進退維谷：糖尿病患者的認同建構

本研究以社會建構式紮根法探討糖尿病患者的認同建構，共訪談44名個案。研究發現認同的意涵不只是一種同一性的意義，也是一種自我認定的形式。然而，糖尿病患者的自我往往是經由與他者的互動對話而現身，而非孤立單位的自我意義。藉由敍說資料的分析與概念命題，可知認同的意涵是鑲嵌於「熟悉經驗的斷裂」到「崩解後尋求回復」轉入「拉扯的兩難困境」再至「動力新平衡狀態」的轉化歷程，恰對應於認同是一種「同一性」與「變異性」的輪替、認同是一種「自我認定」／「他者回應」的協商、認同是一種「陷身困境」／「脫逸而出」的擺盪以及認同是一種「汚名化」／「去汚名」的歷程等概念命題。由此，筆者指出慢性病心理學的研究位置處於「公共」與「私密」／「他者」與「自我」之交疊領域，研究結果亦闡顯糖尿病患者多層次異質流動的後認同狀態。本研究所揭示的認同概念命題及其行動策略與後果，勾勒了慢性病患者不同層次的認同內涵及轉化歷程，顯現本研究對於探討糖尿病患者豐富異樣的社會心理因應方式，當可提供更多元的瞭解。

The study explored the identifications of 44 diabetic patients through the social construction grounded methodology. From the narrative data, we found the nature of the diabetic patients' identity was not only called ''idem-identity'', but also ''ipse-identity''. However, the diabetic patients' selves were represented through the others. Furthermore, the results indicated the patients' psycho-social identity processes showed multiple signifiers, it included identity was the dialectics of sameness and difference, identity was the interactive effects of self and other, identity was the dilemma of suffering and adaptation, and identity was the labeling of stigma and de-stigma. From this research result, it highlighted the chronic illness experiences the patients encountered were inscribed with dynamic transformations whose mechanisms were hypothetically worked from their biographical disruptions toward new balance meaning constructions. Finally, we discussed the implications of the study for clinical health care practice.