探索接受中醫治療痛經婦女經期不適的生活經驗

Exploring the Experience of Dysmenorrhea and Life Adjustments of Women Undergoing Traditional Chinese Medicine Treatment

10.6224/JN.63.4.60

蔡旻旻(Min-Min Tsai)；楊馥綺(Fu-Chi Yang)；李詩敏(Shih-Min Lee)；黃久美(Chiu-Mieh Huang)

婦女健康 ； 痛經 ； 生活經驗 ； 中醫治療 ； women's health ； dysmenorrhea ； life adjustment ； Traditional Chinese Medicine treatment

護理雜誌

63卷4期（2016 / 08 / 01）

60 - 69

繁體中文

背景：過去研究著重於婦女痛經的態度、痛經的特性和自我照顧行為，或探討傳統中醫治療痛經的療效及安全性，對於連結婦女自身的痛經經驗與傳統中醫治療的研究相對較少。目的：探索接受中醫治療痛經婦女的經期不適之生活經驗。方法：本研究以半結構的訪談指引，採一對一深入訪談的方式蒐集資料。參與研究者每人接受一次訪談，費時約60-90分鐘。研究者於訪談過程同時觀察婦女的語氣、表情與行為舉止並予記錄，共有40位因痛經接受中醫治療的婦女參與研究。使用內容分析法分析所得的文本資料，並以ATLAS. ti 5.2版軟體輔助進行。結果：本研究個案經歷痛經並接受中醫治療的過程及相關生活經驗資料，分為四個主題來探索，即「冰山一角」、「破冰之舉」、「心力拔河」和「最終融合」。起先，她們痛經的症狀常被視為像冰山一角的小問題，直到問題逐漸惡化影響到生活才進入破冰階段，想要去改變它，故而尋求傳統中醫的協助。當婦女無法依中醫師提供的治療方式或改變生活習慣的建議時，則會陷入心力拔河，不知是否繼續中醫治療。至最後逐漸接受中西醫作法的交融，致使她們能夠找出最適合自己減除痛經的策略，達到最終的適應與平衡。結論：本研究結果可提供護理人員作為與病患在進行溝通其痛經及中醫治療時的參考。

Background: Previous studies of women with dysmenorrhea have focused on menstrual attitudes, the characteristics of menstrual pain, and self-care behavior. Traditional Chinese Medicine (TCM) studies on dysmenorrhea, on the other hand, have focused on the efficacy and safety of TCM treatments. Few studies have investigated how women perceive their own TCM-treatment experience of dysmenorrhea. Purpose: The objective of this study was to explore the experience of dysmenorrhea and life adjustments of women undergoing TCM treatment. Methods: A semi-structured interviewing guide was used to collect data. A total of 40 dysmenorrheal women participated in the study. Individual, in-depth interviews were conducted for about 60-90 minutes with each participant. Their speech tone, facial expressions, and gestures during the interview process were also observed and recorded. The findings were analyzed using content analysis via ATLAS. ti 5.2 software. Results: The process that the participants used to adjust to dysmenorrhea were distinguished into four progressive stages: ＂tip of the iceberg＂, ＂ice-breaking＂, ＂tug-of-war＂, and ＂blending-in＂. Initially, the participants perceived the symptoms of dysmenorrhea as the ＂tip of the iceberg＂. They attempted to hide / ignore the initial pain until the problem gradually worsened to the point that the symptoms began to significantly affect various aspects of life. It was only then that the participants began to pay attention to the problem and to seek help from TCM practitioners, which we defined as the ＂ice-breaking＂ stage. If they encountered unexpected situations with regard to the treatment regimen, the participants entered the ＂tug-of-war＂ stage, during which they struggled over whether to continue with TCM treatments. Afterward, the participants gradually achieved a ＂blending-in＂ of new ideas, which allowed them to identify the strategies that best facilitated adjustment and rebalancing. Eventually, the participants achieved a new life balance. Conclusion: The outcomes of the present study may be referenced for nurse-patient communications that relate to dysmenorrhea and TCM treatment.

