基督宗教靈性關懷者對臨終病人靈性照顧能力之質性研究

Identifying Spiritual Care Competencies for Providers in Hospice Palliative Care from a Christian Perspective

陳秉華(Ping-Hua Chen) ； 邱仲峯(Jeng-Fong Chiou) ； 范嵐欣(Lan-Hsin Fan) ； 趙冉(Jan Chao) ； 吳森棋(Sen-Chi Wu)

《安寧療護雜誌》 21卷2期 (2016/07) Pp. 166-179

https://doi.org/10.6537/TJHPC.2016.21(2).4

摘要

研究目的：本研究旨在探究從基督宗教靈性關懷觀點，了解對臨終病人提供靈性照顧所需具備的能力。材料與方法：研究參與者包括對安寧病人提供靈性照顧之醫師、社工師、心理師、護理師、牧師、靈性關懷師訓練者、靈性關懷師等共18 人。以焦點團體訪談法收集資料，內容分析為資料分析的方法。結果：研究發現靈性照顧能力包含三個主要類別，分別為靈性照顧的基本知識、靈性照顧的態度、靈性照顧的專業知能，三個主要類別又可分為18 個次類別。靈性照顧的基本知識包括：認識與包容不同的宗教、具備基本安寧照顧知識、提供全人／全程照顧、與其他專業配合、會尋找與使用資源。靈性照顧的態度包括：認識自己、照顧的態度、工作價值與使命感、尊重病人、關心病人／家屬的需要、遵守工作倫理、提供有宗教敏感度的靈性照顧、重視專業進修與成長。靈性照顧的專業技能包括：具備關係建立與溝通技巧、協助病人／家屬處理靈性議題、幫助病人／家屬獲得靈性平安、具備靈性評估的能力、提供以基督信仰為基礎的靈性照顧。結論：本研究的發現對於未來靈性關懷者的教育訓練具有啟發性，未來也可以依據本研究結果發展靈性照顧能力的測量工具。

關鍵字

安寧療護 ； 基督宗教 ； 靈性照顧 ； 靈性照顧能力

並列摘要

Purpose: Spiritual care is an essential domain of quality palliative care. Studies have consistently indicated that patients with serious illness and end-of-life concerns oftenexpressed a need for incorporating spirituality issues into the palliative care they received. Yet, little published literature has investigated core competencies associated with the practice of spiritually-oriented palliative care among providers within this specific field. The current study aimed to identify competencies required for providers of spiritual care within the hospice palliative care system in Taiwan based on a Christian perspective. Method: A total of 18 professional hospice palliative spiritual care providers in Taiwan were recruited to participate in the study. Participants were consisted of physicians, social worker, psychologists, nurses, palliative care trainers, pastors, and spiritual care specialists. Among the participants all were Christians except three members. Interviews based on focused group were conducted and audio-taped. Verbatim were transcribed and analyzed by qualitative Thematic Analysis method. Result: Three domains of competencies (basic knowledge, attitude, and professional skills) and 18 sub-domains for spiritual care were identified based on the analysis. The basic knowledge domain included: understanding and acceptance of different religions, possessing knowledge of basic medical and palliative care, providing holistic spiritual care for whole person/whole process/whole family, collaborating with other professions, and seeking and utilizing resources; the attitude domain concerns with the care providers for having: self-knowledge, caring attitudes, work value and commitment, respect for patients and their autonomy, care for the spiritual needs of the patients and their families, adherence to work ethics, the ability to provide religiously appropriate/sensitive care, and valuing professional development; the professional skills domain includes care providers' competence in: relationshipbuilding and communication skills, assisting patients/families to deal with spiritual issues, assisting patients to gain spiritual peace, conducting spiritual assessment, and providing Christian faith based spiritual care. Conclusion: The study provides insights to help inform health care professionals and academics in developing appropriate curricula to train spiritual care providers and to improve end-of-life spiritual care in Taiwan. Additionally, the findings of the current study can guide the development of new measures to assess spiritually-based palliative care competencies for care providers in future research.

並列關鍵字

Christian basedhospice palliative care ； spiritual care ； spiritual care competency

參考文獻

TanyiRA. Towards clarification of the meaning of spirituality.J Adv Nurs 2002; 39(5): 500-9.

Golberg B. Connection: An exploration of spirituality in nursing care. J Adv Nurs 1998; 27: 836-42.

Efficace F, Marrone R. Spiritual issues and quality of life assessment in cancer care. Death Studies2002; 26(9): 743-56.

Muller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality, and medicine: Implications for clinical practice.Mayo Clin Proc 2001; 76:1225-35.

Tacey D. Contemporary spirituality. In: M Cobb, CM Puchalski, B Rumbold. (Eds.)Oxford Textbook of Spirituality in Healthcare. Oxford, England: Oxford University Press, 2012; 473-9.