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題名 個案研究：複雜型輕度頭部外傷患者之疾病經驗－復原與調適歷程
The recovery process and psychological adjustment of a patient with complicated mild traumatic brain injury作者 蘇郁琳
Su, Yu-Lin貢獻者 楊啟正
Yang, Chi-Cheng
蘇郁琳
Su, Yu-Lin關鍵詞 輕度頭部外傷
腦震盪症候群
認知功能
疾病調適
Mild traumatic brain injury
Post-concussion syndrome
Cognitive functions
Illness adjustment日期 2021 上傳時間 1-七月-2021 19:47:09 (UTC+8) 摘要 背景：輕度頭部外傷是台灣常見的公共衛生議題。病人受傷後會經歷生理、認知與情緒行為等腦震盪後症狀，而且部分病人的症狀可能持續數年之久，造成生活功能困擾。腦震盪後症狀則可能源於生理、心理與社會等多重因素，因此在探討此議題時，除了需了解其生理（神經）病理外，亦須考量其它心理社會因素對疾病的影響。有鑑於此，本研究欲透過一位複雜型輕度頭部外傷病人的疾病經歷，探討其在受傷後的認知功能表現與變化、經歷的疾病階段與調適歷程，試圖以「生理－心理－社會」的角度說明輕度頭部外傷患者之疾病復原歷程。方法：本研究針對單一個案，在受傷後五年內進行五次半結構式訪談，並蒐集其相關病歷資料與神經心理測驗結果，同時以主題分析法對質性訪談資料進行分析。結果：研究結果顯示個案認知功能的表現變化主要發生在「處理速度」、「視覺訊息處理」以及「注意力的維持與調控」等功能上；而在疾病調適歷程上則經歷「失落衝擊」、「退回保守」、「探索嘗試」與「流動平衡」四個主要階段。結論：在輕度頭部外傷病人的疾病復原歷程中，臨床神經心理學之「神經行為」概念與健康心理學之「身心適應」概念在其中相輔相成，透過「生理－心理－社會」的整合性模式，推動整體復原歷程的開展。
Background: Patients with mild traumatic brain injury (MTBI) experience physical, cognitive and emotional disturbances, which might lead to impaired occupational and daily activity functions. Multiple factors, including neurobiological and psychosocial ones, might result in the persistence of post-concussion symptoms. In this study, we explore the experience of a complicated MTBI patient through the biopsychosocial perspective, trying to capture the cognitive pattern and the adjustment process after MTBI.Methods: This is a single-case, qualitative study. We collected the patient’s medical information and results of the neuropsychological assessment, and carried out five semi-structured interviews within five years after injury. We analyze the transcript of the interviews with thematic analysis.Results: Results of the neuropsychological assessment showed relative weakness in the patient’s processing speed, visual information processing and sustained attention. In regards to the patient’s subjective experience and the adjustment process, results indicated a four-stage process of recovery, including “loss”, “retreat”, “explore”, and “liquefy”.Conclusion: Throughout the course of MTBI recovery, the concept of “brain-behavior relationships” in clinical neuropsychology and the concept of “psychosocial adjustment” in health psychology would work collectively, forming an integrative biopsychosocial framework for the unfolding process of recovery.參考文獻 Alexander, M. P. (1992). Neuropsychiatric correlates of persistent postconcussive syndrome. The Journal of Head Trauma Rehabilitation, 7(2), 60-69.Alexander, M. P. (1995). Mild traumatic brain injury: pathophysiology, natural history, and clinical management. Neurology, 45(7), 1253-1260. doi:10.1212/wnl.45.7.1253Bai, L., Bai, G., Wang, S., Yang, X., Gan, S., Jia, X., . . . Yan, Z. (2020). 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國立政治大學
心理學系
106752026資料來源 http://thesis.lib.nccu.edu.tw/record/#G0106752026 資料類型 thesis dc.contributor.advisor 楊啟正 zh_TW dc.contributor.advisor Yang, Chi-Cheng en_US dc.contributor.author (Authors) 蘇郁琳 zh_TW dc.contributor.author (Authors) Su, Yu-Lin en_US dc.creator (作者) 蘇郁琳 zh_TW dc.creator (作者) Su, Yu-Lin en_US dc.date (日期) 2021 en_US dc.date.accessioned 1-七月-2021 19:47:09 (UTC+8) - dc.date.available 1-七月-2021 19:47:09 (UTC+8) - dc.date.issued (上傳時間) 1-七月-2021 19:47:09 (UTC+8) - dc.identifier (Other Identifiers) G0106752026 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/135978 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 心理學系 zh_TW dc.description (描述) 106752026 zh_TW dc.description.abstract (摘要) 背景：輕度頭部外傷是台灣常見的公共衛生議題。