探索健康照護者對癌症患者靈性照護的看法

Exploration of Health Care Professionals’ Perception of Spiritual Care for Cancer Patients

癌症為台灣第一死因，文獻指出大部份癌症患者有靈性的需求，然而健康照護者通常忙碌於執行臨床工作，並不熟悉癌症患者的靈性照護，因此本研究的目地乃在探索健康照護者對癌症患者靈性照護的看法。此研究調查48位南區醫學中心的健康照護者，包括9位醫師及39位護理人員。樣本年齡層範圍由22至50歲，平均31歲，81.3%為女性，過半數已婚且工作超過5年，大部份為專科及大學畢業，分別佔56.3％和41.7％，在信仰方面，33.3％佛教，20.8％道教，6.3％基督教，39.6％無神論。研究者設計的調查量表共分為三部份，第一部份為健康照護者對靈性照護的看法，第二部份為健康照護者以1至5等級同意程度評量25項心靈困擾照護措施，第三部份為健康照護者以1至5等級同意程度評量22項心靈困擾成果指標。第一部份研究結果顯示，50％的健康照護者認為自己普遍瞭解癌症患者心靈困擾症狀，35.4％普遍瞭解癌症患者心靈困擾護理措施，37.5％普遍瞭解癌症患者心靈困擾成果指標。即使如此，75％的健康照護者認為癌症患者常常出現心靈困擾症狀，52.1％甚至認為自己本身也常常有心靈困擾症狀。因此，100％健康照護者認為癌症患者需要靈性照護，98％認為自己需要有癌症患者靈性照護的訓練。第二部份研究結果顯示，19項心靈困擾護理措施經由主成份因素分析出5個主要顯著因子，此5項因子可以解釋68.4％心靈困擾的變異量。第三部份研究結果顯示，20項心靈困擾成果指標由主成份因素分析出3個主要顯著因子，此3項因子可以解釋66.3％心靈困擾的變異量。根據此研究成果，臨床癌症護理人員可運用5項顯著因子設計護理活動及3項顯著因子設計成果指標，未來研究將以此3項成果指標來評價5項靈性護理措施對癌症患者心靈困擾的改善成效。

Cancer is the leading cause of mortality in Taiwan. A literature review indicated that the majority of cancer patients expressed the spiritual needs. Health care professionals are often busy with performing clinical tasks, and not familiar with cancer patients’ spiritual care. Therefore, the purpose of this study was to explore health care professionals’ perception of spiritual care for cancer patients. This study interviewed 48 health care professionals, including 9 doctors and 39 nurses. The subjects’ ages ranged from 22 to 50 (Average 31), more than half were married and had more than five years of working experiences, majority were junior college (56.3%) and college (41.7%) graduates. In religion, 33% were Buddhist, 20.8% were Taoist, 6.3% were Christian, and 39.6% were atheists. The survey scales included three parts: general opinions about spiritual care, 1-5 point scale for ranking agreement of 25 spiritual nursing interventions, and 22 outcomes indicators for cancer patients. In part one, 50% of health care professionals perceived themselves as generally understanding of spiritual distress symptoms for cancer patients, 35.4% for spiritual nursing interventions, and 37.5% for outcomes criteria. Nevertheless, 75% of health care professionals perceived that patients often have spiritual distress and 52.1% of them perceived themselves as having frequent spiritual distress. Therefore, 100% of health care professionals thought cancer patients need spiritual care and 98% considered their need the training of spiritual care for cancer patients. In part two, 19 items of nursing interventions have been analysed by principal component factor analyses, which identified 5 major factors that can explain the 68.4% of variance of spiritual distress. In part three, 20 items of outcomes indicators have been analysed by principal component factor analyses, which identified 3 major factors that can explain the 66.3% of variance of spiritual distress significantly. Clinical cancer nurses can design nursing interventions based on the 5 major factors as well as outcomes indicators based on the 3 major factors. Future studies can evaluate the effectiveness of 5 nursing interventions for alleviating the spiritual distress of cancer patients by following the 3 outcomes indicators.