運用悲傷輔導原則協助一位喪親家屬之護理經驗

A Nurse’s Experience Applying Grief Counseling to a Bereaved Family

本案例報告是運用Worden之「悲傷輔導理論」，協助一位年輕女性在母親突然昏倒住院，一週後去世之護理經驗，敘述護理人員如何協助其度過悲傷期並完成「哀悼的四個任務」。依Worden提出的悲傷反應自7篇行為過程紀錄加以分析，結果發現個案的悲傷反應在感覺方面包括驚嚇、否定、愧疚自責、害怕；生理感官知覺方面出現失眠、不安；認知方面有難以相信、沉迷對母親的思念；行為方面出現社會退縮、避免提起失去母親的感受、呼喚、嘆氣、哭泣等反應。筆者運用悲傷輔導的概念與原則，以悲傷復原的四個任務為目標，陪伴並支持個案經歷悲傷過程，協助其完成體認喪親的哀慟，個案在喪母後二個月已逐漸完成接受失落的事實，重新適應母親不在的新環境及將情感重新投注在生活上等四個哀悼任務。期望藉此個案報告，讓護理人員對家屬之悲傷反應更為敏感接納，並嘗試運用悲傷輔導技巧協助家屬。

This case report describes a nurse’s experience applying William Worden’s Grief Counseling on a young woman whose mother had passed away after a brief period in a coma. The report describes how the nurse facilitated this case and assisted the woman though the grief process, during which the woman completed the four tasks of mourning. Seven behavioral process records were analyzed base on Worden’s grief responses. Emotional reactions included shock, denial, guilt and fear. Insomnia was the sole physical reaction indicated. Cognitive reactions included disbelief with regard to the death and preoccupation with her mother. Social withdrawal, avoidance of mentioning her mother, calling out, sighing and crying comprised the main behavioral reactions. The author applied the concepts and principles of grief counseling by accompanying and supporting this case though the grief process, and helping the patient complete the four tasks of mourning, which are: (1) to experience the pain of grief, (2) to accept the reality of the death, (3) to adjust to life after the death, and (4) to move on with life. It is hoped that this case report will help nursing staffs be more sensitive and receptive to family grieving and be better equipped to provide proper grief care.