肝硬化合併腹水病患之調適經驗

Adjusting Experience ofPatients with Liver Cirrhosis Ascites

本研究目的以探討肝硬化合併腹水病患的調適經驗為主題。透過詮釋現象學方法的引導，以立意取樣選取五位研究參與者。資料取得透過半結構式的深度訪談以及田野的參與觀察。錄音內容逐字謄為文本資料後，與田野觀察紀錄綜合分析，以瞭解研究對象在病身處境中，最深層的內在感受與自我反思。結果得出肝硬化合併腹水病患的調適作為，主要表現在四個交錯的經驗脈絡上：（1）面對身體失序，（2）學習與疾病共處，（3）家庭關係的支持與維繫，以及（4）自我調整後的生存樣態。研究結果顯示肝硬化合併腹水病患雖因身體失序引發情緒與生活等適應問題，但亦學習與疾病共處；此外，家庭關係的支持，有助於生存意義與樣態的調適。本研究可增進對其調適經驗內涵的瞭解，亦可提供護理人員在臨床照顧的參照，建立與病人疾病與共的照護模式。The purpose of this research was to explore the adjusting experience of patients diagnosed as liver cirrhosis with ascites. This research purposively selected 5 participants in accordance with the hermeneutic-phenomenological method. The data were collected by semi-structured in-depth interviews and participant observations in the field. The verbatim text of interviews was then analyzed along with the field notes in order to realize the deepest inner feeling and self-reflections of the subjects who were physically ill. The result showed that the patients’ adjusting behavior was mainly presented in four interacted experiential contexts: 1. facing the bodily disorder, 2. learning to live with the disease, 3. supporting and maintaining family relationship, 4. self-adjusting the mode of life. The results demonstrated that patients with liver cirrhosis ascites learned to live with the disease although they faced the adjusting problems of emotion. In addition, family support was helpful to the adjustment of existential meaning and mode of life. This research can help improve understanding on the meanings of the patients’ adjusting experience. It can also serve as a reference for nurses in clinical care and establish a care model in which caregivers are in tune with the illness of patients.