§ 瀏覽學位論文書目資料
  
系統識別號 U0002-2906202121125800
DOI 10.6846/TKU.2021.00818
論文名稱(中文) 疾病的意義與建構:基於疾病敘事視角的探究
論文名稱(英文) The meaning and construction of disease: an exploration from the perspective of illness narrative
第三語言論文名稱
校院名稱 淡江大學
系所名稱(中文) 大眾傳播學系碩士班
系所名稱(英文) Department of Mass Communication
外國學位學校名稱
外國學位學院名稱
外國學位研究所名稱
學年度 109
學期 2
出版年 110
研究生(中文) 劉江
研究生(英文) Jiang Liu
學號 607054037
學位類別 碩士
語言別 繁體中文
第二語言別
口試日期 2021-06-24
論文頁數 122頁
口試委員 指導教授 - 紀慧君
委員 - 林靜伶
委員 - 王孝勇
關鍵字(中) 疾病敘事
病患認同
常人專家
病人知識
關鍵字(英) Illness narrative
Patients’ Identity
Lay expert
Patients’ knowledge
第三語言關鍵字
學科別分類
中文摘要
人類社會看待疾病的方式,既包含了科學理性的醫學視角,又隱藏著文化脈絡的各自詮釋。自然形成的疾病被人為地賦予了不同的意涵,反過來又形塑了人們的理解與態度。隨著「敘事轉向」的興起,學者們紛紛主張站在患者立場重拾「敘事」,也就是讓患者描述自身的經驗故事,從而了解在患病的歷程當中,疾病的意義是如何建構以及如何轉變。
        敘事研究並不是只能以生命故事、自傳之類的長篇口述或文字作為研究對象,微型故事、臨床訪談或對話式的文本等非典型短篇敘事同樣可以作為材料進行分析。微博上的癌症敘事,作為疾病敘事的一種新興方式,拓寬了人文社會學科研究疾病的視野,也能夠幫助我們更全面地了解當下如何形塑疾病。
        本文以疾病敘事的觀點,選取微博一名癌症病患用戶作為研究對象,結合半結構式訪談和微博文本進行敘事分析,圍繞癌症對疾病意義與建構展開討論。本研究發現:罹癌者作為病患,在肉體上和精神上都受到疾病的壓力。經由應變敘事、道德敘事和核心敘事三個層次的分析,本研究發現病患如何發展出一套新的身體管理技術來適應與癌共生,並且經由罹癌反思人生價值。而罹癌者作為常人專家,在實踐當中發展了病人知識,即是醫學知識混合了地方性知識、自我的身體經驗而形成。病患結合過去健身教練的工作經驗,在體能訓練上面成為癌症病患的示範。他以圖片或影片的方式,分享自己的鍛煉過程,為他人提供有關罹癌者鍛煉的病人知識。
英文摘要
The ways of human understanding diseases are influenced by the scientific and rational medical perspectives, as well as their own cultural context. Natural diseases are artificially given different meanings, which in turn shapes people's understanding and attitudes. With the rise of the "narrative turn", scholars have advocated regaining the "narrative" from the patient's standpoint, which means allowing patients to describe their own experience. By this way, we can find how the meaning of the disease is constructed and changes.
Narrative research is not limited to long oral narratives or texts such as life stories and autobiography. Atypical short narratives such as micro-story, clinical interviews or dialogue texts can also be used as materials for analysis. Cancer narratives on Weibo, as an emerging way of illness narratives, broaden the research horizons of humanities and social sciences about diseases, and can also help us understand more comprehensively how diseases are constructed nowadays.
From the viewpoint of illness narrative, this paper selects a cancer patient on Weibo as the research object, combines semi-structured interviews and Weibo text to conduct narrative analysis, and discusses the significance and construction of cancer. This study found that as a patient, cancer patient is physically and mentally stressed by the disease. Through the analysis of contingent narratives, moral narratives and core narratives, this study discovered how the patient developed a new set of body management techniques to adapt to living with cancer, and reflected on the values of life. As a lay expert, the patient has developed patient’s knowledge in practice which is constituted from medical knowledge, local knowledge and self-experience. Combining the work experience of  a private trainer, the patient has become a model for cancer patients in physical training. He shared his exercise process in the form of pictures and videos, and provided others with patient’s knowledge about the exercise of cancer patients.
第三語言摘要
論文目次
第一章 緒論	1
第一節 研究動機	1
第二節 研究背景	2
第三節 研究目的	6
第二章 文獻探討	9
第一節 被建構的癌症	9
壹、癌症的醫學史	10
貳、癌症的多種想象	14
第二節 疾病敘事與病患敘事	17
壹、何謂疾病敘事?	18
貳、為什麼需要疾病敘事?	21
叁、如何進行疾病敘事?	24
第三節 常人專家觀點	26
壹、常人理論	27
貳、常人專家	28
第四節 社群媒體與癌症敘事	30
第三章 研究方法與問題	33
第一節 研究方法	34
壹、敘事分析	34
貳、疾病敘事分析	35
第二節 研究對象與研究問題	37
壹、研究對象選取與介紹	38
貳、研究問題	40
第四章 研究分析	41
第一節 「我」如何成為癌症病患	41
壹、應變敘事:確認、適應、回應	43
貳、道德敘事:重新定位與評估	67
叁、核心敘事:戰鬥與死亡	79
第二節 「我」如何成為常人專家	87
壹、病人知識的形塑	88
貳、旁觀他人之苦	98
第五章 研究結論與限制	103
第一節 罹癌者:既是病患也是專家	103
第二節 研究限制	105
參考文獻	107
英文文獻	107
中文文獻	115
附錄	120


表圖次
表1-1:108年國人死因統計結果	3
表2-1:歷史上各種癌症觀點	14

圖1-1:2017年癌症發生人數排名	4
圖1-2:部分微博癌症博主簡介	8
圖2-1:1969年《華盛頓郵報》和《紐約時報》刊登的癌症廣告	12
圖3-1:「72把刀」的微博基本信息截圖	33
圖4-1:72把刀對排異的說明微博	54
圖4-2:72把刀發佈的微博內容,包含戰鬥隱喻	82
圖4-3:72把刀私信回復網友提問	89
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