(背景與目的) 人間淨土是大乘佛教中重要之理論與理想,而其落實則應用於不同之領域故有不同之開展,在癌末照護中,宗教靈性之關懷已然在安寧理念有一席之位,臨床工作所好奇的是究竟宗教信仰與癌症病患的生活品質是否相關,佛法又如何應用於臨終的關懷與照顧,本研究則以此為主題探討之。 (方法) 本研究跨及醫學及宗教學雙領域,於質性上,以“心淨則國土淨—建設人間淨土” 之理論為出發點,文獻上回顧其歷年來相關之研究發表,應用上,則就大乘佛教之思想論佛法於臨終關懷的應用,及佛法如何看待生命的終點。量化方面,則以問卷測量,問卷分三大構面(A:宗教信仰之背景及行為;B:對宗教信仰的態度;C:McGill 生活品質問卷評分(MQOL Questionnaire),可分為身,心,靈性存在及社會支持四個範疇及整體評分))於三軍總醫院及台北市立聯合醫院仁愛院區之腫瘤科病房及門診中以立意取樣之方式作訪談,計取得156 份有效之問卷,作A、B 與C 之各範疇及整體評分的相關性探討,所得之量性資料則以SPSS 11.0 版作分析,分析方法包含描述性統計,皮爾遜積差相關,相關性分析及逐步回歸分析。 (結果) 在量化的問卷分析中可得癌症病患在宗教信仰的態度上和其生活品質有顯著的正相關(p<0.001),而尤以和靈性存在之相關性強,即對宗教信仰之態度愈正向者,其對自我之整體生活品質評價愈高,靈性存在感也愈高(p<0.001)。 (結論) 人間淨土之思想源於維摩詰經之”「隨其心淨則國土淨」,而其大乘的菩薩道精神在於「眾生之類是菩薩佛土」,願以此精神應用於醫療工作!共成人間淨土!
(Background and purpose) Since the modern Buddhism has a trend to practice the concept of “The Pure land on earth” in different fields. Nowadays, diverse cares were performed in cancer patients and the role of religion and spiritual care become more noticeable so that we are interested in if cancer patient’s religion and faith has the correlation with their quality of life. Thus we not only design a questionnaire to measure the correlation between cancer patients’ religion and their quality of life, but also review the relative documents and texts about the concept “the Pure land on earth”. (Methods) This study contends both quality and quantity aspects. In quality aspects, we trace the origin of the concept of The Pure Land on Earth and promote the concept of “the buddha-field is pure only to the extent that the mind is pure” (心淨則國土淨)。And we also discussed the opinion of how Buddha Drama treat the end of life and how Mahayana thinking is applied in terminal care and hospice. In quantity aspect, the questionnaire has three categories, the first (A): the patient’s background and behavior of the religion. The second (B): the patient’s attitude to the religion and faith, the third(C): the McGill MQOL iv questionnaires which has four domains (physical, psychological, spiritual –exist, and social support). Total 156 valid materials were collected from cancer patients in oncology ward. The data was analyzed by SPSS version 11.0. Statistical analysis was conducted using Pearson’s product moment correlation, correlation analysis, and multiple regression analysis. (Results and discussion) This study showed that the cancer patient’s attitude to religion has apparent correlation to their quality of life, especially in the domain of spiritual-exist. This interesting finding may encourage the clinical spiritual hospice workers that a total care for cancer patients is needed. And a positive, optimistic religion faith may help cancer patients to imprve their quality of life and go through the difficulties in the end stage of life. If we could always keep the original spirit of hospice in mind, and devote ourselves to the total care of patients, that may just be a practice of “The Pure Land on Earth.
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