從男子氣概分析男性口腔癌存活者的韌性形成過程

The Resilience of Male Oral Cancer Survivors: The Masculinity Perspective

10.6171/ntuswr2014.30.04

林東龍(Dong-Long Lin)

男性口腔癌存活者 ； 男子氣概 ； 韌性 ； male oral cancer survivors ； masculinity ； resilience

臺大社會工作學刊

30期（2014 / 12 / 01）

139 - 185

繁體中文

本研究跳脫公共衛生審視口腔癌病患的階級區隔觀點，從文本分析中找出男子氣概作為理解男性口腔癌存活者的視角，並探究男子氣概或有助於韌性形成的意涵。本研究以深度訪談法蒐集九位男性口腔癌存活者的罹病經驗，繼以主題分析法進行資料分析。研究發現，男性口腔癌存活者因罹病後工作喪失和人際關係萎縮等情形，使其原有性別認同基礎受到衝擊，轉而從家庭關係中重構其自我認同。同時，男子氣概類型從原本「霸權型」或「邊緣型」，轉變成「新好男人型」、「好爸爸型」，以及「老大哥型」等，有助於面對日常生活各方面的挑戰。相對地，亦有二位受訪者同樣面臨失業和人際互動遽減、卻又欠缺家庭支持下，而成為「落魄的男人」。本研究建議，助人專業者可以家庭為男性口腔癌存活者男子氣概轉化和韌性形成的媒介。

This study adopted the masculinity approach to explore the experience of male oral cancer survivors, and to better understand the implications of resilience that may be related to masculinity. Nine in-depth interviews with male oral cancer survivors were conducted and the data analysis adopted a thematic approach. This study argues that male oral cancer survivors had faced unemployment as well as problematic human relationships after they got cancer, and that these events influenced their masculinity. The types of masculinity changed from 'hegemony' and 'marginalization' to 'new good man', 'good father' or 'big brother', and these changes of masculinity could improve their ability to face the challenges in their daily life. In contrast, two male oral cancer survivors turned into 'men out of luck' because of unemployment, impaired human relationship, and lack of family support. Furthermore, the acceptance of family members can help the transformation of masculinity in a positive way. This study suggests that the helping professionals could assist the family in becoming a vehicle for the transformation of masculinity and development of resilience of male oral cancer survivors.

