安寧臨床佛教宗教師於臨終照護的悲憫疲憊經驗初探

Exploratory Study of the Experience of Compassion Fatigue of Clinical Buddhist Chaplains in Hospice Terminal Care

臺灣臨床佛教宗教師對於本土安寧末期靈性照顧具有重要價值與貢獻。由於末期照顧壓力龐大，儘管佛教宗教師具有靈性關懷與調適能力，但臨床也可能出現悲憫疲憊。本研究旨在探討佛教宗教師的悲憫疲憊經驗。採用詮釋現象學為研究法，以建立臨床理解。立意取樣六位研究參與者，以半結構式深度訪談及田野參與觀察取得文本資料，然後再依「部分－整體」的詮釋循環進行分析，並確保研究嚴謹度。本研究發現佛教宗教師的確有臨床悲憫疲憊，主要經驗有四個面向：1.角色轉換的調適壓力，2.面對病患死亡的心志折磨，3.修行信念深耕的召喚，4.團隊支持的需求壓力。建議將佛教宗教師納入安寧團隊成員悲憫疲憊的調查研究及設立輔導工作坊，以緩解專業耗竭的發生。

Taiwanese clinical Buddhist chaplains make great contributions to the spiritual care of terminal patients in hospices. However, because of the tremendous pressure of end-of-life care, they may develop compassion fatigue in clinical settings irrespective of their strength of spiritual care and adaptation. The current study explored Buddhist chaplains' compassion fatigue experience. A hermeneutic-phenomenological method was adopted to establish a clinical understanding of the subject. Through purposive sampling, six hospice Buddhist chaplains were recruited as participants. Data were collected through semistructured in-depth interviews as well as field observation and participation. Data analysis was then implemented in light of the hermeneutic circle between the parts and the whole, and rigor was assured. This study found that the Buddhist chaplains indeed experienced compassion fatigue. Four main experiential aspects were involved: (1) role-shifting pressure; (2) torture of the mind when facing patients' deaths; (3) the calling to deepen Buddhist cultivation; and (4) the pressure of supporting the hospice team. To avoid professional burnout, this study suggested that Buddhist chaplains be included in compassion fatigue surveys of hospice team members, and that guidance workshops be held.