醫務社工協助癌症末期病童及家庭準備死亡之研究

A study of medical social workers working with pediatric patient at terminal stage and their family on death preparation

吳宛育(Wan-Yu Wu)

指導教授 ： 汪淑媛

國立暨南國際大學/人文學院/社會政策與社會工作學系/碩士(2011年)

https://doi.org/10.6837/NCNU.2011.00351

摘要

國內癌症病童接受緩和醫療的比率偏低，且主要的死亡地點都是在加護病房，這也代表了在臨終階段，父母無法接受孩子即將死去，很多的病童仍多是積極性治療，而社工也從診斷初期，一直陪伴到疾病末期。本文以敘事研究，立意取樣的方式選擇了四位研究參與者，分析整理研究參與者的敘說文本。就癌症末期病童家庭的疾病歷程，分為：死亡前的準備、瀕死時、告別式後的悲傷輔導，再加上服務心得與困境等面向加以論述，分別為：
一、死亡前的準備時期：團隊合作的方式、面對家屬的防衛機轉，社工可以同理並尊重案家的防衛、協助病童圓夢、社工或協助家長和病童談死亡、強化對家長及病童的社會支持、陪伴技巧：仍然保持希望、教導家長同理心、積極傾聽；
二、孩子瀕死時：病童在加護病房急救時，社工安撫家屬情緒、剛死亡時，社工協助告別，並提供醫院手續或喪葬的資訊、陪伴技巧：示範、引導家長對孩子告別、生命回顧、給家長正向支持；
三、告別式及後續的悲傷輔導：儘可能參與孩子的告別式、告別式後不定期的追蹤關懷；
四、服務心得與困境：接觸兒癌的感想、服務困境。
最後，依據研究結果與發現，就兒癌領域醫務社工、醫院及社工單位、學校教育、兒癌基金會等四方面，分別提出相關建議。

關鍵字

癌末病童 ； 準備死亡 ； 陪伴 ； 社工專業能力

並列摘要

The percentage of children with cancer receiving medical treatment is low. This is because most die in ICU. It also means that most parents unprepared to deal with the loss of their child. Most children receive active treatment. A Social Worker is involved from the initial diagnosis through to the child’s death. This research involves four participants. It will also deal with the four stages a family must go through when confronting the reality of a child with terminal cancer. The four stages are; preparations before death, the actual death, memorial services, and the emotional difficulty that social workers have to deal with.
1. Preparation before death： Build a team to assist the child’ family.、The Social Worker can help deal with the many emotions surrounding the parents and siblings、The Social Worker can help the family face the reality of death、social support
2. Facing Death： The social Worker must provide positive support for the family. This support can take the form of assisting with the practical considerations of funeral arrangements and the issues surrounding these issues. Social Workers can also assist the parents to say “good bye” to their child in a positive and supportive way.
3. Memorial Service： The Social Worker should attend the child’s funeral/memorial service and provide consultation and care following the service.
4. The emotional difficulty that social workers have to deal with.
In conclusion, according to the research, suggestions for Social Workers to hospitals, schools, and foundations to assist them in dealing with the families of children with cancer.

並列關鍵字

pediatric patient at terminal stage ； Preparation before death ； accompany ； social worker ability

參考文獻

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