| 摘要: | 本研究旨在探討自體免疫患者運用心理位移書寫法之改變經驗。
五位研究參與者在研究期間各進行八篇心理位移書寫，頻率為每週一或二次，為期兩個月。每位研究參與者在進行八次心理位移書寫前後各接受研究者半結構訪談一次，因此，研究之資料分析來源為每人 2 次，每次約為 1.5 小時，共計 15 小時的訪談逐字稿，以及每次運用心理位移書寫法過後的心理位移經驗回溯文本。
本研究以現象學取向研究方法進行資料分析，結果研果發現：
（一）自體免疫患者運用心理位移書寫法之改變經驗：
自體免疫患者運用心理位移書寫法後分別在罹患疾病的認知、情緒、人際關係狀態以及因病產生的失落議題上各有改變及無改變的部分。在有改變經驗中共同的部分包括：自我接納程度提高、負向認知下降、對疾病的負向情緒下降、不沉溺於負向情緒中、情緒較為穩定、對他人是否能接納自己的擔憂程度下降、影響親密關係發展的擔憂減少等７點；在無改變經驗中共同的部分包括不確定感依舊、對疾病的概念依舊、負向情緒依舊等 3 點。而自體免疫患者運用心理位移書寫法之有改變及無改變經驗的獨特部分則根據研究參與者的不同而產生其各自的改變經驗。
（二） 心理位移書寫法如何影響自體免疫患之改變經驗：
其中，自體免疫患者運用心理位移書寫法促成改變之原因包含「情緒的宣洩與調節」、「 促進思考、釐清思緒」、「 協助自我覺察」、「 自我指導」、「 注入現實感」、「 為自己做決定」、「 自我關照」、「 自我肯定」、「 提供兼顧與平衡的功能」、以及「整合自我」等 10 點；而自體免疫患者運用心理位移書寫法無法促成改變之原因包含「不同位格的想法、感受雷同」、「『你』、『他』位格為尚未內化的他人建言」、「對心理位移書寫過程中的自我關照感到虛偽、客套」、「心理位移書寫像是在逃避問題」、「 書寫過程繁瑣，書寫者易產生放棄之念頭」，以及「強化負向情緒」等 6 點。
文末針對研究結果進行討論與建議。
The purpose of this research was to understand the change experiences of psychological displacement paradigm in diary-writing(PDPD) on autoimmune disease patient. 5 participants writing 8 PDPD text during the study period, which were once or twice a week for two months. Each of the participants accepted a semi-constructed interview before and after the writing. Therefore, the sources of research data analysis per 2 times, each time is about 1.5 hours in the total of 15 hours interview verbatim. Furthermore, the backtracking texts were also used for data analysis. This research were collected and analyzed by phenomenon-oriented methodology. The result revealed: 1)The change experiences of PDPD on autoimmune disease patients showed some “changed” or “did not changed” in the cognitive of suffering the disease, mood, relationship and the arising lost feeling due to illness issues. About “changed” including 7 items which were improved self-acceptance, decreased of negative cognitive of the disease, decreased of negative emotions of the disease, do not indulged in negative emotions, emotion were more stable, decreased of concerning whether others will or not accept him or herself, decreased the worry of affecting the development of intimate relationships. In “did not changed” including 3 items which were uncertainty feeling remains, the concept of the disease remains, negative feeling remains. However, the unique of experiences participants’ “changed” or “did not changed” were different from one and another, which produced respectively changing experience. 2)The influence of PDPD on autoimmune disease patients to change their experiences include 10 items which were positive and negative changed, stimulated thinking, clarified thoughts, assisted self-awareness, self-directed, injected the sense of reality, to make their own decisions, self-care, self-affirmation, provide both function and balance and the integration of themselves. In did not facilitated participants to change include 6 items which were different pronoun phases had similar feelings and thoughts, lack of internalized of others’ suggestion in different pronoun phases, feeling hypocritical and courtesy in self-contemplation in diary-writing, diary-writing felt like evaded the problem, writing processes were too cumbersome and easily to quit, strengthen the negative emotions. Finally, results were discussed and suggestions were addressed. |
