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研究生: 吳秋南
Wu, Chiu-Nan
論文名稱: 中途失明者主要照顧家屬心路歷程探討
A Study on the Psychological Process of Family Caregivers for Individuals with Adventitious Blindness
指導教授: 張千惠
Chang, Chien-Huey
口試委員: 林寶貴 何英奇 張千惠
口試日期: 2021/08/26
學位類別: 碩士
Master
系所名稱: 復健諮商研究所
Graduate Institute of Rehabilitation Counseling
論文出版年: 2021
畢業學年度: 109
語文別: 中文
論文頁數: 311
中文關鍵詞: 中途失明照顧家屬生活重建自立生活社會支持
英文關鍵詞: adventitious blindness, caregiver, rehabilitation, independent living, social support
研究方法: 質性研究敘事探究法
DOI URL: http://doi.org/10.6345/NTNU202101670
論文種類: 學術論文
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  • 本研究採敘事探究(narrative inquiry)法,旨在探究中途失明者主要照顧家屬心路歷程,並了解照顧者對社會支持的覺知。為提供其他中途失明者與其照顧家屬能有可供參考之案例,以協助他們能有效面對並適應新生活模式,本研究以立意取樣,邀請五位重建成功之中途失明者,及六位他們的主要家庭照顧者,同為協同研究參與者,採用半結構訪談大綱,蒐集其照顧歷程的生命故事。針對研究問題,提出以下結論。
    本研究對於中途失明者照顧家屬心路歷程研究之新發現有:一、主要照顧者對失明家屬就醫態度視情況有異;二、男性承擔照顧意願增高,顛覆過去的刻板印象;三、照顧者與被照顧者之雙老家庭,照顧的高難度值得關注;四、照顧者與被照顧者都應建立強大內在能量,並擴展生命視野;五、照顧家屬具正向宗教信仰,有助於接受失明的事實,並規劃妥善照顧方式;六、中途失明者成功的生活重建,有助於家庭盡早重回正常的生活軌道。七、本研究五位中途失明者,是屬於生活重建成功適應的案例,且其照顧家屬的人格特質良好,故照顧者的身心健康狀況未必受影響;八、中途失明者不同時期生活狀態,是影響主要照顧家屬情緒歷程的主因;九、現今社群網絡,有助於主要照顧家屬人際關係不受影響;十、本研究中六個家庭之經濟狀況原本即較為優渥,在發生家人成為中途失明者後,其家庭經濟狀況並未受到影響。故照顧家屬者是否受困於經濟壓力,端視該家庭原有經濟狀況而定;十一、照顧家屬能自我覺察,有助於因應負向歷程;十二、照顧家屬向外尋求支援有助於重建正向生活。

    探討中途失明者照顧家屬對社會支持的覺知的結論為:一、具價值性的資訊支持,有助於採取正確且適當決定照顧策略;二、具體的實質支持,有助於消除或減緩照顧者的壓力;三、網絡支持有助於照顧者減少孤單感;四、來自受照顧者的情感支持,有助於主要照顧者感受到愛與鼓勵;五、受照顧者、其他親人或陌生人的肯定,都是主要照顧者自尊支持的來源。
    本研究亦針對中途失明、主要照顧家屬、外部支持系統提出不同建議,期望對照顧安排、照顧能量提升、以及照顧服務規劃,能有所助益。此外,根據本研究限制,亦對未來研究提出相關建議。

    This qualitative study, with narrative inquiry, explored the psychological process of family caregivers for individuals with adventitious blindness. Therefore, the focus of this study is to investigate the psychological process of family caregivers and the social support that caregivers perceived. Data were collected and analyzed from semi-structured interviews of 11 participants, including 6 family caregivers and 5 individuals with adventitious blindness. To investigate the new life of the persons with visual impairments and their caregivers, this study chose purposive sampling methods to find out their experiences and perceptions.
    By analyzing the life experience of the participants, 12 themes emerged as follows: (1) caregivers had different attitudes towards medical treatment of the family members with visual impairments, (2) male mem-bers of family were willing to take more responsibility of caring than before; (3) it was necessary to pay attention to the issues of double-aging families of caregivers and care recipients; (4) both caregivers and care recipients needed stronger inner energy for a wider vision of life; (5) positive religions were helpful for caregivers both in accepting family members with visual impairment and care taking of him/her; (6) successful rehabili-tation of the persons with visual impairments was the key to re-build normal family life; (7) the caregivers maintained physical and mental health because of optimistic personalities and the successful rehabilitation of their care recipients; (8) the main reason of influencing the caregivers’ emotion was the different period of the recovering process of their care recipients; (9) the social network groups contribute to maintain caregivers’ interpersonal relationships; (10) in this study, the financial pressure did not arise since the six families with visually-impaired members had favorable financial situations, hence, the caregivers were not suffering from financial dif-ficulties as some literature mentioned; (11) caregivers’ self-awareness of their challenges was helpful for them to cope with their negative experi-ences during the process; (12) looking for social support contributed to reconstruction of positive life for caregivers.
    The conclusions about caregivers’ perceptions of social support con-tained: (1) appropriate methods can be made for caregivers through helpful informational support; (2) specific tangible supports are able to remove or alleviate the stress of caregivers; (3) longlines of caregivers will be reduced by using social network support; (4) emotional support from the care recipients makes the caregivers feel being loved and encouraged; (5) Recognition from care recipient, family members or outsiders is the sources of caregivers’ esteem support.

    For promoting benefits of life care, this study offers suggestions to persons with visual impairments, caregivers and social support system of the society. Moreover, some suggestions are provided for the future re-search and limitations are also discussed.

    第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的及問題 5 第三節 名詞釋義 5 第二章 文獻探討 7 第一節 中途失明者生活適應的挑戰 7 第二節 主要照顧家屬的心路歷程 15 第三節 社會支持與照顧者 22 第三章 研究方法 31 第一節 研究取向 31 第二節 研究參與人員 31 第三節 研究工具 35 第四節 資料處理與分析 36 第五節 研究信實度 37 第六節 研究倫理 38 第四章 研究結果 41 第一節 春嬌與志明的故事:陪伴一生終不悔幸福再現 41 第二節 小鳳與小傑的故事:長姐如母照顧幼弟不嫌累 72 第三節 淑芬與鈺慧的故事:世上只有媽媽好千古不變 85 第四節 約翰與勇伯的故事:照顧父親是個甜蜜的負擔 114 第五節 文超與薔薇的故事:心眼明亮夫妻感情更契合 150 第六節 恩惠與約伯的故事:夫妻同心走出幽谷迎新生 183 第五章 研究結果分析與討論 233 第一節 中途失明者主要照顧家屬心路歷程 233 第二節 中途失明者主要照顧家屬對社會支持的覺知 267 第六章 結論與建議 283 第一節 結論 283 第二節 建議 291 第三節 研究限制與未來研究建議 297 參考文獻 299 附錄 309

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