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研究生:洪燕萍
研究生(外文):HUNG, YEN-PING
論文名稱:育齡期癌症病人生育決策之經驗
論文名稱(外文):Experience of Fertility-Related Decision-Making in Child-Bearing Adults with Cancer
指導教授:邱秀渝邱秀渝引用關係
指導教授(外文):LEE, SHIUYU C. KATIE
口試委員:邱秀渝高美玲鄭文芳
口試委員(外文):LEE, SHIUYU C. KATIEGAU, MEEI-LINGCHENG, WEN-FANG
口試日期:2022-04-13
學位類別:碩士
校院名稱:國立臺北護理健康大學
系所名稱:護理研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2022
畢業學年度:110
語文別:中文
論文頁數:106
中文關鍵詞:癌症生育決策經驗親密關係
外文關鍵詞:cancerfertilitydecision-makingexperienceintimate relationship
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生育本是人類與生俱來的功能。然而罹患癌症帶來對生命的衝擊,部分癌症治療甚至影響育齡期病友的生育功能;即使生育保存科技進步,面對生育相關的決策或準備仍可能是困難的,亟待進一步的瞭解。本研究採用質性研究方法,以立意取樣的方式於北部某醫學中心及病友團體藉由半結構式問句共錄音訪談13位於育齡期罹癌的血液腫瘤、乳癌或婦癌病人,瞭解罹癌後面對生育相關的決策歷程及其經驗感受。資料經轉騰逐字稿後以質性分析法進行歸類與主題萃取且運用NVivo 12統整資料與編碼分類。
研究結果發現,育齡期癌症病人的生育決策經驗歸納出三個主題:保命與生育的拉鋸、生育相關的決策歷程、三角的親密關係。育齡期罹癌之際,受訪者面臨癌症疾病的脅迫下,考量保存性命優於生育的選擇;當疾病緩解或存活後重新考量生育的重要性,但持續經驗著保存性命與生育之間的抉擇拉鋸。生育相關的決策歷程不僅包含癌症治療前是否保存決策,治療結束後更有生育規劃的旅程。受訪者所經驗的伴侶親密關係或預期的伴侶關係建構,是個存在著癌症所組成的三角親密關係。本研究發現育齡期罹癌後,生育決策充滿著衝突,癌症與治療衝擊著親密關係的建立。本研究結果有助於提供臨床醫護人員瞭解育齡期癌症病人面對生育決策的感受經驗,提供適切護理與生育決策照護措施的發展。
Cancer and some treatments may impact on reproductive function. Even with advances in fertility preservation, deciding preservation or family planning after cancer may be difficult and further understanding is needed. A qualitative study with semi-structured interviews was used to understand the experience of fertility-related decision-making in patients having cancer at child-bearing age. 13 participants who had hematologic, breast cancer or gynecologic cancer at childbearing age were interviewed and data were analyzed by content analysis via NVivo 12. The results reflected 3 themes. First, these cancer patients’ fertility-related decision-making experience signified conflict between survival and childbearing. Patients continuously face the conflict even after the disease undergone remission. Second, the fertility-related decision-making may first experience upon diagnosis for fertility preservation and consider for family planning during surviving. Finally, the fertility-related decision-making after the cancer at child-bearing age brings up the perception of a triangular relation among the patient, the cancer and the partner or partner-to-be. Conclusion, the results of this study help provide clinical medical staff to understand the experience of fertility decision-making, and further support the development of intervention to assist the younger cancer patients in facing fertility-related decision-making.
目  次
中文摘要...............................................i
英文摘要..............................................ii
目次.................................................iii
表次................................................ .vi
第一章 緒論 1
第一節 研究動機與重要性 1
第二節 研究目的 7
第二章 文獻探討 8
第一節 質性研究方法 8
第二節 癌症與生育 9
第三節 不孕與治療 16
第四節 研究問題 22
第五節 名詞界定 22
第三章 研究方法 25
第一節 研究設計 25
第二節 選樣與研究對象 26
第三節 研究工具 27
第四節 資料收集過程 30
第五節 資料處理與分析 31
第六節 研究嚴謹度 34
第七節 研究倫理考量 38
第四章 研究結果 40
第一節 受訪者基本屬性 41
第二節 保命與生育的拉鋸 44
第三節 生育相關的決策歷程 56
第四節 三角的親密關係 63
第五章 討論 67
第一節 保命與生育的思維取向 67
第二節 持續性的保命與生育的拉鋸 70
第三節 倉促下的生育保存決定 71
第四節 親密關係起始的生育規劃 73
第五節 與癌相伴後的自我改變 75
第六節 親密關係的建立 76
第六章 結論與建議 78
第一節 研究結論 78
第二節 研究建議 79
第三節 研究限制 80
參考文獻 82
中文部分 82
英文部分 87
附錄 105
附錄一 受訪者概況表 105
附錄二 訪談指引 106


表  次
表 4-1育齡期癌症病人生育決策經驗之分析表 54
表 4-2受訪者基本屬性 56
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