頭頸癌症照顧者的替代性創傷

Vicarious Traumatization in Caring Patients with Head and Neck Cancer

10.6537/TJHPC.2015.20(3).7

蔡佩渝(Pei-Yu Tsai)；蔡佩真(Pei-Jan Tsai)；鄭適芬(Shi-Fen Cheng)；陳昱伃(Yu-Yu Chen)；郭麗馨(Li-Shin Kuo)；劉泳輝(Yung-Hui Liu)

腫瘤傷口 ； 慈悲疲倦 ； 替代性創傷 ； fungating wound ； compassion fatigue ； vicarious traumatization

安寧療護雜誌

20卷3期（2015 / 11 / 01）

285 - 295

繁體中文

照顧頭頸部惡性腫瘤傷口的末期病人時，醫療人員所面臨的挑戰，除了面對不可避免的死亡之外，視覺的震憾、嗅覺的刺激，出血時血液的流動，溫度的改變，都讓照顧者印象深刻甚至難以承受。安寧療護，強調全人醫療及同理陪伴，醫療助人者在照護過程中所接收到的苦，工作上的創傷經驗與生命不斷交會所帶來的衝擊卻沒有出口，逐漸累積了傷害，更使助人者對自己的能力感到懷疑而焦慮，出現了慈悲疲倦或替代性創傷。我們希望透過此案例，一起來檢視並討論這個問題，並試著提出一些方法，有效建立預防及因應機制，讓助人者也能受到關心與照顧。

When caring terminal patients with malignant fungating wound due to head and neck cancer, medical professionals face not only the inevitable death of patients, but the visual impact, olfactory stimulation and tactual change of the bleeding wound, which are visually stunning and sometimes unbearable to them. Hospice and palliative care emphasizes holistic medicine and empathic accompanying, yet medical professionals suffer during caring process. Work-induced trauma and daily impact are accumulated with no way out. Self-doubt about their ability to help patients causes anxiety, resulting in compassion fatigue and vicarious traumatization. It is expected to establish a prevention and management mechanism to care about professional helpers through this case report.

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