「一切都已經安排好了，不用擔心。」解析與了解照顧者的理智化因應

Relationship between Intellectualization Coping Style and Emotional Adaption of Caregivers of Terminally-Ill Patients

10.6537/TJHPC.202003_24(1).04

吳欣烜(Hsin-Hsaun Wu)；鄭逸如(Yih-Ru Cheng)；張琦郁(Chi-Yu Chang)；楊于婷(Yu-Ting Yang)；吳治勳(Chih-Hsun Wu)；林耀盛(Yaw-Sheng Lin)；陳勇仁(Yung-Jen Chen)

情緒調適 ； 壓力因應 ； emotional adjustment ； stress coping

安寧療護雜誌

24卷1期（2020 / 03 / 01）

47 - 58

繁體中文

本文主旨為探討理智化因應風格對於末期病人照顧者情緒調適歷程的影響與意涵。面臨至親即將離世的失落經驗，個體往往需要耗費許多認知與情緒資源才能成功適應，部分照顧者採取專注於日常的照顧事務，藉此從負面情緒中抽離以因應這樣的壓力。本文透過報告一位安寧緩和場域中的案例，討論在面對至親臨終的照顧歷程中，理智化因應風格在照顧脈絡中的功能與意涵，並且提出臨床工作者若能透過陪伴與照顧者建立關係，則能在喪親失落之壓力超過理智化因應所能負荷的範圍時，作為支援性的調適資源，促進照顧者接觸和調適情緒。

The article aims to explore the influence and implication of intellectualization coping by the caregiver of terminally-ill patient. The threat that facing the forthcoming death of beloved one would require significant cognitive and emotional resources of caregivers to adapt to such situation. Some caregivers applied intellectualization coping which focusing on daily caring task and isolation from emotions for the purpose of managing the stress. By presenting a caregiver of a terminally-ill cancer patient in the palliative care field, the role and implication in the process of emotional adaption during care were discussed. Furthermore, if the loss of relationship were getting overwhelming to the caregiver who adapt intellectualization coping, relationship with clinical workers which based on accompanying would be supporting coping resource.

1. Billings, A. G.,Moos, R. H.(1981).The role of coping responses and social resources in attenuating the stress of life events.Journal of Behavioral Medicine,4(2),139-157.
2. Folkman, S.,Lazarus, R. S.(1980).An analysis of coping in a middle-aged community sample.Journal of health and social behavior,219-239.
3. Lazarus, R. S.(1993).Coping theory and research: past, present, and future.Psychosom Med,55(3),234-247.
4. Lazarus, R. S.(2013).Fifty years of the research and theory of RS Lazarus: An analysis of historical and perennial issues.Psychology Press.
5. Lazarus, R. S.,Folkman, S.(1984).Stress, appraisal, and coping.Springer publishing company.
6. Metzger, J. A.(2014).Adaptive defense mechanisms: function and transcendence.Journal of clinical psychology,70(5),478-488.
7. Perry, J. C.,Kardos, M. E.,Pagano, C. J.(1993).The study of defenses in psycho-therapy using the Defense Mechanism Rating Scales (DMRS) The concept of defense mechanisms in contemporary psychology.Springer.
8. Riolli, L.,Savicki, V.(2010).Coping effectiveness and coping diversity under traumatic stress.International Journal of Stress Management,17(2),97.
9. Roth, S.,Cohen, L. J.(1986).Approach, avoidance, and coping with stress.American psychologist,41(7),813.
10. Vaillant, G. E.(1992).Ego mechanisms of defense: a guide for clinicians and researchers.American Psychiatric Pub.
11. 王心運(2014)。考量身體倫理的醫療照護專業。護理雜誌，61(5)，7-12。
12. 易之新（譯）,Yalom, I.(2003).存在心理治療（上）：死亡.台北:張老師文化.

1. 謝依靜,張麗珍,洪翠蓮(2022)。透過敘事會談方式協助悲傷中的癌末病人家屬。安寧療護雜誌，26(2)，165-177。
2. 謝淯唐,黃曉菁,陳品雯,陳宜慶,周希諴,何仲薇(2022)。乳癌末期病人及其青少年家屬之安寧團隊整合照護經驗。安寧療護雜誌，26(3)，277-289。