探討慢性精神病患兩性交往間病情揭露的心路歷程

Exploring the Illness Disclosure Process Through the Intimacy Relationship Experiences of Chronic Psychiatric Patients

背景：精神病患的兩性交往議題常被人忽略或避而不談，甚至被視為禁忌，但這卻是其人生重要經歷。
目的：本研究透過慢性精神病患的眼光和言談，來瞭解其在病情揭露時所面臨的歷程與處遇。
方法：研究設計應用紮根理論研究法，於台北市某精神專科醫院收取樣本，進行四次焦點團體及個別訪談6人，共有20位慢性精神病患參與研究。
結果：研究資料經分析及歸納，結果呈現參與者「兩性交往時自我病情揭露的歷程」，展現兩性互動時自我病情揭露的三部曲：包括告知前的考量—逃避、掙扎與退縮；告知時之心境—莽撞、坦然面對、或避重就輕；告知後的結果—接受、斥責、質疑或排拒及心境調適。
結論：本研究結果有助於護理人員深入體會精神病者面臨兩性交往時的自我處境與衝擊，瞭解其面對兩性交往時自我揭露病情的心路歷程；期望能依此提供病者個別的護理諮商，提升臨床及社區精神衛生護理品質。

Background: Issues related to psychiatric patient intimacy relationships are often neglected, sometimes to the point of being treated as taboo. Nevertheless, intimacy relationships are very important to the life of psychiatric patients.
Purpose: The authors designed this study to understand the processes used by psychiatric patients to make decisions about disclosing information on their illness to their dating partners.
Methods: This study used grounded theory techniques, and data were collected using four focus group interview sessions and six in-depth individual interview sessions held at a psychiatric hospital in Taipei. Study subjects included twenty chronic psychiatric patients.
Results: Data analysis identified three distinct stages of illness disclosure, including: 1) Considerations before disclosure: avoiding, struggling, or withdrawing; 2) Experiences during disclosure: hastening, facing confidently or choosing the easiest way; and 3) Results after disclosure: accepting, blaming, doubting, or refusing and adjusting their mind.
Conclusions: The authors hope study results will help nurses understand better the stresses and impacts of illness disclosure and gender interaction experiences that psychiatric patients undergo and provide nurses with more ideas and approaches on counseling psychiatric patients about the illness disclosure process in the dating process in order to improve quality of care to this population.