癌症青少年靈性需求內涵與靈性安適情形之探討

A Study of Spiritual Needs and Spiritual Well-Being of Adolescents with Cancer

林育如(Yuh-Ru Lin)

指導教授 ： 陳月枝

國立臺灣大學/醫學院/護理學研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.01440

摘要

本研究的目的是瞭解癌症青少年的靈性需求內涵與靈性安適情形。在台北市某醫學中心以立意取樣選擇13~18歲的癌症青少年。研究方法採用質性研究法，在門診和病房與個案建立關係後，運用低結構性的訪談指引，在安靜不受干擾的情境，包括門診空診間、病房或個案家中，與11位研究個案作訪談並錄音，每位個案的訪談時間介於35-90分鐘，平均約49分鐘，將訪談內容撰寫成描述性的資料，運用內容分析法將描述性資料作歸類、分析，共得1231個行為單元。
將行為單元作量化分析，在靈性需求內涵方面共有五類，分別是：支持的需求55.24％、盼望的需求30.79％、解釋的需求5.61％、意義的需求5.52％、信仰的需求2.84％。支持的需求方面又分為三類，分別是：家庭、社會與娛樂。盼望的需求方面又分為六類，分別是：健康舒適、順利完成發展任務、改善外在條件、推己及人、從事活動、冤親債主遠離。解釋的需求方面又分為五類，分別是：生活方式、還前世債、人生考驗、家族遺傳、命運巧合。意義的需求方面又分為六類，分別是：活得快樂、完成人生使命、活著就有意義、尚未尋到、照神旨意而活、生老病死。信仰的需求方面又分為四類，分別是：獲得安慰平安、心靈寄託、坦然面對目前的疾病與困難、不懼怕未來的痛苦或死亡。
將行為單元作量化分析，在靈性安適情形方面共有兩類，分別是：正向（安適）69.05％、負向（不安適）30.95％。正向方面又分為十二類，分別是：平靜、支持、希望、積極面對、喜悅、感激、信任、平安、珍惜、滿足、無懼、敬畏。負向方面又分為十八類，分別是：不悅、不滿足、痛苦、消極接受、擔憂、壓力、難過、無聊、埋怨、懼怕、孤單、憤怒、不信任、後悔、遺憾、震驚、矛盾、不解。
依據研究個案的性別分為男生組與女生組。男生組與女生組在靈性需求方面的分布差異不大，而靈性安適情形則是男生組正向的比率高於女生組。依據研究個案的年齡分為青少年前期組與青少年後期組。後期組對生命的意義與目的思考比前期組更多。靈性安適情形兩組正、負向比率差異不大。依據研究個案的疾病情形分為停藥組、治療組與復發組。靈性需求方面，復發組在盼望的需求、意義的需求、信仰的需求三方面的比率高於另外兩組；靈性安適情形方面，治療組正向的比率高於其他兩組。
本研究的結果，癌症青少年的靈性需求有五大類，可幫助臨床護理人員更了解癌症青少年之需求。相關因素方面，性別、年齡、治療階段等因素會影響研究個案的靈性需求內涵與靈性安適情形。

關鍵字

癌症 ； 青少年 ； 靈性安適 ； 靈性需求

並列摘要

The purpose of this research is to survey the spiritual needs and well-being of adolescents with cancer. The research was conducted in a medical center in Taipei. During the time of the research, there were 11 cases who fit the sample descriptions in the center, who were 13 to 18-year-old cancer patients. The researcher adopted descriptive qualitative approach in the interview. First the researcher made contact with patients in OPD or their ward. Then the interviews were conducted in a semi-structured interview form in quiet, undisturbed surroundings, such as a vacant clinical room, bed side, or patients’ homes. The interviews lasted from 35 to 90 minutes, 49 minutes on the average. Each interview was tape-recorded and then transcribed into narrative data. After analyzing the data with content analysis approach, the researcher came up with 1231 behavior units.
Using quantitative analysis, these behavior units were classified into 5 categories in terms of spiritual needs, which are need for support 55.24%, need for hope 30.79%, need for explanation 5.61%, need for meaning 5.52%, and the need for belief 2.84%. There are 3 types of need for support, which are family, society, and recreation. There are 6 types of need for hope, which are soundness of health, accomplishment of tasks, better looks, helping others, participating activities, clearing material and non-material debt. The need for explanation contains life style, debt of previous lives, life challenges, genetic facts, and fate. The need for meaning contains happiness, personal missions, aliveness, never found, God’s will, life events-birth, age, illness and death. And the need for belief contains comfort and peace, care for soul, facing disease and challenge, being free from fear of pain and death.
In terms of spiritual well-being, the behavior units are classified into 2 categories, which are positive (well) 69.05%, and negative (not well) 30.95%. The positive conditions include 12 types: calm, supported, hopeful, optimistic, joyful, grateful, trustful, peaceful, cherishing, content, fearless, and respectful. And the negative conditions include 18 types: upset, discontent, painful, passive, worried, stressful, sad, bored, complaining, scared, lonely, angry, distrusted, regretful, sorry, shocked, contradicted, and confused.
The result of the study shows that when divided in two groups according to gender, the male and female cases don’t have significant differences regarding spiritual needs. However, the male cases tend to be more positive than females in spiritual well-being. When divided into two age groups-the younger and the senior adolescents, the senior tend to think about meaning and purpose of life more than the younger ones. But the two age groups are about the same in spiritual well-being. When divided into three groups according to the treatment stage-the cases who have stopped medication, the cases under treatment, and the cases that have returned because of relapse of cancer, the returned cases obviously have higher need for hope, meaning, and belief than the other two groups. And the cases under treatment are more positive than the other two in terms of spiritual well-being.
The finding of this research may act as a reference of clinical nursing and related research. The factors that affect the spiritual need and well-being of adolescents with cancer include gender, age, and treatment stage.

並列關鍵字

spiritual needs ； adolescent ； cancer ； spiritual well-being

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