醫學院學生之靈性照顧的教育需求

The Educational Need for Spiritual Care in Medical School

10.6145/jme.200903_13(1).0002

賴明亮(Ming-Liang Lai)；李佩怡(Pei-Yi Li)；方俊凱(Chun-Kai Fang)；林明慧(Ming-Hwai Lin)；陳興星(Hsing-Hsing Chen)；陳昭榮(Jun-Rong Chen)

靈性 ； 醫學教育 ； 靈性教育 ； 安寧療護 ； spirituality ； medical education ； spiritual education ； hospice

Journal of Medical Education

13卷1期（2009 / 03 / 01）

4 - 14

繁體中文

以全人、全家、全程、全隊之四全照顧為目的之安寧療護，所強調的是藉由安寧療護之理念，提供合乎人道的醫療，其中包括了對生理、心理、社會以及靈性之照顧。這種理念，應是醫療的終極目標。然而靈性議題，在以往的醫學教育中，殊少受到關注。因此本研究期盼探討醫學院學生之靈性需求現況，以及作為未來建構靈性成長之教學課程及評估的基礎。本研究廣邀相關專家學者進行討論，並透過問卷調查法，由成大醫學院學生181份有效問卷以進行分析。結果發現：科系、宗教信仰、宗教活動頻度，以及經歷重要他人過世等經驗，和「靈性需求及靈性照顧之認知」、「靈性照顧能力檢省」、「靈性教育需求」議題上有相關。醫學院學生對於靈性需求及靈性照顧之認知、靈性照顧能力之檢省，皆有提昇之空間。對於課程內容則以對靈性之自我覺察與成長最需要；最理想之研習方式則為臨床案例討論，次為影片欣賞討論。因此作者建議在課程設計時，著重於臨床案例討論及影片欣賞教學。而相關之成效因素，如班級大小，規劃教師之訓練，以及慎選教材，安排合宜效度評核方式等，需要再進一步規劃。

In addition to the treatment of physical, psychological, and social problems of the patients in hospice service, the relieving spiritual suffering and supporting spiritual growth among the hospice patients are essential and may be the final goal of not only palliative treatment but also of different medical therapies. The cultivating of spirituality is less stressed than other subjects in medical education. According to various people on the medical team, spirituality should be included curriculum in medical education. The goal of this project was use questionnaires to evaluate the necessity of teaching spiritual growth in medical school and to formulate a helpful curriculum for the students. Through the responses from the questionnaires, the results were as follows. The parameters of the questionnaires included departments which to the students belonged, religious beliefs, frequency of participating in religious activity, and experience with death related to recognition of spirituality, understanding of spirituality, and need for spiritual education. There was a deficiency in students of medical school with respect to the recognition of spirituality and understanding the spiritual needs and spiritual care of patients. The students welcomed the contents of the curriculum related to spiritual growth and recognition of spirituality. From the methodological aspects, the case conference and discussion after the movie were the most efficient ones. The authors suggested that, the sizes of the classes, training of teachers, and choice of appropriate teaching materials were important for the successful teaching of spirituality in medical school.

1. Chao CS,Chen Ch,Yen M(2002).The essence of spirituality of terminally ill patients.J Nurs Res,10,237-241.
   連結：
2. Anandarajah G,Mitchell M(2007).A spirituality and medicine elective for senior medical students: 4 years' experience, evaluation, and expansion to the family medicine residency.Fam Med,39(5),313-315.
3. Baldacchino DR(2008).Teaching on the spiritual dimension in care to undergraduate nursing students: the content and methods.Nurse Educ Today,28(5),550-562.
4. Barnett KG(2006).Fortin AH 6th: Spirituality and medicine. A workshop for medical students and residents.J Gem Int Med,21(5),481-485.
5. Burke MT,Miranti J,Locke DC.(eds.),Myers JE.,Herr EL (eds.)(2001).The Handbook of Counseling.California:Sage.
6. Chen YJ(2004).Assessment of spiritual care in hospice by hospice nurses and chaplains-a survey of spiritual care in hospices: spiritual assessment questionnaire.University of Glasgow.
7. Cobb M(2001).The Dying Soul: Spiritual at the End of Life.Buckingham:Oxfoenrd University Press.
8. Collett L,Lester D(1969).The fear of death and the fear of dying.J Psych,72,179-181.
9. Guck TP,Kavan MG(2006).Medical student beliefs: spirituality's relationship to health and place in the medical school curriculum.Med Teach,78(8),702-707.
10. Lev-Ran S,Fennig S(2007).Points to ponder regarding contemporary psychiatric training in Israel.Isr J Psychiatry Relat Sci,44(3),187-193.
11. Mooney B(2007).Spirituality as a universal concept: student experience of leaning about spirituality through the medium of art.Nurs Educ Proact,7(5),275-284.
12. Neely D,Minford EJ(2008).Current status of teaching on spirituality in UK medical schools.Med Educ,42(2),123-125.
13. Neurnan B(1995).The Neuman systems model.Norwalk, CT:Appleton & Lange.
14. North American Nursing Diagnosis Association(2001).NANDA nursing diagnosis: definitions & classification 2001-2002.Philadelphia:North American Nursing Diagnosis Association.
15. Paes P,Wee B(2008).A Delphi study to develop the Association for Palliative Medicine consensus syllabus for undergraduate palliative medicine in Great Britain and Ireland.Palliat Med,22(4),360-364.
16. Puchalsky CM(2008).Spirituality and medicine: curriculum in medical education.J Cancer Educ,21(1),14-18.
17. Sandor MK,Sierpina VS,Vanderpool HV(2006).Spirituality and clinical care: exploring developmental changes in nursing and medical students.Explore,2(1),37-42.
18. Schoenbeck SL(1994).Called to care: addressing the spiritual needs of patients.J Prac Nurs,44(3),19-23.
19. Speck P,Doyle D.(eds.),Hanks GWC.(eds.) MacDonald N (eds.)(1998).Oxford Textbook of Palliative Medicine.UK:Oxford.
20. Tang TS,White CB,Cruppem LD(2002).Does spirituality mailer in patient care? Establishing relevance and generating skills.Acad Med,77(5),470-471.
21. 杜明勳(2004)。談靈性照顧。護理雜誌，51(5)，78-83。
22. 金樹人(1995)。存在主義諮商法·諮商理論與技術。台北:空大。
23. 施富金(2002)。靈性困擾病人的護理。靈性關懷之理論與實務應用研討會
24. 許鳳珠(2003)。碩士論文(碩士論文)。嘉義，南華大學生死學研究所。
25. 蕭雅竹、黃松元(2005)。靈性健康量表之建構與信效度考驗－以護理學生為題。實證護理，1(3)，218-227。
26. 賴明亮、方俊凱、李佩怡(2007)。醫學生之靈性教育探研。安寧療護，12(4)，395-407。

1. 謝素英、許麗齡、張惠如、余文彬、朱宗藍(2015)。護理人員接受安寧療護在職教育課程需求之探討。長庚護理，26(2)，125-136。