運用同理心溝通技巧提供年輕癌末病人靈性照護

Using Empathy Communication Skills to Provide Spiritual Care for A Terminally Young Cancer Patient

劉芊葳(Chien-Wei Liu) ； 楊婉萍(Wan-Ping Yang)

《安寧療護雜誌》 22卷2期 (2017/07) Pp. 213-227

https://doi.org/10.6537/TJHPC.2017.22(2).7

摘要

本案例報告中探討如何運用同理心溝通技巧，與一名未滿30 歲淋巴癌末期男性病人，在外科加護隔離病房中，建立信任與親善的醫/護病關係。以行為過程實錄方式，記錄共12 日白班護理照顧過程，繕寫醫/護與病人之互動及對話，經分析整理而成。在照護過程中，以同理心溝通技巧引導病人敘說其生病敘事，討論對死亡與疾病的看法，抒發情緒壓力。同理其面對疾病和死亡的害怕、孤單和壓力過程中，辨識其靈性受苦有三：「苦難無意義-苦海無涯，回頭無岸」、「關係性孤獨-無助如風中凋零殘葉」、「無價值的人生-回顧昔日榮景更添怨嘆不平」。進一步運用同理心引導評估其靈性助力與阻力，並回應其靈性需求，幽谷伴行最後一程。

關鍵字

同理心 ； 溝通技巧 ； 醫/護病關係 ； 癌症末期 ； 靈性照護

並列摘要

This case report discussed how to use empathy communication skills to build trust and rapport doctor/nurse-patient relationship with a nearly 30-year-old male late-stage lymphoma patient at the isolated surgical intensive care unit. By behavioral process recording on 12 consecutive day shift nursing care, we compiled and analyzed medical/nursing care process and interaction with the patients as well as the dialogue. With empathy skills during period of nursing care, we guided the patient narrating his medical history and expressed his emotions by discussing views of disease and death. In the process of facing fear of death, loneliness and pressure from disease, we helped him to identify three spiritual distress. These were ＂Suffering without boundaries＂, ＂Helpless like faded and fallen leaves in the wind＂ and ＂Worthless life with uneven complaining＂. At this moment, we could further use empathy communication skills to assess his spiritual strength and weakness to cope with his spiritual needs and accompanied him with his final journey.

並列關鍵字

empathy ； communication skills ； doctor/ nurse-patient relationship ； terminal cancer ； spiritual care

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