非安寧單位護理人員安寧認知、死亡恐懼與情緒困境之探討

An Exploration of the Non-Hospice Care Unite Nursing Staff's Cognition of Hospice Care, Fear of Death and Emotional Distress

10.6537/TJHPC.2007.12(2).3

藍育慧(Yii-Hai Lan)；趙淑員(Su-Yuan Chao)；陳淑齡(Shu-Ling Chen)；莊照明(Chao-Ming Chuang)；郭容美(Jung-Mei Kuo)

安寧認知 ； 死亡恐懼 ； 情緒困擾 ； cognition ； fear of death ； emotional distress

安寧療護雜誌

12卷2期（2007 / 05 / 01）

156 - 171

繁體中文

本研究主要目的在了解非安寧單位護理人員於末期照護時，個人之安寧認知、死亡恐懼與情緒困擾及其彼此間之相關情形，採方便取樣，以結構式問卷針對中部地區醫療院所之臨床護理人員進行資料收集，共得52份有效問卷，經信效度檢測，以SPSS 10.0 for Window進行資料處理與分析。研究結果顯示，護理人員對安寧照護的理念與認知並不缺乏；恐懼自己瀕死的程度高於恐懼他人瀕死或他人死亡，末期照護經驗多寡會影響護理人員之情緒困境與死亡恐懼；面對非預期、較年輕病患死亡、連續有病患過世或過於投入與病患互動者，較易陷入情緒困境中。本研究結果可作爲進一步探討非安寧單位護理人員於末期照護過程所面臨的死亡恐懼、照護之情緒困境的前驅研究，同時做爲有關單位提供對新進護理人員與末期照護相關的專業知識技能在職教育之參考，及對末期照護過程之護理人員透過1.照護過程之省思，建立有意義及價值的學習2.「死亡恐懼與情緒困境檢核表」之評估，提供適合個別的支持、或團體的情緒諮商，以提升末期照護之品質。

The major purpose of this research was to explore the nursing staff's cognition of hospice care, fear of death, and emotional distress when they take care of dying patients in a non-hospice care unit. The relationships among these factors were also explored in this study. We adopted the convenient sampling method, and used a self-administered structured questionnaire to collect data from the clinical nursing staff in Central Taiwan. SPSS 10.0 for Windows was applied for data analysis. After completing a consent form, there were 52 nurses recruited for this study. The results indicated that the nursing staff's knowledge of hospice care was not inadequate. In addition, the fear of death toward themselves was higher than those toward others, and their emotional distress or fears of death were influenced by their working experienced. Further, the following situations might make the nurse feel more distressed when they face unpredictable or younger patient's death, patients expired one after another, or the nurse over gets involved their own feeling for taking care to the dying patients. The results would be helpful for understanding more about the nursing staff's emotional distress when they take care of the dying patients. It is also suggested to develop a checklist to examine the nurse's fear of death and emotional distress, which would benefit for providing more support or develop an in-service education program, in order to elevate the quality of care for the dying patients.