| 研究生: |
林毅欣 Lin, Yi-Hsin |
|---|---|
| 論文名稱: |
癌症末期病人之重要他人參與死亡準備的經驗及需求 Experience and demand of preparedness of death for significant others of terminal cancer patients. |
| 指導教授: |
賴維淑
Lai, Wei-Shu |
| 學位類別: |
碩士 Master |
| 系所名稱: |
醫學院 - 護理學系 Department of Nursing |
| 論文出版年: | 2023 |
| 畢業學年度: | 111 |
| 語文別: | 中文 |
| 論文頁數: | 114 |
| 中文關鍵詞: | 死亡準備 、重要他人 、經驗 、需求 、現象學 |
| 外文關鍵詞: | preparedness for death, significant others, experience, demand, phenomenology |
| 相關次數: | 點閱:164 下載:0 |
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背景與重要性:善終代表著一個人的生命完整,除了生理的照顧外,亦包括為死亡做準備、至親離世後家人沒有遺憾。死亡準備攸關喪親者身心靈安適,臨床實務上,醫療團隊大多著重於病人的生理照顧,並侷限於現實問題考量如死亡地點、喪葬事宜、醫療決策討論等,以家屬或病人之重要他人的觀點及經驗為主軸,針對死亡準備議題的相關研究極少,且多為西方國家之質性研究,而台灣目前少有針對末期病人之家屬參與死亡準備的相關研究探討。
研究目的:探討因癌症末期而死亡病人之重要他人,參與死亡準備之經驗及需求。
研究方法:採質性研究方法學之描述現象學,以半結構式訪談大綱進行面對面訪談、錄音,並寫下逐字稿。採立意取樣及最大變異數取樣,於南部某醫學中心進行收案,收案對象為20歲以上、能國台語溝通、癌症末期病人之重要他人,且喪親介於兩個月至一年之內。依Gloaizzi現象學研究法分析七步驟進行資料分析,藉由長期投入、持續觀察、同儕辯證及個案檢核檢視研究之確實性,反思日誌的書寫,以確保研究之確實性、確認性、信賴性與可轉移性。
研究結果與討論:依據研究問題進行資料歸納分析,癌症末期病人之重要他人參與死亡準備之經驗共歸納五項主題:一、矛盾跌宕知命知病、;二、心照不宣互做準備;三、順應心願希冀圓滿;四、離別哀傷送愛遠行;五、萬般準備總有遺憾。於需求面共歸納三項主題:一、專業醫護尊嚴伴行;二、資源無虞照護安心;三、心靈共情幽谷相伴。研究結果符合死亡準備本質的動態擺盪,是一個多面向、生命與生命對話的交織歷程。台灣社會以家庭為核心的文化,家人間愛的連結與默契,形塑死亡準備之內斂含蓄、心照不宣獨特性。華人文化生死觀的背景下,從病人為主體之善終、死亡準備的探究,延伸至病人與重要他人互做準備,以及後續喪親家屬面對逝者已矣之境況描述,皆顯示了華人特有的死亡準備面貌。而在需求本質中,發現死亡準備過程蘊含的內在力量包含不確定感獲得解答與協助、珍惜與至親的相處與陪伴、親友支持與信仰寄託,是重要他人喪親後未來前行的養分。
結論與建議:本研究透過研究者具系統地文本分析,融入華人文化獨特性,探索並了解死亡準備的現象本質,可作為臨床醫護團隊對重要他人參與至親死亡準備全貌的理解,及臨床實務中死亡準備文化適切性調整之運用。
INTRODUCION
“Good death” represents the integrity of a person's life. In addition to physical care, it also includes preparing for death. Family members do not regret the death of their loved ones. Death preparation is critical to the physical, mental, and mental well-being of the bereaved. In clinical practice, the medical team mostly focuses on the physical care of patients and is limited to consideration of practical issues such as the place of death, funeral matters, and medical decision-making discussions. There are very few relevant studies on death preparation issues which focused on the views and experiences of significant others of patients, and most of them are qualitative studies in Western countries. In Taiwan, there are currently few studies on the involvement of family members of terminal patients in preparation for death.
OBJECTIVES
To explore the experience and demand of significant others of patients who died of cancer in terminal illnesses in preparing for death.
METHODS
The Phenomenological approach was conducted to the study and semi-structured face-to-face interviews were adopted. The cases will be collected in a medical center in the south of Taiwan, and objects are bereaved significant others of the terminal cancer patients who deceased more than two months and less than 12 months. The sampling was determined purposive sampling and the maximum variation sampling. According to Gloaizzi's (1978) phenomenological research seven steps of data analysis, through prolonged engagement, persistent observation, peer debriefing and member check to check the credibility of the study. The reflexive journal and research memo is to ensure the credibility, confirmability, dependability, and transferability of the research.
RESULTS and DISCUSSION
Five main themes emerged from experiences of preparedness of death, including (1) Contradictions and ups and downs, knowing fate and knowing disease, (2) Mutual preparation for tacit understanding, (3) Comply with your wishes and hope for perfection, (4) Say goodbye to sadness and send love away, (5) Despite all preparations, there are still regrets. And three main themes of significant others’ demand, including (1) Accompanied by professional medical care with dignity, (2) Safe and secure care of resources, (3) Companionship in the valley of spiritual empathy.
The results of the study found that the family-centered culture of Taiwanese society, the connection and tacit understanding of love among family members, shaped the uniqueness of restraint, tacit understanding and tacit understanding of death preparation. In the context of the Chinese cultural concept of life and death, from the exploration of the patient as the subject of good death and death preparation, to the mutual preparation between the patient and significant others, and the subsequent description of the situation of the bereaved family members facing the death of the deceased, all show the unique characteristics of the Chinese. The face of death preparation. In terms of the nature of needs, the research found that the inner power contained in the process of preparing for death includes a sense of uncertainty, obtaining answers and assistance, cherishing the time and companionship with relatives, support from relatives and friends, and trust in faith, which are the nutrients for the future of important people after the loss of relatives.
CONCLUSION
This study explores and understands the phenomenal nature of death preparation, integrating the uniqueness of Chinese culture, which can be used as a clinical medical team's understanding of significant others' participation in the death preparation of loved ones, and the cultural appropriateness of death preparation in clinical practice adjustment.
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校內:2026-12-31公開