實踐的GAYA： 水源文化健康站的太魯閣族文化照顧實作

Abstract

此論文談討的核心主軸為，太魯閣族人世代傳承的GAYA如何影響了當代的照護實作。藉由這個提問，我爬梳與太魯閣族相關的人類學研究及田野調查的回饋，歸納出與健康有關的GAYA（下稱健康GAYA），分別為：追求個人及集體的強盛、力氣（BIYAX）、勤勞（MDRUMUT）、細心的照護（KLAWA）、尊重長者（MDRUDAN）、性的禁忌與性別意識、社會關係致病的疾病觀。\n另外，我透過MADELEINE LEININGER創立的文化照顧模型，揭示了從日本到中華民國殖民政府對太魯閣族造成的結構性負面健康影響，並設定我的部落花蓮縣秀林鄉水源部落文化健康站為參與式觀察的據點，分別針對母語名字課程、古調音樂課程、運動課程、營養餐食、安全環境等五個面向進行深度訪談，取得長者對課程的想法以及他們個人的健康受損歷程，連結至殖民所帶來的結構性負面健康影響層次。\n此論文的田野工作始於2019年結束在2021年，在照護需求與照護實作的來回對話裡，我們可以意識到健康GAYA如何影響著當代的照護實作，因而得到了提問的解答。\n此論文有五個研究發現，一是我們可以意識到GAYA未曾因為殖民而消失，GAYA會在實踐當中浮現並且為當代的需求產出解釋。二是GAYA對於太魯閣族人有著療癒性的力量，逆反GAYA的政策則會造成傷害。三則是奠基於一跟二的研究發現，討論照護殖民與照護解殖的哲學性議題。四是重新檢證MADELEINE LEININGER的文化照顧理論提出四大偏誤：上層七大因素比重、上層因素因素之間的相互影響及關聯、上層親屬結構影響應是考慮因素的尺度，而非其中一個因素。下層三元素比重問題。五是改善四大偏誤提出從個人、家族與部落，生理心理到靈性的太魯閣族文化照顧模型。

How Gaya, which Taroko(Truku) people inherit for several centuries, influencing the caring practice in the contemporary is the main issue of this dissertation. I conclude the Gaya, that related to health knowledge, and named it as healthy Gaya. The outcome of healthy Gaya includes pursuing strong at both individual and collective level, Strenth(Biyax), Hard-working(Mdrumut), Attentive care(Klawa), Respect the elders(Mdrudan), Sex taboo and sexual awareness, The view of disease in the treatment of social relations.\nBesides, I expose the structural and negative health impact to Taroko(Truku) people by the colonial government from the Japanese occupation to the Republic of China, with the cultural care model created by Madeleine Leininger. Set my tribe`s cultural health station, located at Shuiyuan tribe in Xiulin Township, Hualien County, as a base for participatory observation. In-depth interviews were conducted on five aspects: native name course, ancient music course, exercise course, nutritious meals, and safe environment, respectively, to obtain the elderly`s thoughts on the course and their personal health damage history, linking to the colonization brought about structural negative health impact levels.\nThe fieldwork started from 2019 to 2021; we can finally realize how healthy Gaya influences the caring practice in the back and forth dialogue between care needs and care implementation.\nThere are five research findings. First, Gaya has not disappeared due to colonization, and it will emerge in practice and produce explanations for current needs. The second is that Gaya has healing powers for the Taroko(Truku) people, and rebelling against Gaya`s policies will cause harm. The third is based on one and two research findings, discussing the philosophical issues of caring colonization and care for decolonization. The fourth is to re-examine Madeleine Leininger’s cultural care theory and put forward four errors: proportion issue for seven factors at the upper level, the interaction between factor and factor at the upper level, kinship and social factor should be level to measure but not one of factor, and proportion issue for three elements at the below level. The fifth is to propose Taroko(Truku) cultural care model, which provides the aspect to define health care from size individual to family to tribe and from physical to mental to spiritual scale, after amended the four errors announced at the fourth research finding.