新診斷之癌症患童父母之調適過程

Adaptation Process for Parents of a Child Newly Diagnosed with Cancer

本研究主要目的是探討5位癌症患童父母（4位母親與1位父親）在面臨孩童罹患癌症時其心理反應及相關的調適過程。以質性研究方法進行研究，資料收集與分析採並行之方式，並採用Miles & Huberman(1994)所提之資料分析方法加以整理及分析。研究結果顯示：父母親對孩童罹患癌症感受到的壓力為對孩童疾病狀況、醫療與癒後的不確定感，而父母親除了以哭泣與言語表達出其心中的苦水外，也會以身體症狀來表達壓力，並感受到因孩童疾病關係所導致的生活與工作改變、經濟負擔與忽略健康手足等影響。面對此壓力狀況父母會使用不同的調適策略以因應孩童疾病之壓力，包含主動尋求醫療相關資訊、尋求支持系統協助、樂觀面對／逃避與尋求宗教支持的方式，然而調適過程中會受影響因素影響，包括父母親對孩童疾病的認知、孩童疾病嚴重度與性別及人格特質。藉由此研究預先了解癌症患童父母所感受之壓力與反應，適時予以協助，提升護理品質。

The purpose of this study is to explore the psychosocial responses and adaptation process in four mothers and one father who had children with cancer. Based on a qualitative study design, data collection and data analysis proceeded simultaneously. The within and between case analysis suggested by Miles and Huberman was used for data analysis. Results showed that parents perceived stressors from uncertainty of the child's illness, treatment outcome, and progress of disease. Furthermore, in addition to crying and verbal complaints, parents reported psychophysical complaints (such as insomnia, dysmenorrhea, and physical discomfort). They also experienced effects related to changes in their daily life routines, jobs, financial burden, and sibling and health care. Moreover, parents used different strategies to cope with stress. They actively sought related medical information, sought different support systems, relied on religious support, or used avoidance. Factors affecting coping processes were perception of the child's illness, the severity of the child's illness, gender of child and personality of child. Findings suggest that, in order to improve quality of care, nurses need to better understand the stressors and responses of parents of sick children.