探索接受中醫治療痛經婦女經期不適的生活經驗

Exploring the Experience of Dysmenorrhea and Life Adjustments of Women Undergoing Traditional Chinese Medicine Treatment

背景：過去研究著重於婦女痛經的態度、痛經的特性和自我照顧行為，或探討傳統中醫治療痛經的療效及安全性，對於連結婦女自身的痛經經驗與傳統中醫治療的研究相對較少。目的：探索接受中醫治療痛經婦女的經期不適之生活經驗。方法：本研究以半結構的訪談指引，採一對一深入訪談的方式蒐集資料。參與研究者每人接受一次訪談，費時約60-90分鐘。研究者於訪談過程同時觀察婦女的語氣、表情與行為舉止並予記錄，共有40位因痛經接受中醫治療的婦女參與研究。使用內容分析法分析所得的文本資料，並以ATLAS. ti 5.2版軟體輔助進行。結果：本研究個案經歷痛經並接受中醫治療的過程及相關生活經驗資料，分為四個主題來探索，即「冰山一角」、「破冰之舉」、「心力拔河」和「最終融合」。起先，她們痛經的症狀常被視為像冰山一角的小問題，直到問題逐漸惡化影響到生活才進入破冰階段，想要去改變它，故而尋求傳統中醫的協助。當婦女無法依中醫師提供的治療方式或改變生活習慣的建議時，則會陷入心力拔河，不知是否繼續中醫治療。至最後逐漸接受中西醫作法的交融，致使她們能夠找出最適合自己減除痛經的策略，達到最終的適應與平衡。結論：本研究結果可提供護理人員作為與病患在進行溝通其痛經及中醫治療時的參考。

Background: Previous studies of women with dysmenorrhea have focused on menstrual attitudes, the characteristics of menstrual pain, and self-care behavior. Traditional Chinese Medicine (TCM) studies on dysmenorrhea, on the other hand, have focused on the efficacy and safety of TCM treatments. Few studies have investigated how women perceive their own TCM-treatment experience of dysmenorrhea. Purpose: The objective of this study was to explore the experience of dysmenorrhea and life adjustments of women undergoing TCM treatment. Methods: A semi-structured interviewing guide was used to collect data. A total of 40 dysmenorrheal women participated in the study. Individual, in-depth interviews were conducted for about 60-90 minutes with each participant. Their speech tone, facial expressions, and gestures during the interview process were also observed and recorded. The findings were analyzed using content analysis via ATLAS. ti 5.2 software. Results: The process that the participants used to adjust to dysmenorrhea were distinguished into four progressive stages: ＂tip of the iceberg＂, ＂ice-breaking＂, ＂tug-of-war＂, and ＂blending-in＂. Initially, the participants perceived the symptoms of dysmenorrhea as the ＂tip of the iceberg＂. They attempted to hide / ignore the initial pain until the problem gradually worsened to the point that the symptoms began to significantly affect various aspects of life. It was only then that the participants began to pay attention to the problem and to seek help from TCM practitioners, which we defined as the ＂ice-breaking＂ stage. If they encountered unexpected situations with regard to the treatment regimen, the participants entered the ＂tug-of-war＂ stage, during which they struggled over whether to continue with TCM treatments. Afterward, the participants gradually achieved a ＂blending-in＂ of new ideas, which allowed them to identify the strategies that best facilitated adjustment and rebalancing. Eventually, the participants achieved a new life balance. Conclusion: The outcomes of the present study may be referenced for nurse-patient communications that relate to dysmenorrhea and TCM treatment.