1. Chang, Y. T.,Chen, Y. C.(2009).Study of menstrual attitudes and distress among postmenarcheal female students in Hualien County.The Journal of Nursing Research,17(1),20-29.
   連結：
2. Chiou, M. H.,Wang, H. H.(2008).Predictors of dysmenorrhea and self-care behavior among vocational nursing school female students.The Journal of Nursing Research,16(1),17-25.
   連結：
3. Ary, D.,Jacobs, L. C.,Sorensen, C.(2010).Introduction to research in education.Belmont, CA:Wadsworth, Cenage Learning.
4. Burbeck, R.,Willig, C.(2014).The personal experience of dysmenorrhoea: An interpretative phenomenological analysis.Journal of Health Psychology,19(10),1334-1344.
5. Chiou, M. H.,Wang, H. H.,Yang, Y. H.(2007).Effect of systematic menstrual health education on dysmenorrheic female adolescents' knowledge, attitudes, and self-care behavior.The Kaohsiung Journal of Medical Sciences,23(4),183-190.
6. Chung, F. F.,Chou Yao, C. C.,Wan, G. H.(2005).The associations between menstrual function and life style/working conditions among nurses in Taiwan.Journal of Occupational Health,47(2),149-156.
7. Cunningham, S.,Tan, D.(2011).Dysmenorrhoea and acupuncture: A review of the literature.Nursing Standard,25(44),39-47.
8. Elo, S.,Kyngäs, H.(2008).The qualitative content analysis process.Journal of Advanced Nursing,62(1),107-115.
9. Fang, R. C.,Tsai, Y. T.,Lai, J. N.,Yeh, C. H.,Wu, C. T.(2012).The traditional Chinese medicine prescription pattern of endometriosis patients in Taiwan: A population-based study.Evidence-Based Complementary and Alternative Medicine,2012,591391.
10. Graneheim, U. H.,Lundman, B.(2004).Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness.Nurse Education Today,24(2),105-112.
11. Hung, J. Y.,Chiou, C. J.,Chang, H. Y.(2012).Relationships between medical beliefs of superiority of Chinese or western medicine, medical behaviours and glycaemic control in diabetic outpatients in Taiwan.Health and Social Care in the Community,20(1),80-86.
12. Jones, G.,Jenkinson, C.,Kennedy, S.(2004).The impact of endometriosis upon quality of life: A qualitative analysis.Journal of Psychosomatic Obstetrics & Gynecology,25(2),123-133.
13. Lincoln, Y.,Guba, E.(1985).Naturalistic inquiry.Newbury Park, CA:Sage.
14. Liu, X.,Guo, S. W.(2008).Dysmenorrhea: Risk factors in women with endometriosis.Women's Health,4(4),399-411.
15. Lu, Z. Y. J.(2001).The relationship between menstrual attitudes and menstrual symptoms among Taiwanese women.Journal of Advanced Nursing,33(5),621-628.
16. Ortiz, M. I.(2010).Primary dysmenorrhea among Mexican university students: Prevalence, impact and treatment.European Journal of Obstetrics & Gynecology and Reproductive Biology,152(1),73-77.
17. Patel, V.,Tanksale, V.,Sahasrabhojanee, M.,Gupte, S.,Nevrekar, P.(2006).The burden and determinants of dysmenorrhoea: A population-based survey of 2262 women in Goa, India.An International Journal of Obstetrics & Gynaecology,113,453-463.
18. Polat, A.,Celik, H.,Gurates, B.,Kaya, D.,Nalbant, M.,Kavak, E.,Hanay, F.(2009).Prevalence of primary dysmenorrhea in young adult female university students.Archives of Gynecology and Obstetrics,279(4),527-532.
19. Polit, D. F.,Beck, C. T.(2012).Nursing research: Generating and assessing evidence for nursing practice.Philadephia, PA:Lippincott Willians & Wilkins.
20. Sandelowski, M.(1986).The problem of rigor in qualitative research.ANS: Advances in Nursing Science,8(3),27-37.
21. Sharp, B. A. C.,Taylor, D. L.,Thomas, K. K.,Killeen, M. B.,Dawood, M. Y.(2002).Cyclic perimenstrual pain and discomfort: The scientific basis for practice.Journal of Obstetric, Gynecologic, & Neonatal Nursing,31(6),637-649.
22. Simoens, S.,Hummelshoj, L.,D'Hooghe, T.(2007).Endometriosis: Cost estimates and methodological perspective.Human Reproduction Update,13(4),395-404.
23. Tanaka, E.,Momoeda, M.,Osuga, Y.,Rossi, B.,Nomoto, K.,Hayakawa M.,Wang, E. C. Y.(2014).Burden of menstrual symptoms in Japanese women-An analysis of medical care-seeking behavior from a survey-based study.International Journal of Women's Health,6,11-23.
24. Taylor, D.(2005).Perimenstrual symptoms and syndromes: Guidelines for symptom management and self care.Obstetrics & Gynecology,5(5),228-241.
25. 李玉秀編、何美瑤編、孫凡軻編、丘周萍編、陳夏蓮編、邱慧洳編、宋惠娟編(2015)。護理研究概要。台北市=Taipei City, Taiwan, ROC:華杏=Farseeing。
26. 李選編、徐麗華編、李絳桃編、邱怡玟編、李德芬編、雷若莉編、史麗珠編(2015)。護理研究與應用。台北市=Taipei City, Taiwan, ROC:華杏=Farseeing。
27. 林淑玲、夏萍絗、李奇龍、許樹珍(2002)。子宮內膜異位症對婦女婚姻生活之影響。新臺北護理期刊，4(1)，23-35。
28. 邱敏惠、王秀紅(2004)。護校女生經痛與月經態度關係之探討。護理雜誌，51(4)，45-52。
29. 紀麗梅、徐南麗、邱慧洳、蕭正光(2004)。穴位指壓對緩解原發性經痛成效之探討。慈濟護理雜誌，3(4)，29-37。
30. 高瑞青(2007)。痛經之中醫藥療法。台灣中醫臨床醫學雜誌，13(1)，37-40。
31. 陳重光、黃雅珮、方焄蓮、黃雅瑜(2013)。女性痛經影響因素與舒緩方法之研究─以南部某專科學校為例。護理雜誌，60(3)，40-50。
32. 楊士萱(2006)。近十年中醫痛經的研究概況。傳統醫學雜誌，17(1)，194-211。
33. 萬琦、林麗君、郭憲文、賴東淵、劉波兒(2010)。耳穴貼壓對青少女原發性痛經之成效初探。中西醫結合護理雜誌，1(1)，55-64。
34. 蘇慶豐、吳沛錚、郭大維、許昇峰(2009)。針灸治療痛經相關中西文獻之綜述。中華針灸醫學會雜誌，12(3)，9-21。

1. 譚博謙,葉月嬌,黃雪莉,洪月琴,林玲慧(2019)。女性護理人員痛經因子與芳香精油減緩經痛之現況調查。領導護理，20(1)，28-46。