癌末病患家屬面臨喪慟因應行為、人際依附型態與預期性哀慟反應相關之研究

The Relationships of Coping Behaviors with Bereavement, Attachment Styles, and Anticipatory Mourning Reactions among Families of Terminal Cancer Patients

研究目的：本研究主要目的在於探討癌末病患家屬面臨喪慟因應行為、人際依附型態、與預期性哀慟反應之相關性。研究方法：本研究採立意取樣法，選取高雄市三家醫院安寧病房家屬為研究對象，使用人際依附風格量表、簡明因應量表和悲傷經驗量表修訂版作為評量工具，以面對面問卷調查法收集資料，有效問卷為142份（男性64位、女性78位，平均年齡38.94歲）。研究結果：癌末病患家屬之預期性哀慟反應平均而言為中等偏低程度，面臨喪慟因應行為以正向因應行為使用頻率較高。不同人際依附型態的癌末病患家屬於作計劃、正向重建、宗教、否認、行為逃避之面臨喪慟因應行為有顯著差異；不同人際依附型態的癌末病患家屬於存在關注、憂鬱、身體症狀之預期性哀慟反應也有顯著差異。癌末病患家屬之預期性哀慟反應與主動因應、正向重建、接受、工具性支持和發洩因應行為呈現顯著的負相關，與否認、行為逃避和自責因應行為呈現顯著的正相關。研究結論：本研究發現人際依附型態於預期性哀慟反應與因應歷程中確為一重要影響變項，且癌末病患家屬之面臨喪慟因應行為和預期性哀慟反應亦具相關性。

Purpose: The main purpose of this study was to explore the relationships among bereavement coping behaviors, attachment styles, and anticipatory mourning reactions in the families of terminal cancer patients. Methods: Participants were 142 families (64 male, 78 female; mean age: 38.94) from 3 Kaohsiung hospice wards sampled using a purposive sampling method. The Attachment Style Scale, the Brief COPE, and the Revised Grief Experience Inventory were administered in face-to-face interviews. Results: The mean level of anticipatory mourning reactions among participants was moderately low, and the frequency of positive coping behaviors was higher than negative. Attachment styles were significantly related to differences in planning, positive reframing, religion, denial, and behavioral disengagement. Attachment styles were also significantly related to differences in existential concerns, depression, and anticipatory mourning reaction in the form of physical distress. Anticipatory mourning reactions correlated negatively with active coping, positive reframing, acceptance, use of instrumental support, and venting, whereas they correlated positively with denial, behavioral disengagement, and self-blame. Conclusions: The study found that attachment style was an important predictive factor with respect to anticipatory mourning reactions and the coping process, and also demonstrated a relationship between bereavement coping behaviors and anticipatory mourning reactions.