1. 利翠珊(2006)。華人婚姻韌性的形成與變化：概念釐清與理論建構。本土心理學研究，25，101-137。
   連結：
2. 馬財專、葉郁菁(2008)。勞動疆界的拓邊？傳統女性勞動場域中男性勞動者之考察。台灣社會研究季刊，72，1-47。
   連結：
3. 郭淑珍(2008)。健康行為形成的生命歷程探討：以計程車司機嚼檳榔行為為例。台灣衛誌，27(5)，385-398。
   連結：
4. 郭淑珍、丁志音(2006)。茶行裡的檳榔客：嚼食檳榔的社會脈絡初探。台灣社會研究季刊，63，143-205。
   連結：
5. 國家衛生研究院（2006）。〈檳榔、菸、酒對食道癌、咽癌、喉癌及生殖之危害報告〉。取自http://enews.nhri.org.tw/enews_list_new2.php?volume_indx=146&showx=showarticle&article_indx=3129&enews_dt=2006-04-19 【National Health Research Institution (2006). An overview—areca quid and health effects. Retrieved from http://enews.nhri.org.tw/enews_list_new2.php?volume_indx=146&showx=showarticle&article_indx=3129&enews_dt=2006-04-19】
6. 長庚紀念醫院整型外科復健治療中心（2012）。〈頭頸部腫瘤術後〉。取自http://www1.cgmh.org.tw/intr/intr2/c3250/PRS-RC/homepage.htm【Chang Gung Memorial Hospital Plastic and Reconstructive Surgery —Rehabilitation Center. (2012). After head and neck neoplasm surgery. Retrieved from http://www1.cgmh.org.tw/intr/intr2/c3250/PRS-RC/homepage.htm】
7. 行政院衛生福利部國民健康署（2012）。〈運將是罹患口腔癌前三大行業之一─打破健康不平等，健康局幫運將戒！〉。取自http://www.hpa.gov.tw/BHPNet/Web/News/News.aspx?no=201204170001【Executive Yuan, Health Promotion Administration, Ministry of Health and Welfare. (2012). The professional driver is one of three major trades that suffer from oral cancer—Health Promotion Administration is breaking health inequity and helping professional driver to abstain from betel nut. Retrieved from http://www.hpa.gov.tw/BHPNet/Web/News/News.aspx?no=201204170001】
8. 行政院衛生福利部國民健康署（2013）。〈癌症登記報告〉。取自http://www.hpa.gov.tw/BHPNet/Web/Stat/StatisticsShow.aspx?No=201305060001 【Executive Yuan, Health Promotion Administration, Ministry of Health and Welfare. (2013). Cancer registry annual report. Retrieved from http://www.hpa.gov.tw/BHPNet/Web/Stat/StatisticsShow.aspx?No=201305060001】
9. Agadjanian, V.(2002).Men doing women's work: Masculinity and gender relations among street vendors in Maputo, Mozambique.The Journal of Men's Studies,10(3),329-342.
10. Arora, N. K.,Rutten, L. J. F.,Gustafson, D. H.,Moser, R.,Hawkins, R. P.(2007).Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer.Psycho-Oncology,16,474-486.
11. Butler, J.(1990).Gender trouble.London, England:Routledge.
12. Chan, W. C. H.,Epstein, I.,Reese, D.,Chan, C. L. W.(2009).Family predictors of psychosocial outcomes among Hong Kong Chinese cancer patients in palliative care: Living and dying with the "support paradox".Social Work in Health Care,48,519-532.
13. Chapple, A.,Ziebland, S.(2002).Prostate cancer: Embodied experience and perceptions of masculinity.Sociology of Health & Illness,24(6),820-841.
14. Connell, R. W.(2005).Masculinities.Los Angeles, CA:University of California Press.
15. Dominelli, L.(2002).Feminist social work: Theory and practice.Basingstoke, UK:Palgrave Macmillan Limited.
16. Doucet, A.(2004).It's almost like I have a job, but I don't get paid: Fathers at home reconfiguring work, care, and masculinity.Fathering,2(3),277-303.
17. Eiser, C.(1994).Making sense of chronic disease: The eleventh jack tizard memorial lecture.Journal of Child Psychology and Psychiatry,35(8),1373-1389.
18. Ezzy, D.(2002).Qualitative analysis.London, England:Routledge.
19. Flanagan, J.,Holmes, S.(2000).Social perceptions of cancer and their impacts: Implications for nursing practice arising from the literature.Journal of Advanced Nursing,32(3),740-749.
20. Gray, R. E.,Fitch, M. I.,Fergus, K. D.,Mykhalovskiy, E.,Church, K.(2002).Hegemonic masculinity and the experience of prostate cancer: A narrative approach.Journal of Aging and Identity,7(1),43-62.
21. Hammer, J. H.,Good, G. E.(2010).Positive psychology: An empirical examination of beneficial aspects of endorsement of masculine norms.Psychology of Men & Masculinity,11(4),303-318.
22. Ko,Y.C.,Chiang, T. A.,Chang, S. J.,Hsieh, S. F.(1992).Prevalence of betel quid chewing habit in Taiwan and related sociodemographic factors.Journal of Oral Pathology and Medicine,21(6),261-264.
23. Lam, C. B.,McBride-Chang, C. A.(2007).Resilience in young adulthood: The moderating influences of gender-related personality traits and coping flexibility.Sex Roles,56(3),159-172.
24. Mokuau, N.,Braun, K. L.,Wong, L. K.,Higuchi, P.,Gotay, C. C.(2008).Development of a family intervention for native Hawaiian women with cancer: A pilot study.Social Work,53(1),9-19.
