死亡焦慮下的自我照顧－以安寧護理人員為例

Self-Care under Death Anxiety: Take Hospice Nurses as Example

蔡昌雄(Chang-Hsiung Tsai) ； 蔡淑玲(Shu-Ling Tsai) ； 劉鎮嘉(Cheng-Jia Liu)

《生死學研究》 3期 (2006/01) Pp. 133-164

https://doi.org/10.29844/JLDS.200601.0004

摘要

本文以安寧護理人員在死亡焦慮下的自我照顧為主題，採立意取樣，以嘉義某區域教學醫院安寧病房十三位護理人員為研究對象。透過詮釋現象學的方法指引，以及存在心理分析的解釋觀點，從病房讀書會、臨床參與觀察的田野資料，以及深度訪談稿形成研究文本，進行安寧護理人員自我照顧經驗本質及內涵的描寫與詮釋。
研究發現，安寧護理人員正向回應死亡焦慮的自我照顧經驗，主要涉及「原初自我現身」、「與挫折和焦慮共處」、「自我反思」、「自我超越」等經驗主題的階段歷程。而自我照顧的深化，將為護理人員帶來自我價值系統的蛻變，以及臨終陪伴關係質變的效應。
本研究的主要貢獻在於，揭示原初自我處境在安寧護理人員自我照顧工作中的核心位置，且具體呈现個體反思超越的經驗本質和内涵。本研究的個案雖限於安寧護理人員，但所探索的死亡焦慮共處經驗，卻封其他專業助人者類似經驗的研究，具有一定程度的啓發意羲。此外，在臨床寶務的應用上，也可以最為相關訓綀課程的参考。

關鍵字

臨終關懐 ； 自我照顧 ； 死亡焦慮 ； 安寧護理人員 ； 存在心理分析 ； 詮釋現象學

並列摘要

The thesis of this paper is self-care of hospice nurses under death anxiety. Thirteen hospice nurses of a local general hospital were selected as research participants by purpose-sampling method. Guided by hermeneutic-phenomenological approach, the researchers take existential-psychoanalytical perspective as the standpoint. The research data were collected by field participating observation and depth- interview. The research text was, then, described and interpreted in terms of the essence and meanings of self-care experience of those hospice nurses.
The research finds that the self-care experience of hospice nurses in response to death anxiety mainly involves a series of phases like ”presence of the primordial self,” ”to be terms with frustration and anxiety,” ”self-reflection,” and ”self-transcendence.” As the self-care wok goes deeper, the nurses will be likely to bring their self-value system into change, as well as qualitatively improve their caring relationship with dying patients.
One of the major contributions of this research is to reveal the fact that the ”primordial self” situation lies in the central position of self-care work of hospice nurses, and thereby present the experiential essence and contents of how the individual reflects and transcends the situation. Although the research participants are restricted to hospice nurses, the death anxiety managing experience involved may be applied to other researches on helping professionals' self-care work. Besides, the hospice training courses also could be benefited and inspired.

並列關鍵字

self-care ； death anxiety ； hospice care ； nursing staff ； existential psychoanalysis ； hermeneutical-phenomenology