Spiritual Distress Experienced by Cancer Patients-Develop a Spiritual Care for Cancer Patients

癌症患者經歷的靈性困擾－發展癌症患者的靈性照護

顧雅利(Ya-Lie Ku)

《安寧療護雜誌》 10卷3期 (2005/08) Pp. 221-223

https://doi.org/10.6537/TJHPC.2005.10(3).1

摘要

癌症一直佔國人十大死因之首位，文獻回顧發現大部份癌症患者表示其有靈性照護之需求，但是醫護人員常常忽略癌症患者的靈性照顧，問題在於護理人員不熟悉靈性的評估及診斷，和提供癌症患者的靈性照護。本研究計畫的目地乃在發展一個癌症患者靈性照護的模式，並建立癌症患者心靈困擾的定義性特徵、相關因素、護理措施，及成果指標等量表。本質性研究設計採立意取樣，研究者以半開放性問題的方式，依據Wlotersdorff(1994)的架構，引導個案描述自己於罹患癌症期間本身，與他人，和信仰的神之間的經歷。此研究自2003年2至4月期間執行於南部某醫學中心的門診化療室。
依據研究發現的分類，研究者發展出癌症患者心靈困擾的27項定義特徵，13項相關因素，20項護理措施，及18項成果指標。根據這些結果，此研究將靈性困擾定義為一位癌症患者經歷負向的心理狀況，和健康照護者、神、傳統價值、宗教信仰有矛盾關係，及很難處理死亡相關議題。此外，研究者也發展一個癌症患者靈性照護的模式，並建立定義特徵，相關因素，護理措施，及成果指標4個量表。未來研究即測試4個量表的信效度，並應用於癌症患者身上，希望癌症患者經由加強其靈性照護，使其活的更有意義。

關鍵字

心靈困擾 ； 癌症患者 ； 靈性護理照護

並列摘要

Cancer is the leading number one killer for ten cause of mortality in Taiwan. A literature review indicates that the majority of cancer patients explore their spiritual care needs. However, nurses frequently neglect the patients' spiritual care. The problem is that nurses are unfamiliar with assessing and diagnosing spiritual problems, as well as providing spiritual care for cancer patients. This study aims to develop a framework of spiritual care for cancer patients and established defining characteristics, related factors, nursing interventions, and outcomes-criteria of spiritual distress for cancer patients. A qualitative research with a purposive sampling procedure was used in this study. Cancer patients were interviewed by using semi-open questions following Wlotersdorff (1994) framework to guide them describe the experiences of themselves, with others, and with their gods during the cancer illness. This study was conducted in the chemotherapy room of a southern medical center, Taiwan, from February to April, 2003. Based on the categories of study findings, the investigator developed 27 defining characteristics, 13 related factors, 20 nursing interventions, and 18 outcomes criteria of spiritual distress for cancer patients. Based on the findings, the spiritual distress of cancer patients has defined as a cancer patient has the experiences of negative psychological states, contradictory relationship with health care professionals, God, traditional values, religion, and difficulties to deal with death issues. Besides, the investigator developed a framework of spiritual care for cancer patients and four scales on which defining characteristics, related factors, nursing interventions, and outcomes-criteria for spiritual distress for cancer patients. An upcoming study will evaluate the reliability and validity of these scales for future application to cancer patients. The hope is places on cancer patients who will live meaningfully by strengthening their spiritual care.

並列關鍵字

spiritual distress ； cancer patients ； spiritual nursing care