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研究生:林意綠
研究生(外文):Lin, Yi-Lu
論文名稱:自閉症類群障礙症及注意力不足過動症共病兒童母親之親職壓力與因應策略探究
論文名稱(外文):Parenting Stress and Coping Strategies in Mothers of Children with Comorbid Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder
指導教授:趙家琛趙家琛引用關係
指導教授(外文):Chao, Chia-Chen
口試日期:2021-07-07
學位類別:博士
校院名稱:臺北市立大學
系所名稱:教育學系
學門:教育學門
學類:綜合教育學類
論文種類:學術論文
論文出版年:2021
畢業學年度:109
語文別:中文
論文頁數:335
中文關鍵詞:自閉症類群障礙症注意力不足過動症兒童親職壓力壓力因應策略
外文關鍵詞:attention-deficit/hyperactivity disorderautism spectrum disorderchildrenparenting stressstress coping strategy
相關次數:
  • 被引用被引用:7
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  • 下載下載:280
  • 收藏至我的研究室書目清單書目收藏:5
本研究旨在瞭解自閉症類群障礙症(ASD)和注意力不足過動症(ADHD)共病(ASD/ADHD)兒童母親在教養其孩子時所感受到的親職壓力內涵及壓力因應策略。研究者試圖從詮釋現象學方法論觀點,還原ASD/ADHD共病兒童母親之親職壓力本質,並詮釋經驗蘊含之深層意義。本研究邀請兩位養育ASD/ADHD共病兒童之母親,進行半結構式深度訪談,並對所蒐集之文本資料進行分析。
研究發現,ASD/ADHD兒童母親的親職壓力建構有以下特點:(一)親職教養經驗的自我詮釋,影響親職壓力建構情形;(二)親職壓力經驗的觀察和內化,引發預期糟糕情境的心理恐懼;(三)照顧ASD/ADHD孩子,造成職涯早閉;(四)與主流文化互動的主觀詮釋,影響親職壓力建構情形;(五)親職壓力經驗,影響母親建構對自我效能的認知;(六)早期介入至關重要;(七)生心理壓力,讓母親倍覺負荷;(八)父母自身的ASD/ADHD症狀,是影響親職效能的重要因素;(九)家庭支持模式與情感聯繫的策略,是親職壓力緩解的重要考量;(十)喘息服務與增進親職教養策略,是單親家庭親職壓力緩解的重要考量;(十一)「共依附」的親子關係,阻礙了個體的自我分化;(十二)被誤解/標籤的經驗,開啟尋求同理、認同與對話的歷程。本研究進一步發現,親職壓力因應現象的社會建構,奠基於ASD/ADHD兒童母親的主觀真實感受,有以下特點:(一)對社會支持的觀望與展望,影響親職壓力調適情形;(二)多元韌性因子交互作用,以因應親職教養上的困頓與壓力;(三)世俗框架的解構及對孩子ASD/ADHD相關症狀的重構,調解親職壓力;(四)意義的追尋/問題的解答是持續建構親職教養效能的動力。
綜觀研究結果,可將ASD/ADHD兒童母親經歷的親職壓力歸納為五個主題:(一)責任一肩扛;(二)受苦;(三)不確定感;(四)以孩子為生活中心;(五)資源整合的挑戰。其壓力因應策略亦可歸納為五個主題:(一)找解釋、找出口、轉換心境;(二)社會支持的尋求及獲得;(三)教養歷程中透過內在轉化力量而得以抱持較正向信念、自我扶持與成長;(四)尋求意義的解構及重構;(五)生命的體悟。
本研究對ASD/ADHD兒童的母親、家庭、學校教育、政府相關政策、諮商輔導工作及醫療實務,以及未來研究方向等提出建議,以供相關人士參考。
This research intends to explore the parenting stress and coping strategies in mothers of children with comorbid autism spectrum disorder and attention-deficit/ hyperactivity disorder. In-depth semi-structured interviews were conducted with two mothers. Based on the perspectives of Hermeneutic Phenomenology, the researcher tried to restore the stressful nature of parenting children with comorbid ASD/ADHD and interpret the deep meaning of these mothers’ experience.
The results of this study showed that the parenting experience construction of mothers of children with comorbid ASD/ADHD has the following characteristics: (1) The self-interpretation of stress experience affects the parenting construction; (2) The observation and internalization of parenting experience triggers anticipating the psychological fear of bad situations; (3) Taking care of children with ASD/ADHD, causing early closure of work life; (4) Subjective interpretation of interaction with mainstream culture affects the construction of parenting stress; (5) Parenting experience affects the mothers’ perception of self-efficacy; (6) Early intervention is very important; (7) Physical and psychological pressure make mothers feel more burdened; (8) Parental broad autism phenotype is an important factor affecting parental efficacy; (9) The family support model and the strategy of affectional connection are important considerations for the relief of parenting stress; (10) Respite service and improved financial condition are important considerations for the relief of parenting stress in single-parent families; (11) The co-dependence in parent-child relationship hinders the individual's self-differentiation; (12) The experience of being misunderstood/labeled opens the process of seeking empathy, identification, and dialogue.
This study further found that the social construction of parenting stress coping phenomenon is based on the subjective reality of mothers of children with comorbid ASD/ADHD. It has the following characteristics: (1) Waiting and expecting social support affects the stress coping situation; (2) The interaction of multiple resilience factors to cope with parenting difficulties and stress; (3) Deconstruction of the secular framework and reconstruction of children’s ASD/ADHD-related symptoms to relieve parenting stress; (4) The pursuit of meaning/answers for questions are the driving force for the continuous construction of parenting efficacy.
In conclusion, maternal parenting stresses are summarized in five themes: (1) responsibility; (2) suffering; (3) uncertainty; (4) child-centered life; (5) challenge of resource integration. The maternal stress coping strategies are summarized in themes: (1) finding explanations, finding outlets, and shift moods; (2) seeking and obtaining social support; (3) through the power of internal transformation in the parenting process to hold more positive beliefs, self-support, and growth; (4) deconstruction and reconstruction of meaning searching; (5) experiential understanding of life.
Based on the research results, several suggestions are made for mothers and families of children with comorbid ASD and ADHD, educators, policy makers, mental health professionals, medical practitioners, and researchers.
第一章 緒論
第一節 研究背景與動機3
第二節 研究目的與問題7
第三節 名詞釋義7

第二章 文獻探討
第一節 ASD/ADHD共病現象之探討11
第二節 ASD/ADHD共病兒童母親的親職壓力與因應策略17

第三章 研究方法
第一節 研究取向81
第二節 研究參與者85
第三節 研究設計89
第四節 研究工具92
第五節 研究程序98
第六節 文本理解的方式100
第七節 研究嚴謹度106
第八節 研究倫理110
第九節 親師壓力經驗兩研究結果間的對話116

第四章 結果與討論-敏媽
第一節 敏媽的成長背景與調適125
第二節 生命的試探--敏媽的親職壓力經驗探究128
第三節 生命的淬礪--敏媽的親職壓力因應經驗探究168

第五章 結果與討論-廷媽
第一節 廷媽的成長背景與調適199
第二節 人生是一場賭注--廷媽的親職壓力經驗探究201
第三節 雖千萬人, 吾往矣--廷媽的親職壓力因應經驗探究235

第六章 綜合討論
第一節 ASD/ADHD共病兒童母親親職壓力建構與詮釋261
第二節 影響ASD/ADHD共病兒童母親親職壓力建構之關鍵性因素275
第三節 研究反思280

第七章 結論與建議
第一節 結論285
第二節 研究限制與建議287
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