背景：大量傷患為突發狀況且常伴隨災難事件而來，需要額外的人力及物力支援去維持正常的運作。台灣近年來經歷了地震、颱風或人為災害所造成的大量傷患災難事件，身為第一線的緊急醫療救護人員，在參與事件的過程中經歷不同程度心理壓力及情緒反應與調適行為。了解救護人員參與事件的壓力到後續身心反應與調適歷程，對於發展協助這些助人者的介入措施是很重要的。

目的：了解緊急醫療救護人員如何解讀經歷大量傷患事件對個人的意義及調適歷程之經驗。

研究方法：採立意及滾雪球選樣，以半結構式訪談台灣16位直接參與急診啟動大量傷患事件或至大量傷患事件現場給予緊急醫療照護或提供協助之緊急醫療救護人員，且自覺感到壓力及有調適歷程者。根據Colaizzi（1978）描述現象學研究法進行資料收集與分析法進行分析。

研究結果：由16位受訪者（醫師、護理師、消防員）的平均年齡為35.6歲，平均工作年資為9.7年。緊急醫療救護人員參與大量傷患事件之調適經驗涵蓋五個主題：克盡職責、護己利人、尋求資源、自我轉變及系統助力與阻力。緊急醫療救護人員參與大量傷患事件之調適經驗為一個動態且持續進行的過程。事件當下救護人員首重在最短的時間內控制災情及穩定傷患生命徵象，盡力完成救援任務的專業使命，但又須面臨大量傷患事件的危機與壓力，希望能兼顧救人與自我保護，卻發現經常需要在這之間的衝突中取捨。事後救護人員會因為面臨的壓力及家人、同事、媒體間的助力與阻力，出現不同程度的生理及心理反應，使其運用外在與自我資源、自我轉變來幫助自己調適。

結論：本研究為台灣第一篇以了解緊急醫療救護人員調適大量傷患事件為主題的研究。透過結果發現目前救護人員大多以自我調適為主，缺少相關促進緊急醫療救護人員心理健康的政策與措施。建議中央及地方層級需有系統性地評估問題及影響程度，規劃不同階段的措施，並建議在事後以專業心理人員及心理健康問卷辨識及篩檢高風險族群後，進行心理介入措施並持續追蹤。

SUMMARY
This study was to explore and describe health care professionals’ lived experiences of coping and adaptation processes in mass casualty incident. Descriptive phenomenology with semi-structured interview in-depth interviews was used to describe health care professionals’ (HCPs) adaptation experiences. Data were analyzed by Colaizzi’s method. A total of 16 participants participated in this study. The mean age of participants was 35.6 years, and the mean working year was 9.7 years. Five thermes emerged from data: accountability, self-protection, resources seeking, self-restoration and system’s assistance and obstruction. HCPs’ adaptation experience in Mass casualty incident (MCI) was a continuous and dynamic process. Many HCPs in this study were struggled and used their own resources to endure the process. Government and health institutions need to systematically assess HCPs’ needs and psychological impacts affected by MCI. Related psychological interventions and screening tools for PTSD are important to identify their needs and provide assistances for the frontline healthcare providers.
Key words: Health care professionals, Mass casualty incident, Adaptation experiences, Descriptive phenomenology

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