[[alternative]]The study of children’s inner experience on facing a parent with cancer ~ take four children in their third to sixth year in elementary school as an example

[[abstract]]本研究題目為「兒童面對父母罹癌的內在經驗探究~以四位國小中高年級兒童為例」，目的是了解兒童在父或母罹患癌症的經歷中，兒童的情緒、想法與因應行為等內在經驗的樣貌。研究對象是四位國小中年級到高年級的兒童，本研究採質性研究的立場，以詮釋現象學為哲學基礎，以主題分析法進行訪談文本的資料分析與歸納，研究結果發現幾個重要的內涵，摘要如下：一、四位兒童的性別、氣質與面臨權威反應的不同，似乎影響他們願意表現對父母罹癌所產生的情緒程度與期待情緒被支持程度。二、四位受訪兒童呈現出他們平時較少有機會被引導表達出自己面對父母罹癌的內在感受。三、四位兒童面對父母罹癌的內在經驗(一)、兒童對疾病的認知想法：1.父/母癌症與療程的不同，兒童對癌症的認知也會不同。2.兒童「有無被告知」 和「如何被告知」父母的罹癌訊息，取決於父母自身的健康復原信念。3.不論兒童有無被告知父母罹癌，兒童都會覺知與觀察到父母的癌症，因此「父母有無告知罹癌」與「兒童如何覺知癌症」是兩件事。4.兒童透過合適的告知，可以減輕焦慮與能夠較健康地面對父母罹癌過程。(二)、兒童面對父母罹癌時身體、情緒、想法和行為上的反應1.四位受訪兒童在情緒、想法、行為反應有其共通性：例如：驚嚇、傷心、轉移注意力、發洩情緒情行為、認為癌症有威脅性等。2.兒童隨著父母癌症種類不同、治療階段與病程不同，兒童的悲傷反應也有IV程度上的差異。3.兒童將癌症與死亡做連結，害怕父母死亡是預期性悲傷的反應，且有兩位受訪兒童傾向避諱談論害怕父母死亡。(三)、兒童面對父母罹癌時的因應行為與因應姿態1.兒童並非只是默默地承受擔心與害怕，兒童是找方法積極地去因應父母罹癌所帶來的衝擊。2.兒童對健康的信念與復原想法，引導兒童去積極地因應。四、兒童的家庭/學校系統，在兒童因應父母罹癌上有所影響：(一)父母對疾病是否要告知與怎麼告知兒童的態度，使兒童在面對父母罹癌時是否能夠有表達感受並減輕焦慮的機會。(二)兒童因應父母罹癌衝擊的方式可能透過觀察模仿而向父母學習。(三)兒童與罹癌父母在癌症發現前的親子遠近關係與家庭背景脈絡，似乎使兒童在解讀父母疾病經驗、接觸疾病話題程度與獨自因應或陪伴父母因應癌症衝擊等，產生不同的影響。(四)學校導師的關懷與包容、學校朋友的陪伴協助兒童得到關注去面對父母罹癌的衝擊。本研究根據上述的研究結果，提供給相關研究者、臨床醫務助人工作者、學校老師、以及家長，提升其對疾病家庭中的兒童有更多角度的理解，並提出建議。[[abstract]]The purpose of this thesis is to explore and examine children’s concepts,emotional reaction, coping behaviors and their inner experiences while their parentsare afflicted to cancer. Objects of this research are four children in their third to sixthyear in elementary school. Based on the point of qualitative research and thephilosophical thinking of hermeneutische Phanomenologie, and using the way ofthematic analysis to analyze the interview data, some essential renditions are asfollowed:1. Children’s gender, temperament, and reaction toward the authority seem to affecthow much they would like to express their emotion toward their parents’physical condition and how much support they want to get from others.2. During the interview, the four children are encouraged to reveal innerexperiences, which they seldom have the opportunity to do so.3. Four children’s inner experience of facing a parent with cancerA. Their thoughts toward a parent with cancer:a. Parents’ medical treatments and types of cancer influence children’sconcept toward the disease.b. Parent’s health belief decides whether children would be informed thesituation and how they perceive it.c. Children can be aware of parents’ health condition even they are not toldabout it. In this sense, “Whether parents inform kids of their condition”and “ How children become aware of the situation” are unrelated.d. Through being properly noticed, children could lower the level of anxietyand be able to deal with their parent’s disease situation healthily.B. Children’s concepts, emotional reaction, coping behaviors and their innerexperiences while their parents are afflicted to cancer.a. The children share similarities in emotional reaction, thoughts, and copingbehaviors such as getting frightened, feeling depressed, shifting attention ,releasing emotion, and considering cancer threatening.VIb. Children’s level of grief reaction changes based on the types of disease,the stages of disease and the treatment of disease.c. Children’s anticipatory grief is reflected on associating cancer with death.Two children show their reluctance to mention death under the fear thattheir parents would pass away by merely bringing up the word.C. Children’s coping behavior and attitude toward a parent with cancera. Instead of feeling worried along, children find ways to cope with theimpact which their parent’s cancer bring it.b. Children’s belief in being healthy and recovered will result in their positiveaction.D. Children’s family/ school system affect how children treat a parent withcancer:a. How parents decide to inform their children about their health conditiondecides whether children will have the opportunity to express theiremotion and reduce anxiety level.b. The way that children face to parents’ cancer is probably learning andcoping from their parents.c. The parents-children relationship and family background seem to affectchildren not only on understanding and discussing their parent’s cancer,but also on the process of coping way that they are alone or they keepcompany with parents.d.School teachers’ concern and friends’ company help children to facewarmly the impact which their parent’s cancer bring it.According to the result in the research, the researcher provides some suggestionsto medical helpers, school teachers and parents to get more understanding of thechildren that their parents are afflicted to cancer