護理人員照顧癌症病童臨終時的經驗

Providing End-of-Life Nursing Care to Children With Cancer

背景：罹患癌症兒童接受長期醫療照護，與護理人員產生親密的護病關係，當面臨病童死亡時，護士也經歷了失落及哀傷的情緒反應。在台灣以質性研究，由護理人員觀點來探討與病童死亡時之遭逢的照護經驗闕如。
目的：本研究應用現象學研究方法，瞭解護理人員照顧癌症病童臨終時的經驗本質為何。
方法：採立意取樣以Colaizzi（1978）現象學研究法進行資料收集及分析。共十位護理人員參與研究，以開放式訪談指引，採深度訪談並以錄音方式進行資料收集。採Lincoln及Guba（1985）的四個標準來考量研究的嚴謹度。
結果：呈現出護理人員照顧癌症病童死亡時的經驗本質結構，共涵蓋五個主題：一、與瀕死遭逢的關懷與自省﹔二、護理人員之調適策略﹔三、包容與陪伴協助善終﹔四、面對死亡陰霾予以心靈慰藉﹔五、陪伴父母度過病童臨終的階段。
結論：研究結果期望能提供一實證資料瞭解護理人員在照顧癌症病童死亡時之經驗感受，並討論協助護理人員調適和轉換情緒之方式。

Background: There has been little qualitative research in Taiwan on the experiences of nurses who encounter the moment of child’s death from their own perspective. Purpose: Using a phenomenological approach, this study worked to understand the essence of the caring experience for nurses at the moment of a cancer child’s death from the nurses’ own perspectives. Methods: Researchers used Colaizzi’s (1978) phenomenological method and collected data using purposive sampling and in-depth, tape-recorded interviews. Data were analyzed using the Colaizzi (1978) method. Ten registered nurses from a medical center participated into this study. The trustworthiness of the study was examined using Lincoln and Guba (1985) principles. Results: Five major themes emerged, including introspection on caring for dying children after their death; coping patterns of nurses; toleration and ability to help to ensure the child has a good death; facing death and consoling the soul; and accompanying parents though the moment of death. Conclusion: Study findings provide evidence-based information on nurses to care for cancer children and their families facing the moment of death.