臨床護理人員之死亡態度

Death attitude among clinical nurses

本研究旨在了解國內臨床護理人員的死亡相關建構，以供往後醫學與護理人員臨床教育中死亡學課程的設計與國內量表研發之參考。本研究以個人建構理論為基礎，採用三角比較法，對21名招募自台北地區醫院的臨床護理人員進行半結構式的訪談。蒐集到的資料，應用「個人建構理論」與現象學的方法，來分析臨床護理人員的死亡態度。由本研究的結果顯示，臨床護理人員會因為病人的死亡或自身的存在威脅，而引起死亡焦慮。她們初期會採用自然現象、年紀、身體狀況等來確定死亡的「與我無關」，一旦有年輕人、小孩、至親好友的罹患致命疾病或死亡，這樣的防衛機轉將會崩解。臨床護理人員通常必須與病人快速建立起互相信賴關係，卻也因而更難接受病人的死亡。也不知如何面對瀕死病人的家屬、死亡的病人以及自身因而引起的負向情緒，只得形塑自己的獨特性與建立生命意義感以因應死亡。因此需要在怎麼面對自己的死亡焦慮、悲傷情緒、助人的技巧、以及與病人及其家屬的溝通技巧等事情上，多給予關懷、協助與教育。

The present study aimed to explore death attitude among clinical nurses which may be used as reference for developing death education as well as designing death attitude scale for clinical nurses and nursing school students. The theory and methodology of both Personal Construct Theory and Pheonomenology were applied to analyze semi-structured interview texts contributed by 21 clinical nurses recruited from the hospitals in Taipei area. Content analysis of these texts found that clinical nurses’ death anxiety arose from facing the death of patients and threat of their own existence. At first, they used natural phenomena, age and health status as unrelated defense mechanism which collapsed when the young, children and relatives were dying or dead. They ought to build-up reliable relationship rapidly with patients and their families that made it more difficult for them to face those patients’ death. Since they did not know how to deal with dying patients’ families, dead patients and their own negative emotion arisen therefor, they have to shape up their own uniqueness and the meaning of their life to cope with it. Thus, it is necessary to educate and assist them how to solve their personal death anxiety and death grief, and to strengthen their skills on helping and communicating with dying patients and their families.