臺灣安寧病房喪慟關懷服務之調查研究   全文下載

An Investigation of Bereavement Care for Hospice Ward in Taiwan

安寧療護最終希望能導向善終與善別，善終是指病人得到最佳的症狀控制與身心靈的照顧，而善別則是協助家屬度過失落與分離的痛苦，世界衛生組織及臺灣的健康照顧政策均視喪慟關懷是臨終照顧的延續。本研究希望瞭解臺灣各安寧病房目前如何關照喪親者？提供的服務內涵是什麼？研究目的著重喪親服務供給面之瞭解，進行全國安寧療護病房喪慟關懷服務輸送之郵寄問卷調查，以檢視全國性安寧喪慟關懷服務輸送的圖象。研究結果總共有32家安寧病房回覆本問卷，喪慟關懷多數由醫療團隊共同參與，負責統籌與協調悲傷關懷服務之負責人員大部分是社工人員，並有志工協助，半數醫院運用護理人力進行初評；追蹤時點多於逝後一週及告別式時；多數醫院藉由觀察與追蹤來瞭解喪親反應，59.4%的醫院使用衛生署制訂的標準作業參考指引進行悲傷評估；九成以上的醫院都有提供遺族電話聯繫、郵寄慰問信或慰問卡，其次是提供個別會談、協助製作紀念物品、轉介精神科醫師。家屬接受度最高的服務是郵寄慰問信和電話聯繫，接受度最低的是轉介精神科醫師、轉介諮商或臨床心理師及喪親遺族自助團體。各院執行過程不免遭遇挑戰，本文根據調查結果提出相關建議，以作為臨床參考。

The purpose of hospice is to help patients have good death and good grief. Good death means patients get the best symptom control and care of the body and spirit. Bereavement care is to help families work through the pain of loss and separation. the World Health Organization and the Taiwan’s health care policies are subject to bereavement care is a continuation of care. This study would like to know how the palliative care ward provide the service of the families of the terminally ill in Taiwan. What are the services they provide? The purpose of this study is to understand the hospice ward bereavement care service delivery through the mail survey method. The results of this study a total of 32 palliative care wards reply to the questionnaire. The majority of bereavement care by the medical team to participate in, and responsible for most of the personnel in charge of the overall planning and coordination of grief care services by social workers, followed up by volunteers. Half of hospital use of nursing workforce initial evaluation. Tracking point in time passed away more than a week after the funeral; most hospitals by observing and tracking to understand the bereavement reaction, 59.4% of hospitals using standard operating Reference Guide sad assessment developed by the Department of Health; 90% of the hospital provide the bereaved telephone care, mailing letters of condolence or sympathy card, followed by individual meetings, assist in the production of commemorative items, referral psychiatrist. Family members to accept the highest service mailing condolence letters and telephone conversations, the lowest acceptance referral psychiatrist, referrals to counseling or clinical psychologist, bereavement bereaved families self-help groups. During the execution of the respective hospitals inevitably challenged, we make recommendations based on the findings as a clinical reference.