諮商心理師對安寧病人的整全照護

A Holistic Model of Hospice Palliative Care for Counseling Psychologists

台灣的安寧緩和醫療已經有近三十年的歷史，對於安寧病人需要提供全人整全照護雖然已有認識，但是落實在實際照護工作仍有相當大努力的空間。在傳統諮商心理師的養成教育中，重視個體及在社會互動中心理及人際層面的評估、與介入處理，然而安寧與臨終病人需要疼痛症狀控制、有宗教與靈性的需求、也需要接受文化合宜的照護，但對大多數的諮商心理師而言，這些知能卻都相對不足。筆者於本論文回顧過去相關文獻，彙整為五個主題：（一）安寧緩和醫療採取生理－心理－社會－文化－靈性之全人整全照護模式|（二）安寧療護諮商心理師需要具備的專業知能|（三）諮商心理師在安寧療護中的角色與功能|（四）安寧與臨終病人及家屬對於宗教與靈性的特殊需求|五、多元文化與族群的安寧療護。依文獻回顧，筆者進而對未來安寧諮商心理師的專業發展提出以下建議：（一）安寧諮商心理師全人整全的實務工作模式發展與研究|（二）透過教育訓練提升諮商心理師安寧療護的專業知能|（三）教育訓練單位與專業學會合力推展諮商心理師在安寧療護的角色功能|（四）強化安寧諮商心理師對安寧病人靈性照護的知能|（五）成為具有對多元文化與族群工作能力的安寧諮商心理師。論文末尾，筆者提出結論與本文的限制。

The development of hospice palliative care in Taiwan has a thirty-year history. Although the need of providing a holistic hospice palliative care for patients and their families has gradually been recognized, it still has a long way to go to fully put it into clinical practice. Traditionally, counseling psychologists are well trained to provide psycho-social evaluations and interventions for the clients. But for terminally ill patients, they need a bio-psycho-social-cultural-spiritual holistic care, including pain control and symptom management, care for social and spiritual needs, and culturally appropriate interventions. A majority of counseling psychologists who work with terminally ill patients and their families still lack the knowledge and training in this holistic approach to palliative care. In the present article, authors reviewed past research literature and compiled them into five themes, including: 1. the bio-psycho-social-cultural-spiritual holistic care model for hospice palliative patients, 2. the professional competencies required for palliative care counseling psychologists, 3. the role and function of palliative care counseling psychologists, 4. the salient religious and spiritual needs of palliative care patients, and 5. the multicultural competencies of caring for patients and their families from diverse cultural backgrounds. After literature review, the authors proposed five suggestions for future counseling psychologists who will work with palliative patients and family members. Suggestions included: 1. To develop and research the bio-psycho-social-cultural-spiritual holistic care model in clinical practice, 2. To enhance palliative counseling psychologists' professional competencies by receiving more educational trainings, 3. To promote palliative counseling psychologists' roles and functions by the collaboration between educational institutes and professional organizations, 4. To strengthen counseling psychologists' proficiencies of caring for palliative patients' spiritual needs, 5. To become competent palliative counseling psychologists working with patients from diverse ethnic and cultural backgrounds. In the end, the authors drew the conclusion and proposed the limitation of the article.