臺灣博碩士論文加值系統

許多研究指出，聽損者不僅要承受生理缺陷之苦，同時也要面臨在健康生活品質、社交生活、甚至是心理狀態上的衝擊。然而，多數這些研究都是藉由他人的觀點對聽損者給予評價與探討，聽損者自身的觀點卻很少被關注與討論。因此本研究採納質性研究中的敘事探究，以聽損者的視角去理解他們的生命經驗與行動。本研究訪談一名患有前庭導水管綜合症的聽損者—李琦，採半結構式訪談，每次面談一至兩小時，共15小時。如實逐字轉寫訪談內容後進行編碼，再運用「整體－內容」方式反覆分析敘事文本，並以同儕檢報或檢核、持續觀察與省思日誌等方式以確保研究品質。本研究透過李琦所反覆呈現的主題，分為四大部分來探討：（1）李琦服膺主流社會對於正常的看法；（2）李琦使用隱瞞策略維持聽人形象；（3）李琦面臨溝通效度不佳的醫療環境障礙；（4）李琦使用視覺觀察與單一視角代償溝通與聽覺。在李琦的故事中，研究者發現過去在實踐主流醫療、教育理念的同時，可能被忽略的相關社會議題，包含：（1）社會普遍使用缺陷、不健全或生理不能的觀點看待聽損者；且普遍將他們視為需要被照顧的對象（2）聽損者使用隱瞞策略是為了避免洩露自己被汙名化的隱性恥辱，以免遭受社會主流給予的不平等對待；（3）臺灣聽損者的主體性容易被醫療人員忽視，聽損者在缺乏醫療決策權的環境下，依循醫療人員的決策與安排；（4）聽損者普遍使用視覺觀察與主觀臆測去獲得外界資訊，以代償聽覺損失。因此研究者建議，聽力師及醫護專業人員在醫療場域中應重視聽損者之需求及其主體性，以促進醫療服務的品質。建議聽人多閱讀與聽損者、聽覺輔具及聽力損失相關的知識，以具備基本的正確溝通觀念，並參考社會模式的觀點，思考障礙和社會間的關係。

Numerous studies have pointed out thathearing impairment is a physical ailment with a wide range of personal impacts.It can significantly impair a person’s quality of healthcare, social life, andeven psychological wellbeing. However, most of these discussions came from theperspective of hearing people, the first-hand accounts of hearing impairedpeople were lacking or rarely acknowledged in literature. In this study, aperson with hearing impairment resulting from large vestibular aqueductsyndrome (LVAS) was interviewed for her experiences.
The study focused on Chi Lee’s personal journey, and soughtnarrative and phenomenological ways of understanding her lived experiences. Theresearcher captured Lee’s perspectives by using her own words to construct themeaning of “hearing impairment.” Data was collected through semi-structuredinterviews and then analyzed using a holistic content approach. Through thisapproach we identified four significant themes. (1) She conformed to themainstream social views of disabilities and normality; (2) She utilized variousdisguises to hide her impairment in order to maintain the image of a hearingperson; (3) She encountered communication barriers in everyday life; (4) Shekeenly observed environmental cues to aid her assumptions in order tocompensate for communication and hearing issues.
Lee’s personal journey complemented and contextualized traditionalmedical and educational models of disability to give a fuller picture of livingwith hearing impairments. Furthermore, Lee’s accounts related to social issueswere rarely identified or discussed. (1) In Taiwanese culture, disability hasbeen viewed as a deficiency residing in a person’a body or mind, associatedwith disease, dependency, and helplessness. (2) People with disabilities maymanage their condition, perhaps by concealing their disability in public, inorder to minimize stigmatization. (3) Health professionals in Taiwan seldominvolved clients in their treatment decisions, making clients feel unable toparticipate in the decision making process. (4) People with hearing impairmentscompensated for their auditory sense with visual skills.
Audiologists, educators, and health care professionals may be ableto improve the quality of their care by paying closer attention to thepatient’s personal lived experience. Additionally, more work needs to be doneto raise society’s awareness of the social impacts of hearing impairment. Withthe goal being to minimize the social barriers which are experienced by thehearing impaired, rather than focusing on their physical impairments.

 TOC \o"1-2" \h \z \u
摘要.................................................. i
Abstract..........................................iii
目次.................................................. = 7 \* roman v
表次.................................................vii
第一章 緒論...................................1
第一節 研究背景與動機                 .........................1
第二節 研究目的與研究問題               .....................4
第三節 名詞釋義                       ...............................4
第二章 文獻探討. ...............................7
第一節 前庭導水管擴大症    7.......................7
第二節 聾人與聽損的定義與文化    16................ 16
第三節 就讀普通學校的聽損生    25...................25
第四節 生於聽人家庭的聽損者    33...................33
第三章 研究方法. ...............................45
第一節 採取敘事探究的理由               4.....................45
第二節 研究參與者                    4.............................47
第三節 研究工具................... ...............................49
第四節 資料蒐集方式                 ...........................56
第五節 資料分析................... ...............................56
第六節 研究品質................... ...............................61
第四章 研究結果. ...............................69
第一節  隱藏祕密.................. ..............................69
第二節  抗拒助聽器                 ............................77
第三節  尋找助聽器                 ............................91
第四節  希望被當作聽人............. ........................115
第五節  研究結果討論與過程             ................... 139
第五章 研究結果結果與建議.....................161. 161
第一節 研究結論...............................161
第二節 研究建議.................. ...............................162
參考文獻......................................167
附錄..........................................183
表次
表3-1  李琦背景資料.. ...................48
表3-2  李琦聽力情形.. ...................49
表3-3  逐字騰寫註記方式.. ...............57
表3-4  逐字騰寫方式.. ...................57
表3-5  逐字稿形成敘事文本方式.. .........58
表3-6  形成敘事文本主題方式.. ...........59
表3-7  其它編碼不同資料來源方式.. .......59
表3-8  整合敘事內容的主題成核心主題...60
表3-9  確保品質的技術.. .................65
表3-10 研究參與者檢核回饋.. .............151
表3-11 同儕檢核回饋－連貫性............. 152
表3-12 同儕檢核回饋－說服力...........153
表3-13 同儕檢核回饋－實用性...........155
表3-14 同儕檢核回饋－簡約性...........156

壹、中文部分
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貳、西文部分
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