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題名：Don't Make a Hole in My Body, Doctors: An Anthropological Perspective on Liver Disease in an Amis Village in Eastern Taiwan
書刊名：慈濟大學人文社會科學學刊
作者：日宏煜 引用關係
作者(外文)：Ru, Hung-Yu
出版日期：2006
卷期：5
頁次：頁19-66
主題關鍵詞：阿美族；肝病；疾病故事；疾病陳述理論；疾病解釋模式；Amis；Liver disease；Illness narrative；Illness representation theory；Explanatory model
原始連結：連回原系統網址new window
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本研究意圖透過分析罹患肝病的原住民以及參與治療的中、西醫師所講述的疾病故事之文本，用以了解在地方照護系統中不同的醫療本質對於肝病的解釋模式、治療策略及醫病關係。肝病是近年來盛行於原住民社區的傳染病之一，因此透過對肝病的解釋模式的探討，將有助於我們進一步理解以及解釋原住民社區的醫療現象。原住民及中西醫師們根據他們對於肝病的解釋模式陳述了他們對肝病致 原因及治療的看法，本研究發現：(一)原住民已不再使用單一的模式去詮釋肝病的成因及治療對其的意義，取而代之的是使用一種包含了阿美族adada及中西醫學觀念之混合型模式去理解肝病的發生及治療。(二)比較原住民及中、西醫師對肝病的解釋提供我們一個管道去了解病人及醫師在醫療接觸的過程中所發生的衝突與密切性--醫療過程中衝突發生的原因是因為生物醫學視肝病的發生為一種生物性現象，然而阿美族人將肝病的發生視為中斷正常生活中且不受歡迎的一種狀態；因為生物醫學缺乏對阿美族人社會及文化情境的認識，導致許多阿美族人在療程未結束前就中斷其治療。(三)除了西方醫藥外，阿美族人也根據冷、熱的觀念選取並服用阿美族草藥或中藥來治療肝病--阿美族視肝病為"熱"病必需使用"冷"的阿美族草藥或中藥來治療。此外，本研究亦證明了疾病的發生與治療與人類文化和生物因子有關，因此，發展具有生物文化性的疾病治療與預防策略是解決發生在原住民社區的傳染病的根本方法。
Liver disease is a serious infectious disease in aboriginal communities of Taiwan. Field research conducted in one Amis village of Hualien County in eastern Taiwan explored the explanatory models (EMs) of liver disease, which are the embodiments of the epistemologies of illness in different sectors of the local health care system, through scrutinizing illness narratives told by aboriginal people as well as Western-style and Chinese-style doctors. Discrepant EMs of liver disease between sick persons and specialists represent distinct points of views about the identities, causes, and therapeutic implications of liver diseases in different medical realities of the local health care system. Rather than using a single explanation, the Amis manipulate a hybrid form of illness representation which embraces the notions of adada, biomedicine, and Chinese medicine to conceptualize the causes and healings of liver disease. Comparing the illness representation of the Amis with that of Western-style doctors' and Chinese-style doctors' EMs of liver disease provides insight into the conflicts and harmonies of medical encounters between the Amis and practitioners in the local health care system. Western-style doctors simplify liver disease as a pathophysiological phenomenon while the Amis perceive liver disease as an unwanted condition that prematurely disrupts the normal life style. The neglect of sociocultural factors in biomedical treatment led many Amis patients to terminate treatments. In addition to biomedicine, the Amis also prefer to take either botanical medicine or Chinese medicine (or take both at the same time) to treat liver disease. In terms of the notion of hot/cold, the medicines chosen by the Amis and Chinese-style doctors are "cold" remedies opposite to the characteristic of liver disease that is considered as a "hot" disease by sick persons and Chinese-Style doctors. As such, the occurrences and treatments of disease are culturally and biologically constructed. Consequently, seeking a comprehensive understanding of EMs between aboriginal people and practitioners can explicitly elucidate the conflicts and harmonies in the local health care system and, in turn, apply to the development of biocultural strategies to cope with the health problems of aboriginal people in Taiwan.
期刊論文
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學位論文
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