25. Moynihan, C.(1998).Theories of masculinity.British Medical Journal,317(7165),1072-1075.
26. Myers, E. N.,de Boer, M. F.,McCormick, L. K.,Pruyn, J. F.,Ryckman, R. M.,van den Borne, B. W.(1999).Physical and psychosocial correlates of head and neck cancer: A review of the literature.Otolaryngology Head and Neck Surgery,120(3),427-436.
27. Nicholas, D. R.(2000).Men, masculinity, and cancer: Risk-factor behaviors, early detection, and psychosocial adaptation.Journal of American College Health,49(1),27-33.
28. O'Neil, J. M.(2008).Summarizing 25 years of research on men's gender role conflict using the gender role conflict scale: New research paradigms and clinical implications.The Counseling Psychologist,36,358-445.
29. Putnam, R. D.(2000).Bowling alone: The collapse and revival of American community.New York, NY:Simon and Schuster.
30. Rowland, J. H.,Baker, F.(2005).Introduction: Resilience of cancer survivors across the lifespan.Cancer Supplement,104(11),2543-2548.
31. Sabo, D.(Ed.),Gordon, D.(Ed.)(1995).Men's health and illness: Gender, power and the body.London, England:Sage.
32. Sabo, D.(Ed.),Gordon, D.(Ed.)(1995).Men's health and illness: Gender, power and the body.London, England:Sage.
33. Simpson, R.(2004).Masculinity at work: The experiences of men in female dominated occupations.Work Employment and Society,18(2),1-35.
34. Stewart, D. E.,Wong, F.,Duff, S.,Melancon, C. H.,Cheung, A. M.(2001).What doesn't kill you makes you stronger: An ovarian cancer survivor survey.Gynecologic Oncology,83(3),537-542.
35. Wall, D.,Kristjanson, L.(2005).Men, culture and hegemonic masculinity: Understanding the experience of prostate cancer.Nursing Inquiry,12(2),87-97.
36. Wallace, M. L.,Harcourt, D.,Rumsey, N.,Foot, A.(2007).Managing appearance changes resulting from cancer treatment: Resilience in adolescent females.Psycho-Oncology,16(11),1019-1027.
37. Watson, J. M.(2000).Male bodies: Health, culture and identity.Buckingham, UK:Open University Press.
38. Woodgate, R. L.(1999).Conceptual understanding of resilience in the adolescent with cancer: Part I.Journal of Pediatric Oncology Nursing,16(1),35-43.
39. 王行(1998)。解放男人：男性的自覺與成長。台北=Taipei, Taiwan:探索文化=Exploring Culture。
40. 朱妙慧(2003)。Taipei, Taiwan，國立臺灣大學衛生政策與管理研究所=Institute of Health Policy and Management, National Taiwan University。
41. 江姿瑩(2004)。Kaohsiung, Taiwan，高雄醫學大學口腔衛生科學碩士在職專班=Department of Oral Hygiene, Kaohsiung Medical University。
42. 吳德敏、白璐、宋丕錕、蔡宗仁、徐黎玲、李旻貞、孫建安(1999)。抽菸、飲酒與嚼檳榔習慣個人聚集之初探：以健康檢查族群為例。中華公共衛生雜誌，18(6)，453-459。
43. 宋麗玉、施教裕(2009)。優勢觀點：社會工作理論與實務。台北=Taipei, Taiwan:洪葉=Hungyeh。
44. 李玉玲(2003)。Nantou County, Taiwan，國立暨南國際大學輔導與諮商研究所=Department of Guidance & Counseling, National Chi Nan University。
45. 林淑玲、李麗娜(2004)。門診護士協助一位乳癌病患手術後身心社會重建之護理經驗。高雄護理雜誌，21(2)，79-92。
46. 張靖怡(2002)。Kaohsiung, Taiwan，高雄醫學大學口腔衛生科學研究所=Department of Oral Hygiene, Kaohsiung Medical University。
47. 教育部(2012)。重編國語辭典修訂本。
48. 陳佩英、郭素青、張惠甄、徐一瑱、林麗玉、楊桂美(2004)。口腔癌術後病之身心症狀與調適。安寧療護雜誌，9(2)，153-164。
49. 陳佩靖(2003)。Kaohsiung, Taiwan，高雄醫學大學口腔衛生科學研究所=Department of Oral Hygiene, Kaohsiung Medical University。
50. 陳富莉、李蘭(1999)。臺灣地區成年人之吸菸與嚼檳榔行為的組合及相關因子之探討。中華公共衛生雜誌，18(5)，341-348。
51. 陳嘉颺(2009)。Yilan County, Taiwan，佛光大學傳播學系=Department of communication, Fo Guang University。
52. 黃淑玲編、游美惠編(2012)。性別向度與臺灣社會。台北=Taipei, Taiwan:巨流=Chuliu。
53. 溫永頌(1992)。Taichung, Taiwan，中國醫藥學院醫務管理研究所=Department of Health Services Administration, China Medical University。
54. 廖俊達(1999)。口腔癌的外科手術治療現況。癌症新探，8，20-22。
55. 蕭文(1999)。災變事件前的前置因素對心理復健的影響：復原力的探討與建構。測驗與輔導，156，3249-3253。
56. 蕭雅君(2003)。Taipei, Taiwan，國立陽明大學臨床護理研究所=Institute of Clinical Nursing, National Yang-Ming University。
57. 錢基蓮譯、Slayton, G. W.(2013)。我是好爸爸─10 個工具讓妻子、孩子更愛你。台北=Taipei, Taiwan:天下文化=Bookzone。

1. 蔡佩真,林怡芳(2019)。運用賦權概念於口腔癌病人合併惡性蕈狀傷口之照護經驗。腫瘤護理雜誌，19(增訂刊II)，57-68。
2. 曾良鵬、陳武宗、高郁勛、林東龍、周映君、李家和(2018)。團隊合作的社會基礎：多元專業團隊協助男性口腔癌存活者重返工作之實踐經驗。臺大社會工作學刊，38，51-98。
3. 藍元杉,劉怡均,何雯婷(2022)。口腔癌病友罹癌前後生活的敘說：身體心像變化與社工實務反思。臺灣社會工作學刊，25，95+97-130。
4. 劉蕙雯、林東龍(2016)。照顧男子氣概與男性公務人員育嬰留職經驗。女學學誌：婦女與性別研究，39，59-109。
5. 楊建中、徐秀琹、王惠萍(2018)。中風復原期病人復原力及其相關因素之探討。護理雜誌，65(5)，56-67。
6. 鄭清霞,歐紫彤,洪惠芬(2023)。輪班照顧到遷移照顧：男性照顧者返鄉照顧歷程的社會脈絡初探。人文社會科學研究，17(3)，23-60。