醫務社工在器官捐贈過程中與家屬工作之經驗探討

Working with Families on the Organ Donation Process: The Experiences of Medical Social Workers

本研究旨在瞭解醫務社工在器官捐贈過程中與家屬工作的歷程，以建構出醫務社工對於器官捐贈工作的主觀經驗，並分析醫務社工在器官捐贈過程中所遭遇的困境及解決策略，以累積實務工作方法；另透過器官捐贈實務工作方法的統整分析，提供未來器官捐贈工作的參考，期能提升更好的照顧及服務品質。本研究邀請12位曾經或目前從事器官捐贈工作的醫務社會工作者，利用質性研究方法，透過主題分析來探討醫務社工在器官捐贈過程中與家屬的工作經驗。研究結果發現，醫務社工傾向以「意願徵詢」取代「器官勸募」的方式來與家屬展開器官捐贈工作，工作目標為「悲傷輔導」為主，「器官勸募」為輔。過程中持續地陪伴關懷、明確醫療說明及器捐相關資訊等是家屬需要的，後續的追蹤關懷更是不可少。醫務社工面臨的困境挑戰，包含來自於醫院或醫療過程、社工本身，以及捐贈者家屬，亦提出因應的解決策略。最後，研究者針對制度層面、社工實務及未來研究提出建議。 The purpose of this study is to understand the procedure of medical social workers working with family members in the process of acquiring organ donation. This paper aims to reconstruct the medical social workers' subjective experiences in seeking organ donations and to analyze the struggles faced by the medical social workers in the process of guiding families to acquiesce in organ donation as well as the solutions derived thereby in order to accumulate practical work methods. In addition, through the integration and analysis of practical work methods related to organ donation, this study provides reference for future organ donation work, aiming to enhance care and service quality. This study, adopting a qualitative method, invited 12 medical social workers who had been engaged in, or were currently engaged in organ donation to discuss their working experience with family members during the process of organ donation. Thematic analysis was used to analyze 12 texts. The results showed that medical social workers tend to carry out organ donation with family members by willingness consultation instead of purely focusing on organ procurement. The main work target is grief counseling supplemented by organ procurement. Family members need continuous company and care, clear medical explanation and information related to organ donation; in addition, follow-up care is essential. The dilemmas and challenges faced by medical social workers affiliated with hospitals or medical treatment process, social workers themselves and family members of the donors. Solutions are proposed in this study. Finally, the author offers some suggestions on institutional level, social work practices and future research.