死亡地點與癌末病人喪親家屬哀傷反應之相關性探討

Relationship of The Place of Death to Bereavement of Caregivers of Advanced Cancer Patients

黃美菊(Mei-Chu Huang)

指導教授 ： 林佳靜

臺北醫學大學/護理學院/護理學研究所/碩士(2004年)

摘要

論文摘要 論文名稱：死亡地點與癌末病人喪親家屬哀傷反應之相關性探討 研究所名稱：台北醫學大學護理學研究所 研究姓名：黄美菊 畢業時間：九十二學年度第二學期 指導教授：林佳靜 台北醫學大學護理學研究所 教授 癌症末期的死亡是可預期的，喪親故然需經歷哀傷，而哀傷的影響因素甚多，只要針對影響哀傷反應的因素做預防及準備，家屬的哀傷便應可改善。本研究之目的在探討癌症末期病人死亡地點不同與家屬哀傷反應的相關性及探討癌症末期病人死亡地點如願與否與家屬哀傷反應的相關性，採前瞻性研究法，以台北巿某區域醫院之30對住院癌症末期病人及家屬(N=60)為收案對象，以修改後的TRIG量表為工具，針對符合收案條件者分別於住院時及喪親一個月後進行訪談，並完成問巻，結果以SPSS套裝軟體進行資料之統計分析。 研究結果顯示，病人期望的死亡地點及家屬期望的死亡地點與實際的死亡地點有顯著的相關，病人死亡地點的如願率有43.3%，病人所期望的死亡地點之不同對家屬喪親後三天內的哀傷反應得分及喪親一個月後的哀傷反應得分，在統計上無顯著差異。家屬所期望的死亡地點之不同對家屬喪親後三天內的哀傷反應得分及喪親一個月後的哀傷反應得分在統計上亦無顯著差異。病人實際的死亡地點之不同對家屬喪親後三天內的哀傷反應得分及喪親一個月後的哀傷反應得分在統計上無顯著差異。病人死亡地點與病人或家屬的期望一致與否對家屬喪親後三天內的哀傷反應得分及喪親一個月後的哀傷反應得分在統計上無顯著差異。在相關的人口學特性與家屬哀傷得分的相關性方面，病人死亡年齡愈大，其家屬喪親三天內的哀傷程度愈低。家屬為決策者其喪親一個月後的哀傷程度顯著低於非決策者。家屬現已恢復正常工作者其喪親三天內及一個月後的哀傷程度顯著低於未恢復正常工作者。病人有遺憾者其家屬在喪親後三天內及喪親一個月後的哀傷程度明顯大於病人無遺憾者。 本研究探討癌末病人死亡地點與家屬哀傷反應的影響，結果顯示死亡地點並非喪親家屬哀傷反應的影響因素，真正的影響因素為是否為決策者、病人死亡的年齡及病人是否有遺憾，此研究結果有助於能臨床上家屬的哀傷輔導方向。 關鍵字：癌末病人、喪親家屬、主要照顧者、死亡地點、哀傷反應、 哀傷量表

關鍵字

癌末病人 ； 喪親家屬 ； 主要照顧者 ； 死亡地點 ； 哀傷反應 ； 哀傷量表

並列摘要

Abstract Title of Thesis: Relationship of The Place of Death to bereavement of Caregivers of Advanced Cancer Patients Institution: Graduate Institute of Nursing, Taipei Medical University Author: Mei-Chu Huang Thesis Directed by: Chia-Chin Lin, Ph.D., Professor The death of advanced cancer patient is predictable and the grief of losing family is also unavoidable. There are many factors that cause bereavement. As long as it is prepared and prevented to solve the problem caused by those factors of grief, the degree of bereavement can be improved. The purpose of this research is to explore the relationship between the place of death of advanced cancer patients and bereavement of their caregivers. Thirty advanced cancer patients who resident in the hospital in certain areas of Taipei and their families (N=60) were recruited. Using the revised TRIG questionnaire collected data. Family caregivers were interviewed for the qualification of the case respectively when the patients were still in the hospital and one month after the patients died. The questionnaire was analyzed via software SPSS. The result of research shows that where the patient expects to death is significantly related to where the patient actually died. There is a significant relationship between where the patient’s family expect them to die and where the patient actually died. The percentage of patients who passed away in where they wish to was 43%. There is no significant difference between the degree of family’s bereavement in three days and the degree of family’s bereavement in one month when the place of patient’s death is different from where they wish to die. There is also no significant difference between the degree of family’s bereavement in three days and the degree of family’s bereavement in one month when the place of patient’s death is different from where his/her family wish to die. The conformity of where the advanced cancer patient died and his/her family’s or patient’s expectation shows no significant difference in statistics on the impact between the degree of family’s bereavement in three days and the degree of family’s bereavement in one month. The older the patient’s age was when the patient died, the lower the degree of family’s grief was. If family are those who were major decision-makers, the degree of family’s bereavement in one month was significantly lower than those who were not decision-makers. The degree of grief of family who were back to their normal work in three days and one month was significantly lower than those who were not back to their normal work. The degree of grief of families of patient who had undone wishes in three days and one month was significantly lower than those who did not have undone wishes. The place of advanced cancer patient’s death and its impact on family’s grief reaction has been discussed. The result suggests that the place of death is not one of the factors which affect the degree of suffering of family who are bereaved. Key word: advanced cancer patient, family of bereaved, caregiver、the place of death, grief, bereavement, grief questionnaire

並列關鍵字

advanced cancer patient ； family of bereaved ； caregiver ； the place of death ； grief ； bereavement ； grief questionnaire

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