癌症在台灣已經連續38年為十大死因之首，而且在過去的許多研究中都說明了癌症帶給患者的心理適應有很大的衝擊，不僅如此，癌症對於患者與家庭成員之間也有著不小的影響。因此，本研究以目標調適及自我落差兩個概念來探究中年罹癌倖存者在生病前後的目標轉變與情緒之間的關聯性，以及，中年罹癌倖存者對自己的理想期望與現實期望之間的落差，與情緒的關聯為何？再者，以華人文化中的家庭延續脈絡出發，試著探討中年罹癌倖存者對孩子的期望在生病前後如何改變，以及這樣的改變對於患者的情緒有何關聯？以及，中年罹癌倖存者對孩子的理想目標與知覺到孩子實際行爲之間的落差，與患者本身情緒的關聯性為何？
本研究至林口長庚醫院收案，通過倫理審查委員會的審核之後，在合作的醫師門診時段收案，並經由研究助理轉介合適個案，共收案52位。收案方式為利用個案候診時間進行問卷填答，在取得個案之受訪者同意書之後，再請個案填寫自我落差問卷以及情緒形容詞問卷。
研究結果顯示(一)中年癌症倖存者生病前後的目標有明顯轉變，生病前為成就目標最多，生病後則是以健康為最主要的目標。而目標轉變的程度並未與情緒有顯著相關，但是有趨勢存在，中年罹癌倖存者在生病前後的目標轉變越少，負向情緒越高；(二)中年罹癌倖存者在生病前的自我落差與情緒無關，生病後的自我落差與情緒有顯著相關，自我落差越大，負向情緒越高；(三)中年罹癌倖存者對孩子的目標並沒有顯著轉變，與患者本身的情緒也沒有顯著相關，但仍有趨勢存在，如果中年罹癌倖存者對孩子的目標在生病前後轉變越多，正向情緒也越多；(四)中年罹癌倖存者在生病前後對孩子的理想目標與知覺到孩子實際行為之間的落差與患者本身的情緒並未有顯著相關。

Cancer has been the top 10 causing death in Taiwan for 38 years, studies had laid out that the cancer brought great impact to the patients so does their family members. The present study used the concepts of goal adjustment and self-discrepancy to investigate people in the mid-age that their alteration of mental condition between emotions and their goal changing before and after they recovered from cancer, survivors' emotional relativities between the discrepancy of their ideal goal and real life situation. Also, the study tried to examine survivors’ thoughts and change toward expectations of their children before and after they recovered from cancer, and their emotional changing between the discrepancy of ideal expectation and the realization of real situation of survivors’ children.
The findings showed that survivors’ personal goals have significantly changed after recovering from cancer. Health issues become their priority things to care about. And there’s no significant differences relate to their emotion. However, if survivors have little change of their objective, their negative emotion might become higher. The finding revealed that there’s no relativity between survivors’ self-discrepancy and survivors’ emotion before they get sick, however, there’s significantly related after they recovered from cancer. The higher their self-discrepancy they felt, the higher their negative emotions they might have. Also, the result laid out that there’s no significant changed of survivors that their expectations toward their children as well as the emotions survivors’ themselves. However, more changes a survivor have, the much positive emotions it will be. Last but not least, the result showed that there’s no significant related of survivors that the discrepancy between survivors’ expectation toward their children, the real situation of their children and the emotion of survivors themselves.

第壹章、 緒論1
第一節、 研究動機1
第二節、 研究目的3
第貳章、 文獻回顧5
第一節、 中年罹癌患者的目標轉變5
一、 中年階段的發展5
二、 中年罹癌患者的目標調適9
第二節、 華人文化下，對子女期望與知覺行為對罹癌父母之影響12
第三節、 自我落差與負向情緒之關聯15
第四節、 研究問題與研究假設22
第參章、 研究方法24
第一節、 研究對象24
第二節、 研究工具25
第三節、 研究程序28
第四節、 資料分析28
第肆章、 研究結果30
第一節、 罹癌倖存者生病前後的目標轉變差異分析與情緒關聯性30
第二節、 罹癌倖存者生病前後自我落差、對孩子期望落差與情緒之分析33
第伍章、 綜合討論42
第一節、 研究結果討論43
一、 自我目標相似度與情緒的關係43
二、 對孩子的目標相似度與情緒的關係45
三、 罹癌倖存者對自己的自我落差與對孩子期望落差的影響47
第二節、 研究貢獻49
第三節、 研究限制49
一、 研究設計與方法49
二、 研究樣本49
參考文獻50
中文部分50
英文部分52
附錄一、 研究問卷56
附錄二、 患者對自己的目標卡62
附錄三、 患者對孩子的目標卡67

中文部分
王秀槐. (2015). 從 [以我為榮] 到 [證明自己]: 華人文化脈絡下知覺不同父母期待之大學生的生涯因應組型初探研究. 輔導與諮商學報, 37(1), 79-97.
