- 學位論文
居家安寧照顧中的家：家屬照顧者之照顧處境經驗探究
The meaning of “home”: Exploring the situational experiences of home-based hospice family caregivers
摘要
本研究目的探究家屬照顧者於居家安寧場域的處境經驗，期望瞭解居家安寧對照顧者的意義、居家安寧照顧處境中照顧者與他人的關係將如何開展、家的特殊性如何影響照顧經驗等議題。本研究將採用半結構式深度訪談，以東部某醫療院所提供之居家安寧療護服務區域為研究田野，錄音蒐集共六位家屬照顧者之訪談資料，每位受訪者接受二次訪談，受訪者性別為二女四男，年齡介於45至75歲之間，並透過李維倫與賴憶嫺（2009）提出之現象學分析方法進行資料分析，以現象學心理學的觀點，貼近受訪者之生活世界，以深入瞭解家屬照顧者之置身所在。研究結果將從參與者的處境經驗提出三個面向的討論，包含居家安寧照顧中的居家經驗、居家安寧照顧中的關係性、居家安寧照顧中的家屋空間，並嘗試探討醫療場域與居家安寧場域之間的共同性與殊異性，以此凸顯居家安寧場域的獨特性。研究發現，居家安寧的家庭體驗在疾病的影響下，照顧者可能依循醫療的規範行事，亦可能有投入當下「無目的」居家時間，在與病者彼此陪伴之下感到安適；而家庭關聯的家屬、鄰里、看護等關係中的非技術性陪伴關懷，帶出柔適照顧的可能，並於此自在互動中得以接應照顧者的苦。另外，家屋空間中的歷史痕跡、情感連結與歸返之地的意涵，使居家安寧場域中的病者與照顧者開展療癒的可能。透過居家安寧照顧處境之經驗，拓展理解居家安寧照顧者的角度，以提供適當的醫療支持服務，並作為發展未來居家安寧相關服務的參考。
並列摘要
This research starts a homeward journey of the situational experiences of family caregivers in home-based hospice, to explore (1) the meaning of home-based hospice for the family caregiver, (2) the relations between the family caregiver and others, including the patient, other family members and informal caregiver, and (3) the differences between home care and hospital care. We applied the participatory observation and depth interview to collect data. Six family caregivers of four males and two females, aged 45 to 75 who agreed the informed consent were recruited from home-based palliative care service in eastern Taiwan and were interviewed twice. Interviews were recorded, transcribed, and analyzed by a phenomenological psychology method. The data analysis procedures of carrying out phenomenological psychology were based on six steps: data collection, empathic immersion, meaning units, constituent themes, situated structure, and general structure. The results revealed three themes： (1) the living experience at the home of caregivers, (2) the relationship of caregivers, (3) the meaning of home space, and further discusses the similarities and differences between home and hospital. The outcome implied that the companionship from family members, neighbors, and other informal caregivers in everyday activities may provide supportive effectiveness to caregivers and patients. Home as a meaningful place offers the sense of healing to the patient and his family. We discussed the role and benefit of home-based hospice in healthcare service.
參考文獻
延伸閱讀
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