連接自我與家鄉的信物──檳榔在台灣原住民族文化中的角色

A Symbol of Connectedness Between the Self and the Tribal Home: Betel Quid in the Lives of Indigenous Taiwanese

背景嚼食檳榔行為雖被視為形成口腔癌重要的因素，然仍有相當高比例的台灣原住民族具有長期嚼食檳榔的行為。目的本研究目的欲從文化傳統的角度，深入了解原住民個案嚼食檳榔習慣的意義。方法以描述性質性研究法，採立意取樣方式，針對10位長期規律嚼食檳榔的原住民族受訪者，進行4位一對一半結構式深入訪談與6位以焦點團體收集資料，再以質性內容分析法中開放式編碼、意義歸類、同質類別的命名、與次主軸與主軸形成等過程，完成資料的分析。結果對大部分研究參與者，嚼食檳榔是一種生命軌跡呈現的方式，具有一種連結自我定位與歸屬的印信功能。可歸類出五個主軸為：增進自我定位與部落歸屬的功能、人生愛情依戀的見證、傳統生活與成長慶典的元素、與環境永續共存的態度、以及具有身體病痛醫治的效益。結論／實務應用檳榔在原住民族文化中具有特殊的重要意義。因此，健康照護者須先了解檳榔在原住民族文化中扮演的角色，使能提供有效的政策，協助台灣原住民個案成功戒除嚼食檳榔的行為，以降低罹患口腔癌的風險。

Background: Betel quid chewing plays a significant role in the development of oral cancer, yet the high prevalence of betel quid use remains a serious health problem in Taiwan, especially among indigenous Taiwanese. Purpose: The present study aimed to understand the reasons behind betel-quid chewing among indigenous Taiwanese people by examining the larger context of their culture and traditions. Methods: This descriptive, qualitative study recruited ten regular betel quid indigenous chewers using purposive and snowball sampling. Four of the participants were interviewed individually and the remaining six comprised a focus group. Data were collected using in-depth interviews with semi-structured guidelines and analyzed using qualitative content analysis following the process of open coding, identifying codes, giving meaningful names to codes, putting similar codes in categories, and grouping categories into themes. Results: Most of the participants associated betel quid with significant aspects of life, with betel quid symbolizing social belonging. In indigenous cultures, betel nut embodies the enduring companionship of lifelong friends. For the study participants, chewing betel quid was associated with symbolic meanings associated with the following five themes: betel quid chewing helps reinforce self-identity and sense of belonging; betel quid is considered a traditional symbol of love and marriage; betel quid reflects the celebration of simple abundance in indigenous life; betel quid represents an attitude toward life that accentuates the importance of learning to live in everlasting harmony with the environment and nature; and betel quid chewing is used to cure physical ailments and mitigate dental problems. Conclusions / Implications for Practice: Beliefs related to chewing betel quid deeply impact the attitudes of indigenous people toward this behavior. Because chewing betel quid is an essential part of Taiwanese indigenous community life, the cultural and symbolic meanings of this practice must be taken into consideration when drafting related policies and developing cessation programs in order to help indigenous betel-quid chewers effectively reduce the risk of developing oral cancers.