精神病院裡雙重患病經驗詮釋：思覺失調症患者罹癌生活世界

The Phenomenology of Dual Illness Experiences in Psychiatric Hospitals: The Lifeworld of Schizophrenia Patients with Cancer

研究目的：本研究試圖瞭解思覺失調症患者處於精神照護系統和長期安置機構下，又共病罹癌後的生活經驗。研究方法：透過深入晤談與觀察，探討思覺失調症患者罹癌的雙重患病經驗。以東部某精神專科醫院病房患者為研究對象，共訪談7名患者。研究參與者接受1次以上訪談。每次訪談約60至90分鐘。訪談資料轉錄為逐字稿後，以現象學心理學分析方法，分成資料蒐集、沈浸閱讀、意義單元之拆解與改寫、構成主題、置身結構和普遍結構六步驟進行資料分析。研究結果：發現思覺失調患者罹癌經驗具三重存在結構：置身下降與身體感受照料的世界，受威脅裡的觀看／照護行動和處境，在關係裡遭逢阻絕和再連結的可能。研究結論：本研究呈現臨床實踐必須返回生活現場，以彰顯情感性關係存有的人文臨床心理學。

Purpose: This study focused on understanding the psychological experiences of schizophrenic patients in long-term mental care institutions after a cancer diagnosis. Methods: A total of 7 patients were interviewed several times in a psychiatric hospital ward in eastern Taiwan. Each interview lasted about 60 to 90 minutes. After the interview materials were transcribed verbatim, we applied a phenomenological psychology data analysis procedure entailing 6 steps: data collection, empathic immersion, and identification of meaning units, constituent themes, situated structure, and general structure. Results: The analysis revealed a triple structure of existence: affective and physical being in the world, situated caring acts under threat, and relationships between blocking and reconnecting. Conclusion: The results indicated that humanistic clinical psychology practices are essentially a return to the lifeworld, and an attempt to restore reflexive ground in the vitality of the psychological lives of the patients.