複雜性喪慟風險評估架構之初探與未來發展建議

Preliminary Exploration of Complicated Bereavement Risk Assessment Framework and Suggestions for Future Development

10.6537/TJHPC.202303_27(1).04

吳嫚庭(Man-Ting Wu)；賴維淑(Wei-Shu Lai)

哀傷 ； 複雜性喪慟風險評估 ； 末期病人 ； grief ； complicated bereavement risk assessment ； terminally ill patient

安寧療護雜誌

27卷1期（2023 / 03 / 01）

44 - 63

繁體中文;英文

哀傷是自古以來全人類共同的經驗，大多數喪親之慟，其感受及反應的強度會在幾周或幾個月內減退，然後自行重新整合，回歸既有的常態生活，但約有7～20%的喪親者，可能因受到莫大衝擊，出現自我調適因應障礙，故應早期評估，發覺是否可能進展為複雜性哀傷高風險族群，適當提供關懷陪伴、強化保護因子、及早轉介相關資源之專業協助等，避免進一步進展為哀傷困難調適之情形。本文透過哀傷與喪慟、預期性哀傷、急性哀傷、非常態性哀傷、複雜性喪慟風險等概念進行文獻探討與分析，進而提出複雜性喪慟風險評估架構包含內在風險因子、外在風險因子及保護因子，有助於臨床實務中及早辨識需高關懷族群；最後，針對未來研究方向、臨床實務與國家政策提出參考性建議。

Grief is a common experience among humans over the history. Most grief induced by the loss of family members decrease in intensity after several weeks or months before individuals reintegrate themselves and return to their normal daily living. However, 7~20% of the bereaved have experienced tremendous emotional impact and found self-adjustment difficult. Therefore, high-risk groups of complicated grief should be assessed and identified in advance to provide them with professional assistance in a timely and appropriate manner, such as companionships, reinforcement of the protection factors against bereavement, and referral to related resources, thereby preventing difficulty in adjustment to bereavement. This paper presents the literature review and analysis on grief and bereavement, acute grief, anticipatory grief, complicated grief, and bereavement risks. The complicated bereavement risk assessment model, which examines the external and internal risk factors to bereavement along with its protection factors, is introduced accordingly to enable clinical professionals to identify high-risk groups of bereavement early. Finally, we also provide forward suggestions for future research directions, clinical practice and national policies.

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