病人受傷後會經歷生理、認知與情緒行為等腦震盪後症狀，而且部分病人的症狀可能持續數年之久，造成生活功能困擾。腦震盪後症狀則可能源於生理、心理與社會等多重因素，因此在探討此議題時，除了需了解其生理（神經）病理外，亦須考量其它心理社會因素對疾病的影響。有鑑於此，本研究欲透過一位複雜型輕度頭部外傷病人的疾病經歷，探討其在受傷後的認知功能表現與變化、經歷的疾病階段與調適歷程，試圖以「生理－心理－社會」的角度說明輕度頭部外傷患者之疾病復原歷程。方法：本研究針對單一個案，在受傷後五年內進行五次半結構式訪談，並蒐集其相關病歷資料與神經心理測驗結果，同時以主題分析法對質性訪談資料進行分析。結果：研究結果顯示個案認知功能的表現變化主要發生在「處理速度」、「視覺訊息處理」以及「注意力的維持與調控」等功能上；而在疾病調適歷程上則經歷「失落衝擊」、「退回保守」、「探索嘗試」與「流動平衡」四個主要階段。結論：在輕度頭部外傷病人的疾病復原歷程中，臨床神經心理學之「神經行為」概念與健康心理學之「身心適應」概念在其中相輔相成，透過「生理－心理－社會」的整合性模式，推動整體復原歷程的開展。 zh_TW dc.description.abstract (摘要) Background: Patients with mild traumatic brain injury (MTBI) experience physical, cognitive and emotional disturbances, which might lead to impaired occupational and daily activity functions. Multiple factors, including neurobiological and psychosocial ones, might result in the persistence of post-concussion symptoms. In this study, we explore the experience of a complicated MTBI patient through the biopsychosocial perspective, trying to capture the cognitive pattern and the adjustment process after MTBI.Methods: This is a single-case, qualitative study. We collected the patient’s medical information and results of the neuropsychological assessment, and carried out five semi-structured interviews within five years after injury. We analyze the transcript of the interviews with thematic analysis.Results: Results of the neuropsychological assessment showed relative weakness in the patient’s processing speed, visual information processing and sustained attention. In regards to the patient’s subjective experience and the adjustment process, results indicated a four-stage process of recovery, including “loss”, “retreat”, “explore”, and “liquefy”.Conclusion: Throughout the course of MTBI recovery, the concept of “brain-behavior relationships” in clinical neuropsychology and the concept of “psychosocial adjustment” in health psychology would work collectively, forming an integrative biopsychosocial framework for the unfolding process of recovery. en_US dc.description.tableofcontents 目次第一章 緒論 ……………………………………………1輕度頭部外傷與腦震盪症候群…………………………1MTBI病人之認知功能表現………………………………5MTBI病人的疾病調適……………………………………11MTBI病人的疾病經驗……………………………………15第二章 研究方法………………………………………20個案描述…………………………………………………20研究程序…………………………………………………21研究工具…………………………………………………21資料分析…………………………………………………21第三章 研究結果………………………………………26個案事件經歷……………………………………………26認知功能表現結果………………………………………29個案的疾病經驗與恢復歷程……………………………34第四章 討論……………………………………………48認知功能表現與改變機制………………………………48疾病恢復歷程……………………………………………53MTBI病人的生理心理社會模式…………………………66臨床貢獻與研究限制……………………………………68參考文獻…………………………………………………71附錄一 受訪同意書 ……………………………………87附錄二 訪談大綱 ………………………………………88附錄三 主題分析編碼系統 ……………………………89附錄四 神經心理測驗中英文名稱對表 ………………90 zh_TW dc.format.extent 3160512 bytes - dc.format.mimetype application/pdf - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0106752026 en_US dc.subject (關鍵詞) 輕度頭部外傷 zh_TW dc.subject (關鍵詞) 腦震盪症候群 zh_TW dc.subject (關鍵詞) 認知功能 zh_TW dc.subject (關鍵詞) 疾病調適 zh_TW dc.subject (關鍵詞) Mild traumatic brain injury en_US dc.subject (關鍵詞) Post-concussion syndrome en_US dc.subject (關鍵詞) Cognitive functions en_US dc.subject (關鍵詞) Illness adjustment en_US dc.title (題名) 個案研究：複雜型輕度頭部外傷患者之疾病經驗－復原與調適歷程 zh_TW dc.title (題名) The recovery process and psychological adjustment of a patient with complicated mild traumatic brain injury en_US dc.type (資料類型) thesis en_US dc.relation.reference (參考文獻) Alexander, M. 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