[ 摘要 ]

原住民的健康狀況在歷年來的統計資料中，包括平均餘命、死亡率、重大疾病罹患率等健康指標均較台灣地區為弱勢，因此原住民的健康議題在近幾年來受到高度重視，但是對原住民健康劣勢的關注，除了解決醫療資源不平均的問題之外，具有文化主體性的健康策略也是非常重要的課題，在深入瞭解原住民文化的前提之下，始能建立因地制宜的原住民衛生教育，因此本研究的目的便是基於對原住民文化的重視，瞭解復興鄉泰雅族人對健康與疾病的詮釋與定義，以及泰雅族人其特殊文化脈絡下的疾病認知系統，並探索泰雅族人對疾病引發的歸因解釋，提供未來原住民衛生教育另一個更具文化主體性的思考方向。

本研究資料蒐集方式為深入訪談法，抽樣方法採用開放性抽樣與滾雪球抽樣，主要透過兩位資訊提供者作為引介受訪者來源的線索開端，一位為復興鄉醫護人員，另一位為居住在復興鄉的泰雅族村民，引介符合研究需求的訪問對象，總計訪談對象二十二位。訪問內容包括復興鄉原住民的疾病與健康認知、對疾病的歸因解釋、採取治療的行動、對於現行主要醫療體系的信任感與態度等。

研究重要發現如下：1. 泰雅族的疾病觀念認為疾病是生命自然循環中的一部份，因此當疾病發生的時候，不是亟思於將疾病去除於生活的軌道，而是將病痛納入生活軌道的一部份，繼續運作下去。2. 對泰雅族人來說，疼痛感的發生是疾病認同與尋求醫治的關鍵。3.泰雅族人心靈身的健康觀念中，心理健康是健康的人所應具備的基本要素。4. 泰雅族人的疾病歸因主要可分為心理歸因、文化歸因、生物歸因與環境歸因四類。5. 泰雅族人使用西醫以急性病為主。6. 在疾病發生初期，不會馬上採取尋醫的行動，而是發揮自我效能，用意志力讓身體自然痊癒。

[ 英文摘要 ]

Over the years in the health status of the aboriginal people, including average life expectancy, mortality, health indicators, such as the incidence of major diseases, the aboriginal people in Taiwan were more vulnerable. The health issue of the aboriginal people catches more attention in recent years. Even though, not only the problems of unequal distribution of medical resources are unsolved, but it is also important a cultural-blinded health strategy is addressed. An fully understanding of aboriginal culture is important, thus we be able to establish a culture-friendly policy for aboriginal health education and medical systems. The purpose of this study is based on exploring the values of the aboriginal origins, regarding health and diseases. We will also look into how they explain and deal with diseases. It will provide us with a understanding of how we could approach in the future health education for the aboriginal people.

Using a snowball sampling method,the data gathering method for this study is in-depth interviews. Two informers helped us to get in touch with the Atayal tribe as well as to act as interpreters. One of them is a health care worker of the Fushing Village while the other is a resident living in the Fushing village. Under their introduction, we had interviewed 22 aboriginal people belong to the Ayatal tribe in Fushing Village. Our questions include their views toward health and disease, how they explain and deal with disease, their views on the medical system of Taiwan as well as their trust on the system.

Major findings are as follows :

1. The Atayal tribe believes that the disease is a part of the natural cycle of life. Therefore, when people is ill, they do not try to get rid of disease from life, but try to regard it as part of the life cycle.

2. For the Atayal people, “feeling of pain” is a cru signal for them to look for medical help.

3. To the Atayal people, mental health is the basic element of healthy people.

4. The Atayal people explain the reason for diseases which come from four factors - psychological, cultural, biological as well as environmental factors.

5. Western medicine system is the major approach for the Atayal people to acute diseases.

6. In early stages of disease, Atayal people will not take immediate action to seek medical help. They will resolve by self-recovery approach, using their willpower to let the body recover by itself.