新生命新適應：腎臟移植者心理與社會適應之詮釋

New Life New Adaptation: An Interpretation of the Psychological and Social Adaptation of Kidnay Transplant recipients

研究者以腎臟移植者家屬的角度出發，運用對器官移植相關的「前理解（pre-understanding）」進入研究場域，採用詮釋現象學研究方法將研究對象置於其生活世界進行理解並詮釋其腎臟移植的生活經驗。研究對象選擇10名腎臟移植1年以上之受訪者，包含4位臺灣屍體移植、4位中國大陸移植、2位活體親屬移植。研究問題著重在腎臟移植者的心理與社會層面，包括：（一）探討腎臟移植者在治療經驗中身體心像（body image）的樣貌、（二）在心理方面，腎臟移植者對新器官的身體適應過程、（三）在社會方面，腎臟移植術後透過新腎臟與社會系統互動連結的經驗。對文本的詮釋分為：（一）新適應－與新器官共處，包含：1.身體心像：我的身體不是我的身體；2.體化：新器官內在化的過程；3.器官捐贈者的互動：永無止息的連帶；（二）新生活－對生活世界的再理解，包括：1.存有與時限性：新器官無法確定的使用期限；2.新生活型態：一切以健康為重、3.生命的價值：生命意義的再理解。文末研究者從移植前的準備工作：著重以醫療處遇為基礎的衛教與資訊傳遞、以正向身體心像對新腎臟寄予希望、數字或心智：誰決定腎臟移植後存有的樣貌三部分提出討論。並提出以全人為中心移植團隊為外圍的包覆性服務、強化心理社會適應資訊完整度奠定等待移植者的決策基礎、增進腎臟移植者病友團體功能三項建議。

The researcher used the 'pre-understanding' of the family members of kidney transplant recipients as a starting point for this research. Based on hermeneutical phenomenological research methods, put the research object in their life world to understand and interpret their life experience of kidney transplantation. The subjects of the study included 10 people who had undergone kidney transplantation for more than one year, including 4 cadaver transplants in Taiwan, 4 transplants in China, and 2 relatives transplanted. The research questions focus on the psychological and social aspects of kidney transplant recipients, including: (1) Exploring the body image of kidney transplant recipients in their treatment experience; (2) In the psychological aspect, the process of the kidney transplant recipient's physical adaptation to the new organ; (3) In the social aspect, the experience of interacting with the social system through the new kidney after kidney transplantation. The interpretation of the text is divided into three parts: (1) The new adaptation: coexist with the new kidney; (2) The new kidney: service without warranty; (3) The new life: re-understanding of the life world. At the end of the article, the researcher starts from the transplant recipient, and discusses three parts: Information acquisition before transplantation, hope for the new kidney with a positive body image, The appearance of human beings after kidney transplantation. And three suggestions are put forward: (1) Focus on the whole person as the center of the transplant team for the peripheral covering services; (2) Increase the completeness of psychosocial adaptation information, in order to lay the foundation for decision-making for transplant recipients; (3) Improve the patient group of kidney transplant recipients Function.