王靖惠. (2006). 中年人生命期發展內涵及其影響因素之研究. 臺灣師範大學社會教育學系學位論文, 1-113.
林青蓉, 王碧華, 楊翠雲, & 黃君瑜. (2013). 癌症病患之子女的生活衝擊與適應. 台灣醫學, 17(2), 171-179.
林亭妤, 鄭逸如, 張琦郁, 楊于婷, & 張安華. (2017). 為什麼我這麼努力, 癌症還是復發? 癌末病人的目標調適. 安寧療護雜誌, 22(1), 97-107.
洪光遠, & 鄭慧玲. (1995). 普汶 (Lawrence A. Pervin) 著, 人格心理學, 台北, 桂冠書局.
洪晟惠, & 周麗端. (2011). 家庭發展階段與家庭結構對中年世代生活滿意度的影響• 人類發展與家庭學報, 13, 75-100. Hong, CH, & Chou, LT (2011). Effects of family development stages and family structures on life satisfaction of middle-aged generation. Journal of Human Development and Family Studies, 13, 75-100.
孫靖婷. (2015). 國中生知覺父母期望, 情緒智能與生活適應之相關研究.
陳珍德, & 程小蘋. (2002). 癌症病人生命意義之研究. 彰化師大輔導學報, (23), 1-48.
陳虹汶, 林賢謀, & 李玉嬋. (2010). 兩位食道癌男性患者失落健康的悲傷之經驗探究. 台灣癌症醫學雜誌, 26(6), 240-256.
曾幼涵, 許文耀, & 陳畹蘭. (2011). 主動探索學業認同對於青少年的情緒適應是好還是壞? 青少年的學業認同歷程與情緒困擾之關係. 臨床心理學刊, 5(1), 13-13.
曾幼涵、許文耀（2009）。不同類型的自我落差對華人憂鬱與焦慮情緒的影響。教育與心理研究，32（1），57-79。TSSCI
黃光國. (2005). 儒家關係主義: 文化反思與典範重建 (Vol. 43). 國立臺灣大學出版中心.
葉昀. (2013). 學齡階段子女面對母親罹患乳癌之經驗探究.
葉紀妤. (2013). 目標調適量表之發展: 癌症患者目標調適, 情緒因應, 罹癌影響知覺, 與情緒適應間相關之探討. 高雄醫學大學心理學系碩士班學位論文, 1-93.
廖育青. (2006). 成年前期子女經歷父母罹患癌症其家庭角色經驗與個人發展任務之初探.
顏綵思, & 黃光國. (2011). 儒家社會中學生的角色義務及其對獎懲正當性的知覺. 中華心理學刊, 53(1), 79-95.
蘇建文, 林美珍, 程小危, 林惠雅, 幸曼玲, 陳李綢, ... & 陳淑美. (2003). 發展心理學. 台北: 心理.
英文部分
Baltes, P. B. (1987). Theoretical propositions of life-span developmental psychology: On the dynamics between growth and decline. Developmental psychology, 23(5), 611.
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 68(6), 394-424.
Bruch, M. A., Rivet, K. M., & Laurenti, H. J. (2000). Type of self-discrepancy and relationships to components of the tripartite model of emotional distress. Personality and Individual Differences, 29(1), 37-44.
Collins, R. L., Taylor, S. E., & Skokan, L. A. (1990). A better world or a shattered vision? Changes in life perspectives following victimization. Social cognition, 8(3), 263-285.
Derogatis, L. R., Morrow, G. R., Fetting, J., Penman, D., Piasetsky, S., Schmale, A. M., ... & Carnicke, C. L. (1983). The prevalence of psychiatric disorders among cancer patients. Jama, 249(6), 751-757.
Faulkner, R. A., & Davey, M. (2002). Children and adolescents of cancer patients: The impact of cancer on the family. American Journal of Family Therapy, 30(1), 63-72.
Gagliese, L., Jovellanos, M., Zimmermann, C., Shobbrook, C., Warr, D., & Rodin, G. (2009). Age-related patterns in adaptation to cancer pain: a mixed-method study. Pain Medicine, 10(6), 1050-1061.
Gazendam-Donofrio, S. M., Hoekstra, H. J., Van der Graaf, W. T. A., Van de Wiel, H. B. M., Visser, A., Huizinga, G. A., & Hoekstra-Weebers, J. E. H. M. (2007). Family functioning and adolescents' emotional and behavioral problems: when a parent has cancer. Annals of Oncology, 18(12), 1951-1956.
