心理師與社工師在安寧緩和療護團隊中的角色關係－以某醫學中心安寧團隊的歷史經驗為例

The Role Relationships between Psychologist and Social Worker in the Hospice and Palliative Care Team: A Case Study of the Hospice and Palliative Care Team in a Medical Center

魏書娥(Shu-Er Wei) ； 林姿妙(Tzy-Miao Lin)

《生死學研究》 4期 (2006/07) Pp. 37-83

https://doi.org/10.29844/JLDS.200607.0002

摘要

就目前安寧緩和療護的發展現況而言，醫師、護理人員、社工師、宗教師以及志工是安寧緩和療護團隊核心的專業成員。心理學符合安寧緩和療護理念要求的整體性照顧原則，已被認可對安寧緩和療護具有重要的貢獻，但是心理師在安寧緩和療護團隊裡的角色地位仍無定論。在醫療全球化的趨勢下，各地安寧緩和療護團隊如何實踐心理層面的照顧，端視其所在的組織環境與制度條件，而這也涉及心理師與社工師在安寧緩和療護團隊運作模式中的角色關係。本研究據此，採用健康照護團體的動態觀點，討論其運作機制的可行性與在台灣安寧緩和療護脈絡內部的未來走勢。
本研究採持續比較分析法(CCM)。我們以某醫學中心安寧病房社工師與心理師為訪談對象，在資料收集方面，除了半結構式開放問卷的訪談逐字稿外，還包括其相他關文獻、書面訪談以及田野觀察紀錄等。經由持續比較分析過程，我們發現該病房心理師與社工師的合作過程形成了「團隊運作默契」，而且可以發現，心理師加入安寧緩和療護團隊的核心成員可以促進團隊運作默契。基於這個成功的經驗，我們認為心理師也應該被整合為安寧緩和療護團隊的核心成員之一。

關鍵字

心理師 ； 社工師 ； 安寧緩和療護團隊 ； 團隊運作默契

並列摘要

So far as it has developed, physicians, nurses, social worker, chaplain and volunteers are the professionally core personnel of hospice and palliative care team. In order to embed in the globally medical systems and its cultural institutional varieties, it has developed varieties of the local care model. This article aims to explore the role relationships between psychologist and social worker in the hospice and palliative care team in perspective of the dynamic of a health care group, and to discuss its possible practice and developmental mechanism within the context of modern hospice movement in Taiwan.
In terms of constant comparative method (CCM), this study has been grounded on the semi-structured questionnaire transcribed interviews with a psychologist and a social worker of the same hospice ward in a medical center, the associated literatures, manuscripts and the notes of field observation. It has been found that there exists the tacit understanding of team practice between psychologist and social worker, which is positive and helpful to the hospice and palliative care team. As result, we suggest the psychologist should be integrated as one of the professionally core personnel in the hospice and palliative care team due to their contribution to psychological care.

並列關鍵字

psychologist ； social worker ； hospice and palliative care team ； tacit understanding of team practice