初次罹患急性心肌梗塞婦女病發的生病經驗

Illness Experiences of Women Following First Incidence of Acute Myocardial Infarction

本研究目的為探索初次急性心肌梗塞婦女心臟病發作的生病經驗。研究對象取自南部某教學醫院，共17位初次急性心肌梗塞婦女參與研究。研究步驟依循Denzin之解釋性互動論，以參與式觀察及深度訪談收集資料，並將錄音訪談過程及田野筆記以內容分析法分析，共歸納出三個主題及十二個次主題。初次急性心肌梗塞婦女心臟病發作的生病經驗中，在最初「我怎麼了？」的主題包含了六個次主題，呈現婦女在身體症狀出現後，到進入醫療系統被診斷出急性心肌梗塞的求醫歷程。再者第二個主題「我是個病人！」包含了三個次主題，呈現出婦女在權威的醫療體系中，如何尋求病人角色的定位以維持內心的自我。最終主題「我還是我自己！」包含了三個次主題，呈現婦女從醫療體系回到日常生活後，努力的回到原有的社會角色功能，以擺脫病人角色並重獲身體自主權。本研究貢獻在於建立屬於本土婦女的生病經驗，及提醒醫療人員在面對女性病患時應有的認知，做為真正落實人性化醫療的照護觀點。

Purpose sampling methods were used to recruit 17 participants from a medical center in southern Taiwan. Data were collected via participant observations and interviews, with an emphasis on following Denzin’s interpretative interactionism principles. Interviews were audiotaped and transcribed and the texts analyzed using constant comparative methodology. Three themes and twelve subthemes were identified. The first theme, “I have something wrong,” embraced six subthemes associated with body symptom awareness and diagnosis. The second theme, “I am a patient,” included three subthemes tied to patient roles and making use of rational strategies to maintain stability and self within a complex medical system. The last theme, “I can still be myself,” included three subthemes connected with the struggle to return to old roles and functions to overcome limitations. The findings offer a picture of Taiwanese women’s illness experiences that can be used by medical and nursing school professional to increase awareness of special needs among female patients.