面對臨終病人之角色扮演課程對醫學院學生個人死亡建構之影響

Evaluation of the Effects of Role-playing with Dying Patients Using the Death Constructs of Medical College Students

洪栩隆(Hsu-Lung Hong) ； 張利中(Li-Jung Chang)

《Journal of Medical Education》 9卷2期 (2005/06) Pp. 162-174

https://doi.org/10.6145/jme.200506_9(2).0006

摘要

近年來，國內各醫學校院紛紛開設「臨終關懷」與「生死學」相關的課程，培養醫學校院學生處理自己面對瀕死和死亡情緒的能力，並學會如何提供臨終病人及家屬「身、心、靈」整全的照顧。本研究的目的在探討以「角色扮演」方式練習「如何面對臨終病人及家屬」的小團體體驗式教學，對醫學院學生個人死亡建構的影響，以作為往後醫學教育中死亡學課程的設計參考。本研究以某醫學大學選修「醫學與戲劇」並自願配合實驗研究者為實驗組，有33位，施以「面對臨終病人之角色扮演練習」的課程。同校同期選修「助人的歷程與技巧」課程，且願意配合前、後測者為對照組，有21位，不做任何死亡教育的介入。實驗及對照兩組均在實驗組之教育介入前一週，施以前測，教育介入後之同一週內，施以後測。本研究並運用以個人建構心理學為基礎的編碼系統來分析醫學院學生對死亡之自由表述文，作為前、後測的評量工具。研究結果支持了本研究的假設：「實驗組的個人死亡建構向度數與總數平均數，在後測時比前到時有明顯的增加，而且顯著地高於對照組的」。且發現教育介入變項為後測的個人死亡建構向度數、總數，以及正向認知、正向情意與負向情意等核心建構的顯著預測因子。顯示面對臨終病人的角色扮演教育方式可以有效地協助實驗組成員放棄原來具有堅實防衛作用的專業角色，開始由人的角度來理解與感受死亡，有助於面對他們自己，或協助別人面對未來人生的劇變。

關鍵字

死亡教育 ； 角色扮演 ； 個人建構 ； 醫學院學生

並列摘要

The aim of the present study was to investigate the influence of role-playing with dying patients and their families on the personal death constructs of medical college undergraduates. Personal constructs of free-response narratives were analyzed and compared before and after the completion of a course on role-playing with dying patients (N=33) or a course on coping processes and techniques (N=21). The hypothesis of the present study was supported by the results. The quantities of the personal death construct dimensions and the frequencies of the role-playing in classes significantly increased scores on the post test compared with those of the pretest or after taking the coping processes and techniques class. Regression analyses showed that role-playing was the predictor of post test quantities of personal death construct total dimensions, total frequencies, as well as that of dimensions of the following core constructs including positive cognition, positive affect and negative affect. The meanings of construct changes and how role-playing was effective in addition to the practical implications for medical education and future research were discussed.

並列關鍵字

personal construct ； death education ； role-playing ； medical college undergraduates

參考文獻

Durlak JA,Neimeyer RA (ed.)(1994).Death anxiety handbook.Washington, DC:Taylor & Francis.

Neimeyer RA,Epting FR,Neimeyer RA,Neimeyer GJ (eds.)(1992).Advances in personal construct psychology.Hampton Hill:JAI Press.

Kelly GA(1955).A theory of personality the psychology of personal constructs.New York:Norton.

Neimeyer RA (ed.)(1994).Death anxiety handbook.Washington, DC:Taylor & Francis.

Holcomb LE,Neimeyer RA,Moore MK(1993).Personal meanings of death: A content analysis of free-response narratives.Death Stud.17,299-318.