| Summary: | 碩士 === 國立臺北護理健康大學 === 護理研究所 === 102 === Cancer mortality of adolescent remained the top major causes mortality of disease in this age group and the cancer death rate of aboriginal adolescent aged between 15 and 24 is 1.1 times that of non-aboriginal adolescent(Council of aboriginal Peoples, Executive Yuan, 2010). Current studies about children cancer mostly focus on the effects of cancer therapy and its side effects, rarely involving the resilience of children cancer. However, resilience is an important factor which contributes to adolescent positive adaptation to cancer. Haase (2004) reported that family, economy and culture are important influencing factors of resilience. Although the socio-economic status of aboriginal families is generally lower than that of Han population, humorous and optimistic characteristics in the culture of aboriginal peoples as well as unique ceremony of ancestral spirits may contribute to positive attitudes toward diseases, which is beneficial to the disease adaptation and patients’ resilience. Adolescent are in a period of rebellion and how aboriginal culture influences adolescent requires further investigation. At present, literature involving the cancer experience and resilience process of different populations from the perspective of cultural context is still very limited. Therefore, the purpose of this study was to understand the lived experiences of diagnosed cancer and resilience process of adolescent cancer survivors.
The qualitative research method was designed in this study. The purposive sampling was used to recruit the subjects from the pediatrics department of a medical center in east Taiwan. One by one in-depth interviews was used for data collection among the aboriginal adolescent aged between 12 and 18 end treatment of cancer, and a recorder was performed to record the interview with the average duration of interview being 50-90 minutes. Miles and Huberman (1994) content analysis was applied for interview data. A total of 11 aboriginal adolescent with cancer participated in the study, with an average age of 15 years old. The results revealed two major themes among three stages, including “diagnosis process”, “treatment process” and “resilience process”. In the stage of diagnosis process, two themes were revealed including “response to initial diagnosis” and “seek for multi-channel treatment”. The “storm and impact of treatment” and “source of resilience” were found in the stage of “treatment process”. In the resilience process, “transformation and growth” and “meanings of traditional sacrifice ceremonies for the resilience process” were demonstrated..
According the results, there is no differences between aboriginal and non-aboriginal adolescent in the response of aboriginal adolescent to initial diagnosis, but aboriginal adolescent may visit witch doctors for traditional treatment of aboriginal people when seeking for multi-channel treatment. Although western medicine treatment is the major treatment for adolescent cancer, aboriginal adolescent hold an opinion that their traditional treatment ceremony may be helpful for cancer treatment. In the treatment process, “storm and impact of treatment” and “source of resilience” of aboriginal adolescent were roughly the same with those of non- aboriginal adolescent, but impact from family economic burden and poor access to medical service of aboriginal adolescent was relatively higher than that of non- aboriginal population. In the resilience process, “transformation and growth” of aboriginal adolescent was roughly the same with that of non-aboriginal adolescent, and the only difference was that aboriginal adolescent with cancer would study hard aiming to change their family economic condition in the future although family economic burden might bring distress. In addition, tradition sacrifice ceremony of indigenous people can gather the protective power from ancestral spirits and supports from the people, which can also provide power for positive resilience of aboriginal adolescent. Therefore, it is suggested that medical staff should provide individualized and cross-cultural care for the patients according to their knowledge of cancer experience and resilience process so as to improve the quality of care.
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