Havighurst, R. J. (1976). Education through the adult life span. Educational Gerontology, 1(1), 41-51.
Heidrich, S. M., Forsthoff, C. A., & Ward, S. E. (1999). Psychological adjustment in adults with cancer: The self as mediator.
Higgins, E. T. (1987). Self-discrepancy: a theory relating self and affect. Psychological review, 94(3), 319.
Higgins, E. T., Shah, J., & Friedman, R. (1997). Emotional responses to goal attainment: strength of regulatory focus as moderator. Journal of personality and social psychology, 72(3), 515.
Hullmann, S. E., Robb, S. L., & Rand, K. L. (2016). Life goals in patients with cancer: A systematic review of the literature. Psycho‐Oncology, 25(4), 387-399.
Krattenmacher, T., Kühne, F., Führer, D., Beierlein, V., Brähler, E., Resch, F., ... & Möller, B. (2013). Coping skills and mental health status in adolescents when a parent has cancer: A multicenter and multi-perspective study. Journal of Psychosomatic Research, 74(3), 252-259.
Kuther, T. L., & Burnell, K. (2019). A Life Span Developmental Perspective on Psychosocial Development in Midlife. Adultspan Journal, 18(1), 27-39.
Lachman, M. E. (2004). Development in midlife. Annu. Rev. Psychol., 55, 305-331.
Lauver, D., Connolly-Nelson, K., & Vang, P. (2007). Health-related goals in female cancer survivors after treatment. Cancer Nursing, 30(1), 9-15.
Liebman, R., Minuchin, S., & Baker, L. (1974). The use of structural family therapy in the treatment of intractable asthma. American Journal of Psychiatry, 131(5), 535-540.
Little, B. R., Salmela-Aro, K., & Phillips, S. D. (Eds.). (2017). Personal project pursuit: Goals, action, and human flourishing. Psychology Press.
McGoldrick, M., & Gerson, R. (1985). Genograms in family assessment. Norton.
Nelson, E., Sloper, P., Charlton, A., & While, D. (1994). Children who have a parent with cancer: a pilot study. Journal of Cancer Education, 9(1), 30-36.
Neugarten, B. L., Moore, J. W., & Lowe, J. C. (1965). Age norms, age constraints, and adult socialization. American journal of Sociology, 70(6), 710-717.
Phillips, A. G., & Silvia, P. J. (2005). Self-awareness and the emotional consequences of self-discrepancies. Personality and Social Psychology Bulletin, 31(5), 703-713.
Pinquart, M., Fröhlich, C., & Silbereisen, R. K. (2008). Testing models of change in life goals after a cancer diagnosis. Journal of Loss and Trauma, 13(4), 330-351.
Pinquart, M., Nixdorf-Hanchen, J. C., & Silbereisen, R. K. (2005). Associations of age and cancer with individual goal commitment. Applied Developmental Science, 9(2), 54-66.
Pinquart, M., Silbereisen, R. K., & Fröhlich, C. (2009). Life goals and purpose in life in cancer patients. Supportive Care in Cancer, 17(3), 253-259.
Schmitt, F., Santalahti, P., Saarelainen, S., Savonlahti, E., Romer, G., & Piha, J. (2008). Cancer families with children: factors associated with family functioning—a comparative study in Finland. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 17(4), 363-372.
Schroevers, M., Kraaij, V., & Garnefski, N. (2008). How do cancer patients manage unattainable personal goals and regulate their emotions. British journal of health psychology, 13(3), 551-562.
Snyder, R. (1998). Self-discrepancy theory, standards for body evaluation, and eating disorder symptomatology among college women. Women & health, 26(2), 69-84.
Street, H. (2003). The psychosocial impact of cancer: Exploring relationships between conditional goal setting and depression. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 12(6), 580-589.
Veale, D., Kinderman, P., Riley, S., & Lambrou, C. (2003). Self‐discrepancy in body dysmorphic disorder. British Journal of Clinical Psychology, 42(2), 157-169.
Visser, A., Huizinga, G. A., Hoekstra, H. J., Van Der Graaf, W. T., Klip, E. C., Pras, E., & Hoekstra‐Weebers, J. E. (2005). Emotional and behavioural functioning of children of a parent diagnosed with cancer: a cross‐informant perspective. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 14(9), 746-758.
Wrosch, C., Scheier, M. F., Miller, G. E., Schulz, R., & Carver, C. S. (2003). Adaptive self-regulation of unattainable goals: Goal disengagement, goal reengagement, and subjective well-being. Personality and social psychology bulletin, 29(12), 1494-1508.
Zahlis, E. H., & Lewis, F. M. (1999). Mothers' stories of the school-age child's experience with the mother's breast cancer. Journal of Psychosocial Oncology, 16(2), 25-43.