從一位喪親者的照護探討延遲性哀傷的沿革與評估介入－以Prigerson模式探討：一個案報告

The Experience of Evaluation and Intervention for a Patient with Prolonged Grief-According to Prigerson's Model: A Case Report

楊鎮誠(Chen-Cheng Yang) ； 邱鈺雯(Yu-Wen Chiu) ； 黃洽鑽(Chia-Tsuan Huang)

《安寧療護雜誌》 18卷1期 (2013/03) Pp. 89-103

https://doi.org/10.6537/TJHPC.2013.18(1).8

摘要

延遲性哀傷是一種病態性哀傷反應，其症狀和成因、機轉均有別於合理的哀傷反應，喪親者在至親去世六個月以後，仍然有著對於已逝親人的痛苦思念、認知情感或者行為的異常症狀，而且造成其社交、職業與功能上的失能。本文分享一位喪親者，在其至親癌末驟逝之後，追蹤超過六個月後，仍持續有延遲性哀傷的表現，我們以Prigerson模式探討延遲性哀傷的診斷準則，個案符合該準則的要點包括1.很難相信案夫已經過世、2.希望與案夫再重聚、3.對週遭人事物呈現不關心與沒興趣、4.社交退縮等現象。而我們秉持安寧療護精神，運用同理個案及改變親人居住照顧模式之後，其延遲性哀傷因此逐漸緩解。再者，對於延遲性哀傷的沿革，評估要點，其他精神疾患之異同提出回顧與討論。安寧療護不僅需要緩解末期患者生前之痛苦，對於提供哀傷的遺族（喪親者）之身心靈平安也扮演重要角色。

關鍵字

延遲性哀傷 ； 安寧療護

並列摘要

Prolonged grief is an abnormal bereavement. Unlike normal bereavement, the individual with prolonged grief suffers from separation distress, cognitive, emotional and behavior abnormalities. Moreover, these symptoms lead to impairment in social, occupational, or other dysfunctions even after the loved one passed away for a long time. We reported a case with prolonged grief. According to Prigerson's model of prolonged grief, she suffered from difficulty of accepting the loss, separation distress, troubles in making new friends, pursuing interests and social impairment. These symptoms persisted more than 6 months after the death of her husband. We took care of her by hospice care, empathized her grief, increased her family supports and changed her living style. Hence, her prolonged grief was resolved gradually. Furthermore, we discuss the development and assessment of prolonged grief as well as the differentiation diagnosis. Palliative care plays an important role in relieving physical, psychological and spiritual difficulties not only to the patients but also the family (bereaved individual).

並列關鍵字

prolonged grief ； palliative care