醫學系學生之死亡概念

Death Concepts among Medical School Students

10.6145/jme.200609_10(3).0005

洪栩隆(Hsu-Lung Hong)；鍾秉穎(Ping-Ying Chung)；張利中(Li-Jung Chang)

個人建構理論 ； 死亡建構 ； 死亡概念 ； 醫學系學生 ； personal construct theory ； personal death construct death concept ； medical school undergraduates

Journal of Medical Education

10卷3期（2006 / 09 / 01）

215 - 224

繁體中文

本研究旨在了解醫學系學生的死亡相關概念，以供往後醫學教育中死亡學課程的設計與國內量表研發之參考。本研究以個人建構理論為基礎，採用三角比較法，對36名分層隨機抽樣產生的研究對象進行半結構式的訪談。蒐集到的資料，應用以「個人建構」為基礎的編碼系統來分析醫學系學生的死亡概念。結果發現這群醫學系學生的死亡建構面向分布情形，與含有醫學院其他科系學生的死亡建構分佈情形及排序情形不同。後者最普遍的概念是在死後生命的存在感，而前者則強調自由選擇程度，顯示他們在面對死亡時，希望能擁有較多的控制權，並企圖扮演「終極拯救者」的決心與自信來面對死亡的威脅。因此應妥善規劃醫學生的死亡教育，讓未來醫師擁有正確的知能，不僅使自己能適切地因應死亡的焦慮，也有能力協助處理臨終病人及家屬們的情緒，在全人的照顧上有更好的成效。

The present study aimed to explore death concepts among medical school undergraduates. The results can be used as a reference for the development of a death education course as well as the creation of a death attitude scale for medical school students. A reliable coding system based on the Personal Construct Theory was applied to semi-structured interview texts contributed by 36 medical school undergraduates. Content analysis of these texts found that the death construct dimension distribution and rank order of these subjects differ from the results of a previous study obtained from medical college undergraduates. More subjects had believed in the existence of life after death in the previous study, while choice was more strongly emphasized in the present study. This indicated that the subjects wanted a greater sense of being in control and also wanted to act as an ultimate life-saver when facing a death threat. Therefore, death education for medical students should be well planned so that it empowers doctors-to-be by providing them with adequate knowledge about how to cope with death anxiety, which will allow them to help dying patients and their family to deal with their emotions.

1. 洪栩隆、翁慧卿、張利中(2002)。某醫學院學生之個人死亡建構。醫學教育，6(1)，26-38。
   連結：
2. Barclay S,Todd C,Grande G(1997).How common is medical training in palliative care? A postal survey of general practitioners.British J of Gen Practice,47(425),800-804.
3. Buss MK,Mark ES,Sulmasy DP(1998).The preparedness of students to discuss end-of-life issues with patients.Acad Med,73(4),418-422.
4. Chang L,Lin C(2000).Repressive coping style and death anxiety among medical and nursing school students at a medical college in Taiwan.J Med Educ,4(4),74-84.
5. Dickinson GE,Mermann AC(1996).Death Education in U. S. Medcical School, 1975-1995.Acad Med,71(12),1348-1349.
6. Evans JW,Walters AS,Hatch-Woodruff ML(1999).Deathbed scene narratives: A construct and linguistic analysis.Death Stu,23(8),715-733.
7. Holcomb LE,Neimeyer RA,Moore MK(1993).Personal meanings of death: A content analysis of free-response narratives.Death Stud,17,299-318.
8. Kelly GA(1955).A theory of personality the psychology of personal constructs.New York:Norton.
9. Kitchen AD(1988).Potentials and pitfalls in death education in medical schools.Loss, Grief & Care,21(1-2),3-13.
10. Krieger SR,Epting FR,Leitner LM(1974).Personal constructs, threat, and attitudes toward death.Omega,5,299-310.
11. Neimeyer RA,Epting FR,Neimeyer RA,Neimeyer GJ (eds.)(1992).Measuring personal meanings of death 20years of research using the threat in dex.Advances in personal construct psychology,121-147.
12. Rosenthal NR,Corr CA,McNeil JN (eds)(1986).Adolscense and death.New York:Springer Publishing.
13. Sand RB,Blackall GF,Abrahm JL(1998).A survey of physicians` education in caring for the dying: identified training needs.J Cancer Educ,12(4),242-247.
14. Yalom ID(1989).Existential Psychotherapy.New York:Basic Books.
15. 吳芝儀(1998)。犯行青少年生涯建構系統與生涯關注。中正大學學報，9(1)，51-92。
16. 呂碧鴻(1998).小班教學.醫學教育,2(4),367.
17. 張利中、林志龍、洪栩隆(2001)。醫學系與護理系學生自我概念落差與死亡焦慮之關係。醫學教育，5(1)，40-51。

1. Lu, Feng-Hwa,Lin, Shio-Jean,Lin, Peng-Chan,Kan, Wai-Ming,Ho, Tzong-Shiann,Feng, Jui-Ying,Chen, Ching-Huey,Chao, Co-Shi(2013).Thanatology for Medical College Students-Cultivation of Medical Humanity.醫學教育,17(3),97-106.
2. 黃松元、郭美璋、張利中、江漢聲(2010)。大學生苦難覺察、個人宗教性、同理心與利他行爲之相關研究。學校衛生，56，1-20。
3. 南玉芬(2011)。自殺企圖者的死亡意涵探討。生死學研究，12，89-123。
4. 鄭逸如,楊于婷,黃文翰,黃士哲,張琦郁(2017)。如何面對臨終的死亡焦慮－誰該為自身的死亡負責？。安寧療護雜誌，22(2)，202-212。