緩和醫療的重頭戲－「生命回顧」：以視覺影像述說病人的故事

過去的臨床經驗發現，為癌症末期病人拍攝「生命紀錄片」（life story documentary），能有效引導病人進行生命回顧（life review），進一步肯定其人生經驗與生命價值，有助於緩和病人情緒、協助病人完成心願、減輕家人的預期性哀傷，也使醫病關係更加融洽。本病例為南部某區域教學醫院緩和醫療病房一位胰臟癌末期病人，照護團隊透過「照片引談法」（photo-elicitation method），讓病人在家屬協助及照護團隊的友善引導下，訴說自己的生命故事，再將病人的老照片及所聽取的故事加以整理，輔以訪談過程中所拍下的影片或照片，為病人製作成生命紀錄片。生命故事的拍攝，讓病人不執著於身體層面的困擾，家屬也轉而關心病人心理與靈性的狀態，並於拍攝過程中，陪同病人一起回顧生命、肯定人生。記錄內容包括住院過程與深度訪談、出院後的圓夢之行、居家照顧到臨終陪伴，真實將緩和醫療五全照護的內容，與病人生死兩相安的結局成功記錄下來。

關鍵字

生命回顧；照片引談法；生命紀錄片；緩和醫療；癌症

並列摘要

＂Life review＂ is the core content of palliative care. From the past experiences, recording ＂life documentary＂ for terminal cancer patients would be greatly helpful to the life review of patients. With high quality of life review, it would be beneficial to ease the patient's mood, assist the patient's wish to be completed, affirm his life experience and life value, reduce the family's anticipatory grief, and make the physician-patient relationship more harmonious. This study aimed to investigate the effects of life review by editing ＂life documentary＂ for terminally-ill inpatient on palliative care setting. To fulfill this study, researchers or family enrolled in the study were supposed to employ the ＂photo-elicitation method＂, inviting the patient to tell life stories by showing old photos. Investigators later on would be required to finish a film-based work by photos and stories provided/told by the patient. All films were feed backed to patient himself and shared with his family. In the report, we shared a successful experience in our study, which demonstrated the comprehensive palliative care by recording the treatment process, deep interviews with patient and family, hospice home care, wish accomplishment and end-of-life accompany.