臨終處境現象：一位癌症末期患者的心理經驗

Phenomenon of the Terminal Situation: Exploring the Psychological Experiences of a Terminal Cancer Patient

本研究目的經由深度陪伴與多次臨床訪談,嘗試探究、接近一位癌症末期患者的心理經驗現象。使用個案觀點,以存在取向的敘說心理法,呈現癌末患者的心理經驗。受訪者稱為P1,為南部某醫學單位緩和醫療病房的59歲癌症末期個案,共訪談9次。訪談資料經詮釋分析結果顯示,P1的臨終處境心理經驗,呈現三大結構主題(包含七個次主題),分別是一、「時間性與置身結構」(包含「無法理解的遭遇」、「生活處境的變異」及「對未來生命延續的矛盾」三個次主題)。二、「死亡與焦慮」(包含「罣礙與恐怖的臨終掛慮」、「存有處境的瀕死深淵」兩個次主題)。三、「彌留之際的被動綜合狀態」(包含「任自然態度與宿命論間」、「臨終的意義與無意義間」兩個次主題)。癌末患者P1的心理經驗,瀕死狀態均顯露出本體上安全感之「求」與「囚」的歷程。P1透過敘說的認同與擱淺之間的存有掙扎,處於「不一亦不異」的模糊處境,而後從形而上的宗教寄託,到常人的日常世界,進而轉向面對死亡的此有主體。在這轉向的過程,瀕死者終將「求」得臨終啟悟,而開展走出「囚」途的意涵。

The purpose of this study was to explore the psychological experiences of a patient with terminal cancer, called P1, a fifty-nine year old male subject in a palliative care medical unit in southern Taiwan. Through accompaniment and nine times interviews, personal narratives were generated and analyzed using an existential-phenomenological approach. Three structural themes emerged through data interpretation: Temporality and situated structure, death anxiety, and passive synthesis state near the end of life. P1s narrative through description and inscription illustrates the enlightenment at the point of death in terminal illness experiences and the metaphysical interpretations of this phenomenological process are discussed.