淺談安寧療護社會工作

Social Work in Hospice and Palliative Care

近年來臺灣積極推廣安寧療護的理念，希望提供癌症末期病患身、心、社會及靈性各層面的照護，以提升末期患者生活品質。本文是探討一位末期子宮頸癌轉移性腫瘤導致腸阻塞的病患接受安寧療護的照護經驗，在89年6月10日~7月3日的護理期間，運用Gorden十一項健康型態評估，確定疼痛、液體容積缺失、自我心像紊亂、知識缺失、潛在危險性傷害╱跌倒等五項護理問題，針對各層次護理問題，給予適當的護理措施，支持個案及家屬一同度過癌症末期的各種身、心、靈問題，使其能在病情穩定時返家休養。更期望以此護理經驗，提供給日後照護類似病患之參考。

Hospice and palliative care is the care to those terminal ill patients and their families when patient's death is inevitably approaching and they choose not to prolong their lives with aggressive medical care. It aims to alleviate patient's physical and mental agonies, to maintain their quality of life, and to respect their dignity.「Hospice and Palliative Care Law」was enacted in June 2000, which allows hospice and palliative care being covered by National Health Insurance Program, increases hospice ward reimbursement, elevates the quality of medical care, and protects patient's rights.According to writer's experiences in clinical practices, this article, based on social work values and beliefs, adopting social work skills, is to discuss social work services in hospice and palliative care. In sum, it emphasizes flexible services and extendable time frame, unique individual needs, client-centered services, and united resources. Social worker undertakes the roles of supporter, coordinator, information source, enabler, and counselor. For the future, we should have more comprehensive and flexible services, better manpower and quality in social work profession to meet the needs.