透過敘事會談方式協助悲傷中的癌末病人家屬

Narrative interviews with a terminally ill cancer family experiencing anticipatory grief

洪翠蓮(Tsui-Lian Hung) ； 謝依靜(I-Ching Hsieh) ； 張麗珍(Li-Chen Chang)

《安寧療護雜誌》 26卷2期 (2022/03) Pp. 165-177

https://doi.org/10.6537/TJHPC.202203_26(2).05

摘要

本文介紹血腫科團隊輔導一位癌末病人的配偶面對預期性悲傷的經驗。當醫療對病人的疾病治療出現極限時，醫療團隊向案妻及家屬們第一次提出安寧療護的建議，但案妻和其他家屬對於病人的治療效果仍抱著期待，未採納安寧療護的建議，也為病人作氣切的決策。在病人氣切之後，意志顯得消沉，與人的互動行為減少。案妻眼見病人的身體漸衰弱和社會功能漸喪失，出現預期性悲傷的反應。本團隊觀察到案妻的心理與社會需求，主動關懷與進行會談。藉由敘事方式探索案妻經歷預期性悲傷的感覺與想法，引導案妻在敘說過程，接納病人癌末的事實，體驗心中的分離焦慮，重整與病人的關係意義，轉化態度接納未來喪偶之後的單親生活。

關鍵字

預期性悲傷 ； 敘事會談 ； 安寧療護

並列摘要

This article describes the experience of the hematology and oncology team in counseling the spouse of a patient with advanced cancer with anticipatory grief. When the patient's condition worsened, the medical team suggested hospice care to his wife and other family members for the first time. However, the wife along with other family members did not follow the recommendation for hospice care. In addition, the patient's wife and other family members made the decision for the patient to undergo a tracheostomy. After the tracheostomy operation, the patient became distressed and reduced interactions with others. Witnessing the patient's gradual physical deterioration and loss of social functioning, the wife started to show anticipatory grief reactions. The team observed her psychological and social needs and took the initiative to provide care and counseling. Through the narrative interviews, the team helped the wife explore the feelings and thoughts she had while experiencing anticipatory grief and guided her to accept that the patient was dying, feel the separation anxiety, reorganize the meaning of her relationship with the patient, and move on to her future life as a single parent following the loss of her spouse.

並列關鍵字

anticipatory grief ； narrative interview ； palliative care

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