臨床護理之靈性照護

Spiritual Care in Clinical Nursing

顧雅利(Ya-Lie Ku) ； 張淑媛(Shu-Yuan Chang) ； 李鳳屏(Feng-Ping Lee)

《安寧療護雜誌》 12卷4期 (2007/11) Pp. 408-418

https://doi.org/10.6537/TJHPC.2007.12(4).4

摘要

靈性照護的文獻大都偏向腫瘤與安寧單位的患者，很少針對其他科別的病患進行整體性的靈性文獻回顧。筆者協助護理系學生回顧2000年間於內外科、婦產科、兒科、及精神科中與靈性相關的文獻，整體而言，在內外科方面，發現大部份的患者靈性問題偏向於自己方面，大都擔心疾病或後遺症會造成家人的負擔，對此其自尊會呈現低落，無存在價值感。在婦產科方面，無論外籍或本籍配偶，均擔心自己是否能夠受孕，及懷孕過程中胎兒是否平安與健康；而針對子宮或乳房切除患者，其問題則偏向失落、哀傷、及身體心像改變，婦產科患者靈性問題著重於其母職角色及女性特徵的喪失，導致自我情緒症狀的困擾。在兒科方面，發現住院孩童的靈性問題偏向缺乏對環境與自己的掌控力，然而孩童於表達自我感受與需求的能力有限，以致於病童若被父母、同儕、或醫護人員所忽略，會導致其焦慮、恐懼、無助、不安全、及被隔離感，使孩童靈性需求無法得到滿足，且壓力無法得以釋放。在精神科方面，患者常因爲其症狀干擾及情緒失控，加上無效地因應問題，及缺乏支持系統，導致其想以自殺方式來解脫內心的痛苦。根據以上各科種種的靈性問題，筆者協助護理系學生提出建議性的靈性護理措施，期許各科護理人員均可重視患者的靈性評估與照護。

關鍵字

靈性 ； 護理

並列摘要

Literature in the spiritual care is focused on the oncology and hospice patients, and few in the other units. The author reviewed literature related to spirituality in the medical-surgical, obstetric, pediatric, and psychiatric units through the assistant of nursing students. Overall, in the medical-surgical unit, the majority of spiritual problems are in the patients' themselves, and often worry their illness or side-effects playing as burdens for the family that made them low self-esteem and no-valued existed. In the obstetric unit, no matter the foreign or domestic wives, they all afraid to be infertility and once they are conception and started to worry the safety and health of the babies. For uterus or breast surgery women, their problems are lost, sorrow, and body image changes. The spiritual problems in the obstetric units are emphasized on the losing of mother role and female symbolism that lead women emotion distress. In the pediatric unit, the spiritual problems for the hospitalized children are lack of controlling for the environment and themselves, plus the limitation of expression feeling and needs for the children and if sick children are ignored by their parents, peer, or health care professionals, they may become anxiety, fear, helpless, insecurity, and being isolated; therefore, the stress cannot be released due to non-satisfied spiritual needs. In the psychiatric unit, patients lost emotion control because of symptoms disturbances, and ineffective copying problems and lack of support systems that cause them using suicide to release the inner pain. According to the spiritual problems in the different units, the author has given nursing students suggestions of spiritual nursing care interventions. It is expected that nurses in the different units can value spiritual assessment and care of the patients.

並列關鍵字

spirituality ； nursing