主要照顧者於病人生命末期照護過程的心理經驗－個案報告

Psychological Experiences of Primary Caregiver in Patient's Terminal Stage: A Case Report

10.6200/TCMJ.202409_21(3).0006

沈晏羽(Yan-Yu Shen)；吳曉聞(Hsiao-Wen Wu)；楊啟正(Chi-Cheng Yang)

疾病末期 ； 心理照護 ； 哀傷失落 ； 照顧負荷 ； terminal stage ； psychological care ； loss and grief ； care burden

北市醫學雜誌

21卷3期（2024 / 09 / 30）

264 - 269

繁體中文;英文

過去研究較少呈現末期病人主要照顧者之壓力負荷與哀傷失落。本研究以訪談方式分析個案在親人罹病過世歷程中之哀傷失落；訪談個案為67歲女性，長期照顧罹病的婆婆，自民國107年使用安寧療護服務，並與心理師開始進行會談，談論照顧負荷、家人關係與生活規劃。婆婆過世後，會談議題也從歷經哀傷失落進行至生活的調整與改變，以及失落經驗帶來的人生意義的轉化。藉由個案的生命經驗，本研究提供對主要照顧者進行哀傷治療的臨床工作者重要之臨床實務參考。

Previous studies have rarely shown the stress burden, loss, and grief among the primary caregivers of terminally-ill patients. This study adopted an interview approach and analyzed the loss and grief of the client in the dying process of a family member. The client was a 67-year-old woman who had been taking care of her sick mother-in-law for a long time. She used palliative care services since 2018, and started the consultation sessions with a psychologist to discuss her caring burden, family relationship, and life planning. After her mother-in-law passed away, the topic of consultation progressed from experiencing grief and loss to life adjustments and changes, and the transition of life meaning brought by the losing experience. Through the life experiences of this case, our study offers an important clinical reference for clinical workers who provide grief therapy to primary caregivers.

1. 錡姵如，唐婉如，徐亞瑛，高振益。主要照_x000D_ 顧者面對親人死亡之焦慮。安寧療護雜誌_x000D_ 2006；11(4)：383-91。
   連結：
2. 汪慧玲，陳怡安，張馨元。以安寧療護理念_x000D_ 協助一位膽管癌末期病人善終之護理經驗。_x000D_ 安寧療護雜誌2018；23(1)：85-98。
   連結：
3. 吳麗珍，周傳姜，林妍君。哀傷理論於喪親_x000D_ 家屬之護理應用。護理雜誌 2017；64(6)：_x000D_ 98-105。
   連結：
4. 王守玉、Carol Windsor、Patsy Yates。簡介_x000D_ 紮根理論研究法。護理雜誌2012，59(1)，_x000D_ 91-5。
   連結：
5. Stroebe M, Schut H. The dual process model of coping with bereavement: rationale and description. Death Stud. 1999; 23(3): 197-224.
   連結：
6. Ullrich A, Marx G, Bergelt C, et al. Supportive care needs and service use during palliative care in family caregivers of patients with advanced cancer: a prospective longitudinal study. Support Care Cancer 2021; 29(3): 1303-15.
   連結：
7. 黃英惠。台灣家屬在癌末病患瀕死過程之預_x000D_ 期性哀傷經驗。國立陽明大學臨床暨社區護_x000D_ 理研究所碩士論文2008：1-195。
8. Neimeyer R. Techniques of grief therapy: Creative practices for counseling the bereaved. New York: Routledge; 2012.
9. Worden JW. Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner. 5th ed. New York: Springer Publishing; 2018.
10. 徐嘉鳳。從戰後嬰兒潮世代職業婦女生命敘_x000D_ 事談友善家庭政策。社區發展季刊2017；_x000D_ 159：34-44