學齡期注意力缺陷過動症兒童接受中樞神經興奮劑治療的生活經驗

Abstract

注意力缺陷過動症(Attention Deficit Hyperactivity Disorder; ADHD)，是一種常見於兒童的神經精神疾病。研究顯示ADHD在台灣兒童的盛行率約為7.5%，是兒童心智科門診最常見的兒童精神疾患。過動兒在成長的過程中充滿挫折與誤解，以致於常有低成就、低自尊及人際關係的問題。 目前仍被視為ADHD治療的第一線用藥之中樞神經興奮劑(CNS stimulants medication)用於兒童仍存有許多迷思及爭議，這些疑慮常使ADHD兒童及其家長陷入無所適從的處境，擔心藥物對兒童造成傷害，不使用藥物又不知該如何幫助孩童渡過每日的困境？本研究採取現象學研究法，以深度訪談(in-depth interview)的方式對8位過動兒和7位家長收集資料，並使用Colaizzi(1978)資料分析法加以統整。目的在於探索學齡期ADHD兒童服藥的主觀經驗和相關日常生活經驗，以期發展出切合實際且符合生活脈絡的照護策略。以全人的觀點檢視過動兒接受藥物治療的主觀感受和相關生活經驗。 研究顯示ADHD兒童接受藥物治療的生活經驗如下：面對日常生活的失序與混亂、尋求醫療照顧的支持、於千變萬化中重建新的平衡。此三大主軸乃過動兒和其家庭經歷藥物治療的歷程和改變，是過動兒接受藥物治療時，表現在其身、心、社會層面值得關注的現象。研究結論說明過動兒與中樞神經興奮劑之間的關係是一動態的歷程，用務實的觀點看待成長過程中需要藥物治療的事實，能幫助過動兒重建其對自我的掌控感。過動兒體察藥物作用對於自我及社會環境的影響，是學習與ADHD 和平共存的起步。

Attention deficit hyperactivity disorder (ADHD) is a neuro-psychological disorder frequently found in children. Studies indicate that about 7.5% of school children in Taiwan suffer from ADHD. It is the most common psychiatric juvenile disorder. Children with ADHD are often misunderstood and have problems with low school achievement, low self-esteem and social difficulties. There is much controversy and concern about the treatment of ADHD patients with CNS stimulants medication. Patients and parents of patients are often faced with difficult decisions. In order to find a way to provide patients better medical care, the author interviewed 8 patients and 7 parents. The Colaizzi (1978) method is used to analysis and to integrate the data. Three themes of the findings show that: Facing the disorder and confusion, seeking support from the health care and rebuilding new balance from uncertainty. Studies show that use of CNS stimulants to treat ADHD patients is not a straight forward or exact process. There can be different outcomes when treating patients with CNS stimulants. Nonetheless, it is of benefit to most patients that they realize the necessity for medical treatment of ADHD. The treatment helps patients regain their self-control and later self-esteem. It is a good start for the patients to live with the ADHD.