中華心理衛生協會

Chronically disabled patients with acute onset suffer from dysfunction, low self-esteem, and psychological distress. With the use of prospective and retrospective interviews, this study explores patients' psychological rehabilitation process of moving from resisting the sick role to accepting it as a part of their self-concepts. We apply grounded theory procedures and techniques to collect, analyze and interpret the qualitative data. The results indicate that the psychological rehabilitation process presents in the continuous interaction between the individual and the society, and the patients express in the way of suffering and trying to cope with it. They pass through the cycles of 'making great efforts in resistance', 'being stranded helplessly', and 'accepting the new self', and the core psychological constructs that transformed underlying this process are illness representation and self-esteem. These two underlying psychological constructs go through two transformation cycles, and determinate the coping behavior and emotional reactions of the patients. The first is the opposing cycle: patients move from 'making great efforts in resistance' to 'being stranded helplessly', and the second is the dialectical cycle: patients move from 'being stranded helplessly' to 'accepting the new self'. When patients go through the two psychological transformation cycles, their illness representation will merge new and positive viewpoints instead of being totally negative, and their self-esteem will be repaired from being crumbling. Then we go a step further to explore the facilitating conditions for those transformation processes. The results indicate that positive congnitive strategies and social support and important factors for the psychological rehabilitation process.