為什麼是我？一位青年期慢性病人於疾病與 自我間的掙扎

Why Me? An Adult Chronic Patient’s Struggle between Illness and Self-Identity

本文整理筆者在一般內科醫療病房，透過持續性的臨床會談，深入了解一位慢性病人的自我認同與疾病表徵變化等心理議題，同理共感於痛苦處境並得付出心理關懷之照顧歷程。本例病人為31歲男性，曾向主治醫師陳述家庭衝突造成其情緒低落及自殺意念，並經常未規律回診，常因症狀嚴重難耐才由急診轉住院治療。於心理會談中，病人自陳常因受困於醫院或聽到他人對自身處境的嫌棄貶損，陷入自我懷疑與批判，渴望能以死解脫。此病人在罹病後，會為疾病妥協生活，在抗拒與接受疾病間掙扎，致使全面影響其身心健康和病情控制。本文發現臨床工作者若可以透過反思與支持，以心理學的人文視角協助病人在自我認同與疾病表徵上的調適，有助於未來之疾病因應，本文的照護經驗可以作為其他醫療人員全人照護時的參考。

 

In the article, we summarized our endeavor in reaching an in-depth understanding of the struggle between illness and self-identity and other related mental health issues of an adult chronic patient in an internal medicine ward through clinical interviews, an endeavor prompting us to recognize the crucial importance of empathy in treating adult chronic patients struggling with changing perceptions of self-identify and illness representation. The patient in this case was a 31-year-old male who reported to his visiting staff that family conflicts had caused his depression and suicidal ideation. During the clinical interview, the patient expressed that he often fell victim to self-doubt because of being trapped in the hospital or hearing others criticize him, and he longed for death to find relief. Patients with chronic diseases often need to compromise their lives due to the illness and may struggle between resisting and accepting the illness, which can have adverse impacts on their mental health and disease control. The author suggests that medical practitioners should foster and use their empathy to help patients adjust their perceptions of self-identity and illness representation, encouraging patients to better cope with the impacts of their chronic diseases.