教養機構服務人員面對服務對象死亡態度之研究

中文摘要本文主要探討教養機構服務人員面對服務對象死亡之態度，而研究目的包括:一、服務人員處理服務對象死亡過程中的死亡經驗。二、服務人員處理服務對象死亡態度。三、服務人員處理服務對象過程中的社會支持體系。四、對於機關實務工作者提供經驗交流分享的平台與實務建議。研究者在欲研究之老化教養機構以立意取樣方式針對七位曾經處理過服務對象死亡經驗的服務人員，進行深度訪談，分析當時死亡經驗背景脈絡如何影響服務人員死亡處理事件的角色，包括：台灣身心障礙福利趨勢演變與組織文化喪葬儀式的變革。此外，服務人員面對服務對象死亡態度具有多元性，其中有兩位服務人員死亡態度是傾向趨近導向死亡態度，源由於堅定的宗教信仰，故將死亡視為通往快樂來生的通道，其他服務人員死亡態度面向大致包括:死亡恐懼、死亡逃避、趨近導向死亡與逃離導向死亡等，分析服務人員主要死亡恐懼的原因包括個人因素如:年齡、性別與宗教因素或環境因素，如: 空間設計、服務對象死因、與服務對象的熟悉度、家屬的態度、接觸死亡經驗多寡、服務人員陪伴等對於服務人員的死亡態度有不同程度的影響。故影響死亡態度因素，包括個人認知與環境因素，而服務人員獲得社會支持的經驗對於處理服務對象死亡有相當大的幫助，其中服務人員表示兩人以上陪伴對於服務人員面對死亡事件會是最佳情感與資訊性支持因素。最後，對於該機關與服務人員建議如下: 一、鼓勵服務人員談論死亡與不帶批判性的內省，可以幫助自己尋求適合的社會支持。二、邀請認知能力尚佳的院生與有意願家屬討論生前遺囑可能性。三、建立隱性知識的傳承機制，非正式溝通管道是重要的溝通與交流平台。

關鍵字

死亡態度；社會支持；教養機構

並列摘要

The Abstract Death is part of the life cycle. The issue of death is considered as a taboo to most people, especially to Chinese people. However, as aging residents increase in the Education and Nursing Institute, it will be a trend for the staff to face their resident’s death. The purpose of this study is to explore the staff’s past experiences when they confronted their resident’s death. Besides, this study also discovers their attitude toward student’s death. The researcher selects seven participants from the staff working in Educational and Nursing Institute. These participants at least have one experience to deal with the resident’s death event. By interviewing the seven participants and by observing how they describe their past experiences and death attitudes, the result of the analysis is presented through a variety of aspects as follows: 1.The participants’ experiences are mainly affected by the trend of social welfare. 2.The participants’ attitudes toward the resident’s death is diverse . 　 3.The participants’ attitudes toward the resident’s death contain personal and environmental levels. 4.The main coping strategy is their social support system. A good partner is the best social support for the participants. 　This research aims to understand the attitudes of the staff facing the resident’s death. The staff must recognize their own needs and find a good way to support them. In the long term, it will be easy to face the resident’s death and corpse care. Finally, based on the findings of the study, several suggestions for this institution and further research are provided.