頭頸部癌末病人之靈性照顧研究

Spiritual Care for Terminal Patients with Head and Neck Cancer

釋宗惇(Tsung-Tueng Bhikkhuni) ； 釋滿祥(Man-Shyang Baikkhuni) ； 陳慶餘(Ching-Yu Chen) ； 胡文郁(Wen-Yu Hu) ； 邱泰源(Tai-Yuan Chiu) ； 釋惠敏(Hui-Ming Bhikkhu)

《安寧療護雜誌》 7卷4期 (2002/11) Pp. 269-282

https://doi.org/10.6537/TJHPC.2002.7(4).1

摘要

爲療解臨床佛教宗教師在頭頸部癌末病人靈性照顧的服務及專業角色，本研究針對2001年5月至10月期間在臺大醫院緩和醫院病房頭頸部癌末病人，有臨床宗教師提供靈性照顧爲對象進行回溯性調查，共計收案23名。男性17名(73.9%)、女性 6名(26.1%)，平均年齡56.3歲，平均存活天數40.7天。臨床宗教師平均接觸時間爲128.6分鍾，平均接觸次數爲6次，善終總分平均爲14.3分。在38人次照顧進程中，其照顧方式各爲：清醒間接8次(21.1%)，清醒直接16次(42.1%)，昏迷直接6次(15.8%)，昏迷間接8次(21.1%)。服務內容以「協助病人、家屬面對死亡」最多，有35次(92.1%)。法門應用則以念佛法門(63.2%)及衆善法門(47.4%)施作最高。靈性照顧問題依次爲「死亡恐懼」(39.5%)、「不捨：不放心」(34.2%)、「不捨：放不下」(28.9%)、「不捨：不甘願」(18.4%)、「其他需轉介者」(15.8%)、「自我尊嚴感喪失」(13.2%)及「對正法認識不正確」(13.2%)、「心願末了」(10.5%)、「自我放棄」與「不捨：做錯了」(5.3%)。從照顧進程與法師服務內容、法門應用及靈性照顧問題的關係來看，念佛法門及衆法門之施作與照顧方式有顯著相關性。另外，從住院時與往生前死亡恐懼程度與靈性境界之比較來看，很明顯在臨床宗教師照顧之後，死亡恐懼減少和性境界提升。

並列摘要

To investigate the service and professional role of clinical Buddhist chaplains as a team member in taking care of terminal patients with head and neck cancer, this study recruited 23 patients from May to October 2003 at palliative care ward of National Taiwan University Hospital. There were 17 male (73.9%) and 6 female (26.1%). The mean age was 56.3 years and mean survival time was 40.7 days. The mean contact time and frequency by clinical chaplains were 128.6 minutes and 6 times during admission. The total good death score was 14.3 points. Among 38 times of caring processes: 8 times the patients were awake and the spiritual care was indirect (21.1%); 16 times the patients were awake and the spiritual care was direct (42.1%); 6 times the patients were unconscious and the spiritual care was direct (15.8%); and 8 times the patients were unconscious and the spiritual care was indirect (21.1%). In regard to service contents, 35 out of 38 times the clinical Buddhist chaplains were helping the patient and the relatives to face death with the proper attitude (92.1%). Most widely employed methods by the patients were to recite Buddhas' name (63.2%) and to give charity (47.4%). Spiritual care issues raised by patients were: fear of death (39.5%); not willing to pass away due to concern of one's family (34.2%); not willing to pass away due to one's unfinished concern (28.9%); not willing to pass away due　to against one's will (18.4%); concerned about being transferred to another hospital (15.8%); losing one's self- respect (13.2%); having misunderstanding about the Truth (13.2%); having unfulfilled wishes (10.5%); abandoning oneself and not willing to pass away due to one's past mistakes (5.3%). To analyze the spiritual care processes with services by the clinical Buddhist chaplains, the methods employed and the concerns of the patients, only the methods of reciting Buddhas' name and giving charity showed significant differences. Moreover, in comparison of relationship between fear of death and spiritual strength on admission and before death, the former was reducing and the latter was increasing significantly along with spiritual care sessions provided by the clinical Buddhist chaplains.

並列關鍵字

palliative medicine ； spiritual care ； clinical Buddhist chaplain ； dhamma-practice ； dying preparation