運用家庭調整與適應反應模式於一位愛滋病患家庭之照顧

Applying the Family Adjustment and Adaptation Response Model to Care of an AIDS Patient's Family

社會對愛滋病患存在歧視，不但影響病患也使家庭可利用社會資源受到限制。本文敘述一位31歲愛滋病患因其家庭需求、家庭能力以及家庭意義三者間不平衡而面臨家庭危機，筆者於照護期間應用家庭調整與適應反應模式進行評估與資料收集，歸納後發現個案家庭面臨的健康問題包括：(1)家屬間溝通不良；(2)家屬缺乏疾病照護相關知識與技巧；(3)家庭運作過程紊亂。筆者秉持著以家庭為中心的理念，成為其家庭成員的溝通橋樑而化解彼此的誤會；提供疾病照護知識，減輕因照顧個案帶來的壓力。透過跨部門間聯繫，提供該家庭社會資源並協助家屬運用得宜，成功地協助個案家庭的家庭意義、家庭需求和家庭能力間再度恢復平衡，達到良好適應。臨床上若能運用此模式，掌握愛滋病患家庭存在的能力、需求與意義，協助家庭成員發展其能力、降低需求以及對家庭意義有正面的認知，即能幫助愛滋病患家庭朝正向的調適。

Discrimination against AIDS patients occurs in our society, not only influencing the patients but also restricting their usage of social resources. We report on a 31-year-old AIDS patient facing a family crisis because of an imbalance between the meanings, demands, and capabilities of his family. In this paper, we have applied the family adjustment and adaptation response (FAAR) model to assess this family, and identified three health problems, including (1) poor communication among family members, (2) deficiency in disease-related knowledge and skill, and (3) dysfunctional processing among the family. Throughout the care, we adopted a family-centered belief to communicate with the family to resolve their misunderstandings. We provided the family with information related to the disease to reduce their stress arising from caring for the patient. We also helped the family to utilize social resources by coordinating multi-disciplinary care. The family successfully restored a balance between meanings, demands, and capabilities. If we can apply this model clinically to understand the capabilities, demands and meanings of family existence as well as to help family members to develop their capabilities, reduce demands and recognize the positive meanings of family, we can help AIDS patients and their families to achieve positive adaptation.