從事安寧緩和療護工作之困境與轉變之研究－家庭醫學科住院醫師之觀點

The Research to the Plights and Transitions of Engaging Hospice Palliative Care-Family Medicine Residents' Perspectives

余宜叡(I-Ruei Yu) ； 林益卿(I-Ching Lin) ； 蔡佩渝(Pei-Yu Tsai) ； 盧建中(Jian-Zhong Lu)

《安寧療護雜誌》 15卷1期 (2010/03) Pp. 35-46

https://doi.org/10.6537/TJHPC.2010.15(1).3

摘要

本文主要以家庭醫學科住院醫師的視角解析其從事安寧緩和療護工作的困境與轉變，透過質性研究深刻地進入醫師們的內心世界，再現其工作情境中的各種困境現象，結果發現：在專業能力與素養上，遭遇醫療處置與判斷未成熟、理論與實務銜接、悲傷能力處理、醫病關係溝通、與醫療團隊分工合作問題及適法與否等挑戰；在情感層面承受醫療處置壓力與決定的掙扎、無力感侵襲、倫理與情感拉鋸、對死亡鬼怪之恐懼及人生與家庭觀的衝擊；在制度與人力的受限下也面臨妥協與否的困境；最後，並從這些困境中學習轉變與適應。因此，透過本文一方面希望喚醒對安寧工作參與者感受的重視外，也呈現實際工作上的各種問題，以利未來參與安寧緩和療護工作者參考。

關鍵字

安寧緩和療護 ； 質性研究 ； 困境 ； 轉變

並列摘要

This article mainly analyzes the plights and transitions of hospice palliative care from four family medicine residents' sights. The consequence of plights in three aspects from professional abilities and attitudes, emotional parts and system and faculties assigned, including immature medical management and judgment, incoherence with theory and reality, ability to manage grief, communication between physicians and patients, problems about medical team working, legal problems, stress from medical management, the struggle to make decision, the helpless feeling, contradictory between ethics and affections, the fear of death and ghost, impact of a view of life and family. And finally, they have learned to transit and adapt from these plights. Through qualitative research method enters their inside worlds to interpret plight phenomenon at work. One for awaking to attention the consciousness of people engaged in this field, one for revealing practiced problems they encountered at work to future attendants.

並列關鍵字

hospice palliative care ； qualitative research ； plight ； transition