愛滋病患診斷期之心理歷程及因應行為

The Psychological Progress and Coping Behaviors for AIDS Patients During the Diagnostic Phase

本研究採現象學研究法，目的在瞭解愛滋病患診斷期之心理歷程及其因應行為，依據Denzin身心交互影響說(Interpretive interactionism)為研究架構，收集16位南部某醫學中心門診或住院的HIV(+)/AIDS病患進行觀察及低結構式訪談，讓病患以回溯方式，就初知愛滋病診斷的心路歷程及其因應行為，做深入的自我揭露。在資料分析信度，評量者間信度為93.3～95.5%，評量者本身之信度為94.5%。結果在診斷期之心理歷程共分兩階段：紊亂的負向經歷與生命重置；因應行為分為消極的逃避與積極的生活延展。經過因應策略之後，診斷期愛滋病患約在3個月後由紊亂的負向經歷進入生命重置階段。建議深入瞭解診斷期愛滋病患之心理歷程，且協助適當之因應策略，使診斷期愛滋病患由紊亂負向經歷中順利進入生命重置歷程。

The purpose of this study was to understand the psychological progress and coping behaviors for AIDS patients during the diagnostic phase. A phenomenological design was used. The study framework was based on Denzin's interpretive interactionism. In-depth interviews and observation were used to collect data from sixteen patients during their outpatient visits or during their hospitalization at a southern medical center in Taiwan. Patients retrospectively recalled their psychological progress and coping behaviors. The inter-rater reliability was 95.5%; intra-rater reliability was 94.5%. Results showed that the psychological progress was divided into two stages: a disorderly stage with negative progress and a life orderly stage. Coping behaviors included passive avoidance and active life moving on. Once AIDS patients developed positive coping behaviors, they moved from the disorderly stage to the life orderly stage within three months of diagnosis. Findings suggest that it is important to understand the psychological progress and coping behaviors for AIDS patients during the diagnostic stage and to assist them to use appropriate coping behaviors. By so doing, AIDS patients in the diagnostic stage can pass smoothly from the disorderly stage with negative progress to the life orderly stage.