尊嚴療法於末期照護之深化、實踐與推展

Strengthening, Practicing and Promoting Dignity Therapy in End-of-Life Care

張靜年(Jing-Nian Jhang) ； 賴維淑(Wei-Shu Lai)

《台灣醫學》 25卷4期 (2021/07) Pp. 531-540

https://doi.org/10.6320/FJM.202107_25(4).0013

摘要

維護病人尊嚴是護理核心要素，「尊嚴療法（dignity therapy, DT）」為一新型、簡短、個別化且具實證基礎的心理靈性治療性介入措施，透過訪談促使病人反思生命重要議題，並編製包含病人重要回憶及人生智慧精華之生命紀念物。尊嚴療法有助於促發病人自我統整（ego-integrity）、傳承生命紀念物與家屬情緒支持，亦可強化醫療照顧者敘事醫療的臨床實踐過程。希冀未來進一步在台灣文化背景下，測試尊嚴療法之潛在效力、可接受性和可行性並做修訂，從病人、家屬或重要他人、醫療照顧者端多面向評值介入成效，有助於國內以實證為基礎文化適切性尊嚴療法之推展與應用，期能加深對尊嚴的覺知、反思與行動，提升尊嚴照護能力。

關鍵字

尊嚴療法 ； 敘事醫學 ； 末期照護 ； 自我統整

並列摘要

Maintaining the dignity of patients is the core element of nursing. Dignity therapy (DT), a novel, brief, individualized, and evidence-based psychotherapeutic intervention, helps patients reflect on important life issues through interviews and generate a 'legacy' that captures their most important memories and the essence of the lessons they have learned in life. DT can improve a sense of ego-integrity, help patients passing on their legacy and provide emotional support for their families. For healthcare providers, such intervention promotes the practice of narrative medicine approach in clinical setting. The authors hope to further explore the potential effectiveness, acceptability, and feasibility of dignity therapy in Taiwanese culture, make revisions, and evaluate the effectiveness of DT from the perspectives of patients, family members, their significant others, and healthcare providers in order to promote the application of culturally appropriate, evidence-based dignity therapy, deepen awareness, reflection and action on dignity, and enhance the ability in dignity care.

並列關鍵字

dignity therapy ； narrative medicine ； end-of-life care ； ego-integrity

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