virtues”, “balancing the controlling and intimate upbringing”, “modifying the positive and negative feedbacks”, “flexible complementation among three-generation members’ interaction” and “stressing ‘style’ as the behavior norm.” Family dynamics included three forces: the directing force of parents’ ally, the coordination force of grandparents’ and grandchildren’s subsystems, and the children’s cultural feedback. The three forces led the family to go forward and follow the social changes.
3. Taiwanese medical family’s intergenerational transmission was the process in which the members identifying and cohering family collective meanings. During the process, career meanings kept constructing with the role changed, and the positive values of the doctoral profession were transmitted in an indirect but persistent way. The career intergenerational transmission included two interactively influenced models: social model and parental model. The social model constructed the “social prominences “, affects parents’ values and children’s identification, and directly or indirectly made children accept the career preference. After accepting the “social prominences “, the parents proceeded to develop the “family’s devotions” of help and altruism. This influenced the children, entrenched them to seriously learn the skills needed in this field, and accelerated the time point for career choosing.

Finally, based on the research findings, this study provides suggestions for those working in counselling practice and related research.

目次……………………………………………………………………………………………………i
表次……………………………………………………………………………………………………iii
圖次……………………………………………………………………………………………………iv

第一章 緒論…………………………………………………………………………………1
第一節 研究動機…………………………………………………………………………1
第二節 研究目的與問題……………………………………………………………8
第三節 名詞釋義………………………………………………………………………12

第二章 文獻探討………………………………………………………………………15
第一節 生涯抉擇………………………………………………………………………15
第二節 代間傳遞………………………………………………………………………37
第三節 從整合歷程系統觀點觀看家庭………………………………65

第三章 研究方法………………………………………………………………………85
第一節 研究取向………………………………………………………………………85
第二節 研究參與者…………………………………………………………………89
第三節 研究工具………………………………………………………………………98
第四節 研究程序………………………………………………………………………103
第五節 資料分析………………………………………………………………………113
第六節 研究品質………………………………………………………………………122
第七節 研究倫理………………………………………………………………………124

第四章 研究結果………………………………………………………………………127
第一節 醫師世家絮語………………………………………………………………127
第二節 世代的生涯抉擇歷程…………………………………………………213
第三節 世代間的生涯傳遞………………………………………………………256

第五章 討論與反思……………………………………………………………………275
第一節 台灣醫師世家中的個體生涯抉擇歷程……………………275
第二節 台灣醫師世家的家庭系統…………………………………………292
第三節 台灣醫師世家的生涯代間傳遞…………………………………312

第六章 結論與建議……………………………………………………………………321
第一節 研究結論…………………………………………………………………………321
第二節 研究者的省思…………………………………………………………………323
第三節 研究限制…………………………………………………………………………326
第四節 研究建議…………………………………………………………………………329

參考文獻……………………………………………………………………………………………333
中文部分……………………………………………………………………………………………333
英文部分……………………………………………………………………………………………341
附錄……………………………………………………………………………………………………355
附錄一 初步訪談大綱…………………………………………………………………355
附錄二 專家審查邀請函……………………………………………………………356
附錄三 專家效度審查名單…………………………………………………………357
附錄四 專家審查訪談大綱評鑑表……………………………………………358
附錄五 正式訪談大綱……………………………………………………………………361
附錄六 訪談同意書…………………………………………………………………………363
附錄七 錄音逐字稿轉錄原則…………………………………………………………364
附錄八 研究參與檢核函……………………………………………………………………365

表次
表2-3-1 家庭心理學矩陣:核心理論與調查向度……………………74
表3-5-1 訪談逐字稿摘要表……………………………………………………………114
表3-5-2 刪除贅字後的替代文本及語意摘要表…………………………117
表3-5-3 概念辨認與歸納表……………………………………………………………119
表4-1-1 受訪家庭重要事件一覽表………………………………………………128
表4-1-2 受訪家庭訪談順序表………………………………………………………135
表4-1-3 受訪家庭成員角色一覽表………………………………………………167
表4-1-4 祖孫三代家庭系統互動關係的交互建構一覽表…………209
表4-2-1 選擇醫師生涯成員之生涯信念一覽表…………………………242
表4-2-2 選擇醫師生涯成員之工作價值觀一覽表………………………248
表4-2-3 選擇醫師生涯成員之生涯行為特質一覽表……………253
表4-3-1 個體生涯抉擇影響與價值傳遞一覽表………………………270
表5-1-1 選擇醫師生涯成員之生涯信念主題一覽表………………283
表5-1-2 選擇醫師生涯成員之工作價值觀主題一覽表……………285
表5-1-3 選擇醫師生涯成員之生涯行為特質主題一覽表…………288
表5-2-1 祖孫三代家庭系統系統互動關係的交互建構情形
一覽表…………………………………………………………………………………………………………293
表5-2-2 二代父母次系統互動關係的合作方式一覽表………………295

圖次
圖2-2-1 Grusec與Goodnow二階段價值傳遞認知歷程……………44
圖2-2-2 Paryent 與 Orr價值觀傳遞之整合歷程……………………46
圖2-3-1 家庭中循環性衝突的成因及運作歷程………………………………77
圖2-3-2 接近性與代間階層性家庭界限圖………………………………………81
圖3-2-1 本研究的受訪家庭圖……………………………………………………………97
圖3-4-1 本研究的主體流動………………………………………………………………105
圖3-4-2 研究流程圖……………………………………………………………………………109
圖4-2-1 第一代阿公生涯抉擇之家庭互動序列……………………………216
圖4-2-2 第二代爸爸生涯抉擇之家庭互動序列……………………………224
圖4-2-3 第三代長子生涯抉擇之家庭互動序列……………………………235
圖5-1-1 醫師世家中個體之生涯抉擇歷程……………………………………290
圖5-2-1 家庭中醫師生涯延續的成因與運作歷程圖……………………311
圖5-3-1 價值觀傳遞之整合模式………………………………………………………320


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