癌症末期病人的善終觀點

The Cancer Terminally Ill Patients' Perspectives on Good Death

方俊凱(Chun-Kai Fang) ； 林子涵(Tzu-Han Lin) ； 畢世萱(Shih-Hsuan Pi) ； 李閏華(Jun-Hua Lee) ； 李佩怡(Pei-Yi Li)

《安寧療護雜誌》 22卷3期 (2017/11) Pp. 288-309

https://doi.org/10.6537/TJHPC.201711_22(3).003

摘要

「善終」的探索與實踐，對病人、家屬、健康照護人員來說，都是無法迴避的議題。研究目的：本研究為探討末期病人建構其善終經驗以及體驗其存在處境的方式。材料與方法：以十二位末期病人為研究參與者，並以深度訪談的形式收集其口述資料，最後以「詮釋現象學」研究方法進行研究結果的分析。結果：末期病人談論「善終」時會觸及三大主題：「在瀕死過程中繼續生活＂Living in dying＂ (L)」、「持續經驗存在的自體＂Experiencing the Existential self＂ (E)」、「在臨終過程中面對死亡＂Dying in Living＂ (D)」。其中，「在瀕死過程中繼續生活」包括建立生活格局、回憶過往時光、確認自我認同、連結重要他者、維繫醫病關係等五個面向。「持續經驗存在的自體」包括對生病經驗的正向回應、處於生死邊界的矛盾感受、維持個人自主性、與他人真實相伴、以宗教或靈性體驗安頓身心等五個面向。「在臨終過程中面對死亡」包括對病情有完整的認知、以理性的態度面對死亡、透過身體狀況覺知死亡、規劃生後事宜、預想死亡的情景等五個面向。結論：本研究提供探索末期病人善終經驗的詮釋現象學視野，期望從「存在」的角度探討病人建構臨終生活的歷程。

關鍵字

末期病人 ； 善終 ； 詮釋現象學

並列摘要

The exploration and practice of ＂Good Death＂ is an unavoidable issue for patients, families and health care workers. Purpose：The research is a discovery on how the terminally ill patients construct their ＂good death＂ experience and the existential situation they find themselves. Method：We invited twelve terminal patients to be research participants, collected data by in-depth interviewing which then analyzed with method of hermeneutic phenomenology. Results：When the terminally ill talked about ＂good death＂, they inevitably touched upon three main dimensions: ＂Living in dying＂ (L), ＂Experiencing the Existential self＂ (E), and ＂Dying in Living＂ (D). Dimension ＂Living in dying＂ includes creating a life style, revisiting memories, maintaining self-identity, bonding with significant others, and maintaining relationships with health care providers. Dimension ＂experiencing the Existential self＂ includes having positive response to illness, being ambivalent towards life and death, assuring autonomy, having sincere and true companions, and finding peace in faith or spiritual experience. Finally, Dimension ＂Dying in Living＂ includes being informed of prognosis, facing death with a reasonable attitude, being aware of death through one's own physical condition, and envisioning the moment of death. This research intends to provide a new way of understanding the terminally ill's perspectives on ＂good death＂ through the lens of hermeneutic phenomenology and existentialism. Conclusion：Researcher hopes to gain insights into how terminal patients experience and construct their last days of life.

並列關鍵字

the terminally ill ； good death ； hermeneutic phenomenology

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