莊登閔Chuang, Deng-Min曾宣儒Tseng, Hsuan JU2024-12-172024-07-182024https://etds.lib.ntnu.edu.tw/thesis/detail/3fb8ac71b1041bc2edca0d32ba2c2ee8/http://rportal.lib.ntnu.edu.tw/handle/20.500.12235/122176本研究旨在探討憂鬱症患者和其伴侶的關係維繫策略，本研究招募了共5組的憂鬱症患者和伴侶。其中憂鬱症患者4位女性，1位男性。伴侶則是4位男性，1位女性。憂鬱症患者皆罹患憂鬱症至少2年以上，每對異性戀情侶交往皆滿一年。憂鬱症患者年齡區間為24-31歲，伴侶的年齡區間為25-39歲。研究採用一對一深入訪談，並使用主題分析法分析。研究結果發現分別論述以下幾個主題，(1)從憂鬱症患者和伴侶的視角探討維繫策略，涵蓋生活層面及情感層面、日常衝突維繫策略。(2)憂鬱症患者和其伴侶對於疾病的看法研究發現如下: 一、 憂鬱症患者視角的關係維繫: (一)生活層面的關係維繫 在日常生活層面，憂鬱症患者和伴侶的關係維繫策略和普通情侶無異。在生活層面會分工家務、日常的約會等。在日常的約會中，患者和伴侶會共同討論要從事的活動，而在家務分工上，患者則認為自己處於比較被照顧的一方。這樣的日常維繫策略，和Stafford (2011)所提出來的「共享任務」類似。 (二)情感層面的維繫策略 情感維繫層面上，患者會在伴侶感到低落、需要陪伴時給予關懷和鼓勵，也會透過和伴侶分享感受，來維繫情感。大部分的患者受訪者皆認為自己對伴侶提供的情感關懷大於日常生活上的照顧。而伴侶在患者情緒低潮時，也會提供相對應的支持。在情感層面的關係維繫策略像是「觀察」、「反向通道響應」(Albertse et al.,2005)、「理解」和「支持」(Haas &Stafford ,1998)。 (三) 日常衝突維繫策略 首先在爭吵當下是「僵持己見」、「指責」等。爭吵過後患者會獨自思考爭吵的原因，這段時間則是呈現「迴避」、「冷戰」等維繫策略。最後一步是「理性溝通」、「建設性溝通」。在疾病發作時，患者所的衝突維繫策略則是兩個極端，會呈現「迴避」、「沉默」等維繫策略。或是情緒強度更強烈的「大哭大吵」。二、 伴侶視角的關係維繫策略 (一) 生活層面的關係維繫 伴侶在生活層面所使用的維繫策略，和患者並無太多的差異，同時伴侶也認為自己在家務分工層面，所提出的照顧多於患者。在關係維繫的策略上，除了「共享任務」外，伴侶會視患者的情況來調整約會的安排，伴侶受訪者會考量另一半的身心狀態，謹慎籌劃相關活動。而這樣的維繫策略，是因應患者的社交狀態而衍伸出的相關維繫策略，這樣的策略則算是「社交促進策略」。 (二)情感層面的維繫策略 在情感層面的維繫，伴侶多採取舉凡像是精神上的支持、情緒安撫、陪伴等。而面對患者的關懷，伴侶多半選擇對自己的負面狀態採取「關懷與保留」的維繫策略。其原因為伴侶不想讓患者有更多煩心的事。而在患者憂鬱症發作時，伴侶則是採取以下策略「疾病照顧」、「情緒支持及安撫」等 (三) 日常衝突維繫策略 在伴侶的部分面對爭吵，多為忍讓、情緒安撫、優先關懷對方狀態等策略。較少提及自身在爭吵時的感受。可以發現在衝突策略當中，伴侶的維繫策略重點會以憂鬱症患者為主，另外則是會採取「忍讓」的策略。而在患者發病時，伴侶除了前向所述採取以患者為主的維繫策略。無論發病與否，伴侶在爭吵時皆會較以憂鬱症患者的狀態為主。This study aims to explore the relationship maintenance strategies of patients with depression and their partners. This study recruited a total of 5 groups of patients with depression and their partners. Among the patients with depression, 4 were female and 1 was male. The partners are 4 men and 1 woman. All patients with depression have suffered from depression for at least 2 years, and every heterosexual couple has been in a relationship for more than a year. The age range of patients with depression is 24-31 years old, and the age range of partners is 25-39 years old.The study employed one-to-one in-depth interviews and was analyzed using thematic analysis. Findings revealed the following themes: (1) Maintenance strategies in daily interactions, (2) Maintenance at the emotional level, (3) Conflict maintenance strategies and maintenance dilemmas. The research findings are as follows:1. Relationship maintenance from the perspective of patients with depression:(1) Relationship Maintenance in Daily LifeIn daily life, the relationship maintenance strategies of depression patients with their partners are similar to those of ordinary couples. They engage in household chores and plan regular dates together. During these outings, patients and their partners discuss activities to participate in, while patients often feel that they are in a more cared-for position regarding the division of household responsibilities. This daily maintenance strategy is akin to the"shared tasks" (Stafford ,2011). (2) Emotional maintenance strategies On the emotional level, patients provide care and encouragement when their partners feel down and need companionship. They also maintain emotional connections by sharing their feelings with their partners. Most patient respondents believe that their emotional support for their partners outweighs the practical care they provide in daily life. When patients experience emotional lows, their partners offer corresponding support.The emotional relationship maintenance strategies resemble"observation," " back-channel communication " (Albertse et al., 2005), "understanding," and "support" (Haas & Stafford, 1998) (3) Strategies for maintaining daily conflicts First of all, in the moment of quarrel, there are "stalemate", "accusation", etc. After the quarrel, the patient will think about the reasons for the quarrel alone. During this period, they will display maintenance strategies such as "avoidance" and "cold war". The last step is "rational communication" and "constructive communication". During the onset of the disease, the conflict maintenance strategies used by patients are at two extremes, and they may present maintenance strategies such as "avoidance" and "silence". Or "crying and arguing" with stronger emotional intensity. 2. Partner's Perspective on Relationship Maintenance Strategie (1) Relationship Maintenance in Daily Life The strategies used by partners to maintain the relationship on a daily basis are not significantly different from those used by the patients. Additionally, partners believe that they contribute more to household chores compared to the patients. In terms of relationship maintenance strategies, beyond"sharing tasks," partners adjust their dating plans based on the patient's condition. Partners consider their significant other's physical and mental state and carefully plan related activities. This type of maintenance strategy arises in response to the patient's social situation and can be categorized as "social facilitation strategies." (2) Emotional maintenance strategies For emotional maintenance, partners often provide mental support, emotional comfort, and companionship. In response to the patient's care, partners usually adopt a "concern and reserve" strategy for their negative states. The reason is that partners do not want to add more worries to the patient. When the patient's depression flares up, partners implement strategies such as "illness care," "emotional support," and "comfort." (3) Strategies for maintaining daily conflicts In the case of arguments, partners tend to adopt strategies such as tolerance, emotional soothing, and prioritizing the other person's state of mind. They rarely mention their own feelings during disputes. It can be observed that in conflict strategies, the focus of the partner's maintenance strategies is primarily on the person with depression, and they often adopt a "tolerance" strategy. Additionally, when the patient experiences an episode, partners not only implement previously mentioned patient-centered maintenance strategies but also prioritize the state of the person with depression during arguments, regardless of whether an episode is occurring or not.憂鬱症患者伴侶親密關係維繫策略maintenance strategiesDepressionintimacycompanion學術論文