本研究旨在探討女性重鬱症患者及其配偶在罹病過程中的醫療關注問題及夫妻互動類型。研究以南部兩所區域醫院以上的精神科門診之女性重鬱症患者及其配偶為對象，經立意取樣選出五對夫妻進行共同訪談。資料收集以研究者自擬之訪談大綱為指引，再以Colaizzi的現象學研究法進行資料分析。研究結果發現：重鬱症患者及其配偶的醫療關注問題聚焦在症狀困擾及藥物掙扎兩個面向；而夫妻互動有「爭而不和」、「歸因咎責」、「冷熱拮抗」、「主導強制」、「順應防備」、「直言勸說」、「商議求援」、「忍讓妥協」及「因應和解」等九種夫妻互動類型；而其中最常出現的互動類型為「爭而不和」、「因應和解」及「商議求援」。本研究可提供臨床實務者對女性重鬱症患者及其配偶在罹病過程中的醫療關注問題及夫妻互動類型有更多的瞭解；並作為重鬱症患者及其配偶在疾病照護與調適、夫妻治療的評估及介入之參考。

The objective of this study is to explore the patterns of couple interaction between female major depressive patients and their spouses, and their medical concerns in the illness process. The study subjects are the female patient with major depressive disorder and their spouses recruited from the psychiatric outpatient department of two regional or above hospitals through the purposive sampling. There are five pairs of couples were interviewed jointly. The data were collected via semi-structured interview guidelines by the researcher and then analyzed with Colaizzi’s method of phenomenological analysis. The results revealed that: the medical concerns of the patients with major depressive disorder and their spouses focused on the distress of the symptoms and the struggles with medications; the patterns of couple interaction concluded to 9 styles that included “rather disputation than agreement”, “imputation”, “intensive to passive interaction adjustment”, “domination and coercion”, “adaptive precaution”, “frank persuasion”, “consultation and recourse”, “forbearance and compromise”, and “facing and accommodation”. The “rather disputation than agreement”, “facing and accommodation” and “consultation and recourse” are the most common patterns in couple interaction. This study provides clinicians more understandings on the patterns of couple interaction between female major depressive patients and their spouses and their medical concerns in the illness process; and it also offers a reference for the caring and adaptation with illness and the assessment and intervention of the couple therapy.

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