以照顧癌末病人之醫學倫理，建構醫師靈性成長課程

The Construction of Spiritual Growth Programs for Physicians Based on Medical Ethics of Caring for Terminal Cancer Patients

方俊凱(Chun-Kai Fang) ； 賴明亮(Ming-Liang Lai) ； 呂欣芹(Hsin-Chin Lu) ； 林明慧(Ming-Hwai Lin) ； 李佩怡(Pei-Yi Li)

《台灣癌症醫學雜誌》 26卷3期 (2010/06) Pp. 100-111

https://doi.org/10.6323/JoCRP.2010.26.3.2

摘要

本研究探討醫師的靈性狀態與靈性成長現象，據以規劃醫師靈性成長課程及評估的基礎。採用現象學取向的質性研究法，以立意取樣研究對象，半結構訪談及焦點團體收集資料。結果發現照顧末期病患醫師所遭遇之困難與成長需求包括：醫病關係與溝通、病患的生理、心理、靈性照顧、醫師自我照顧、醫療團隊與制度七大層面。因此規劃了八小時的「醫路同行」醫師靈性成長課程及「醫師靈性安適量表」，分別在馬偕紀念醫院與成大醫院進行，共177位醫師參與課程並完成量表。結果發現「醫師靈性安適量表」的四個內涵為醫師的特質、行醫困境、因應轉變及整體安適狀態，可解釋總變異量為65.65%，量表的四個次概念為：自我肯定、照顧病患、活出意義、人際關係。計算全量表的內在一致性其Cronbach'α為0.871，因素分析後各因素（遭逢困境、各人特質、因應轉變、整體安適）四層面的內在一致性Cronbach'α值介於0.63~0.74之間。折半信度為0.865。顯示此量表有滿意的信度及效度，可作為評估醫師靈性安適的指標，以及作為發展促進靈性成長教育之參考。

關鍵字

醫師 ； 靈性成長 ； 靈性安適 ； 醫學倫理

並列摘要

A physician is the leader and decision-maker of a medical team and has a direct influence on the well-being of all team members as well as patients and their families. A physically and mentally fit physician is especially important to the well-being of a terminal patient. However, little attention has been paid to the spiritual well-being of physicians. This study explored physicians’ spiritual status and spiritual growth, and the results served as a basis for planning spiritual growth programs for physicians and assessing their spiritual well-being. The present study adopted Heidegger's qualitative phenomenological method and selected through purposive sampling physicians who took care of terminal cancer patients as study participants. Data were collected through semi-structured interviews and from focus groups. Results showed that the physicians faced difficulties in doctor-patient relationships and communication, patient's physical, mental and spiritual care, physician's self-care, the medical team and the medical system. Based on these findings, an 8-hour spiritual growth program for physicians and a 'Physician's Spiritual Well-Being Scale' (PSpWBS) were established at the Mackay Memorial Hospital and the National Cheng Kung University Hospital. A total of 177 physicians completed the program and the PSpWBS before and after the program. The study results showed that the lower-than-expected spiritual well-being of physicians was an important issue. Physicians' high level of satisfaction with the program indicated a need for programs in medical ethics.

並列關鍵字

physician ； spiritual growth ； spirituality well-being ； medical ethics