家庭護理對精神分裂症父親之子女生活經驗的影響

The Effect of Family Nursing on the Lived Experience of Children Living with Schizophrenic Fathers

本研究主要目的為探討與罹患精神分裂症父親同住之子女的生活經驗，及家庭護理對子女生活經驗的影響。研究設計採現象學的方法，研究對象來自四個精神分裂病患者家庭中共六位青春期子女，資料收集方法為藉由家庭護理處置的提供，及低結構性的會談，深入探討六位青春期子女與罹患精神分裂症父親同住的生活經驗。研究結果發現，子女的生活經驗分為陷入困境、逐漸調適、超越三個向度。陷入困境包含與病父沉重的相遇、情緒不穩定二個次向度，為情緒受到父親疾病負面衝擊的結果；逐漸調適包含病父－－家父的擺盪、與病父共存、在能力範圍內照顧父親、認同及分化、家父的再形成五個次向度，為子女在家庭護理介入後，面對父親疾病在認知、行為、情緒上所做的調適過程；超越則包含對精神病患的正向態度、關懷父親的疾病及藥物以及開展家庭生活格局三個次向度，主要描述子女能夠關懷父親並參與改善家庭生活品質，能量移轉的階段。研究結果可提供精神衛生護理人員照護精神分裂症病患時，能以家庭護理的介入措施，了解子女的生活經驗並協助子女正向調適。

The purpose of this study was to explore by means of the phenomenological method the effect of family nursing on the experience of six adolescent offspring living with schizophrenic fathers. Data were collected by family intervention with low structured interview. Three themes of the lived experience of adolescents were identified: stalemate, coping and transcendence. The sub-dimensions of stalemate included encounter with ”sick father” and unstable emotion, which resulted from the negative impacts of the father's illness. The sub-dimensions of coping included ”sick father” or ”my father”, being with ”sick father”, trying to take care of ”sick father”, identification and differentiation, and the reformulation of ”my father”. These sub-dimensions emerged after family intervention and included coping in cognition, emotion, and behaviors. The sub-dimensions of transcendence included positive attitude toward psychiatric patients, caring for father's disease and medications, and family life restructuring. The findings from this study could help psychiatric mental health nurses to apply family interventions in order to gain a better understanding of the lived experience of children living with schizophrenic fathers and to enable them to cope positively with the father's disease.