安寧護理過程中所應用的諮商技巧

The Counseling Skills of Nursing Therapist Applied to the Process of Hospice Care

本研究旨在深入探討18位腫瘤病患於接受為期四週的安寧護理過程中，治療者所應用的諮商技巧。研究者以治療者身份，於某綜合醫院參與諮商過程收集資料。徵得樣本與家屬同意採現場錄音，於諮商後立即加以文字化，將治療者與病患在諮商過程中所表達的言語與非言語行為，寫成敘述體的行為過程記錄，再以內容分析法，將諮商過程的互動行為加以系統性分析、歸納。研究結果發現，治療者於諮商過程中所使用的諮商技巧依五個不同之諮商治療階段：陪伴期、工作期、認知期、重建期與執行期，在諮商意圖、情境安排與口語反應而有不同之應用，透過分析研究者應用之諮商技巧，可了解促使有效改善病患憂傷反應之具體因子。研究結果可做為未來推廣安寧護理諮商訓練課程之依據。

The purpose of the study is to explore counseling skills in the process of hospice care for 18 cancer patients. The subjects agreed to accept hospice care and make appointments for counseling during hospitalization. Contents of the counseling consisted in the theme, the subjects and families mentioned and were concerned about. The researcher then guided it to words both in depth interview and a one hour discussion. Tape recording on the spot was performed through subjects' permission. Those narratives recorded by the researcher were systemically analyzed and categorized.The counseling skill applied by researcher during the hospice care process could be categorized as counselor intension, verbal responses, and setting arrangement. Study findings highlighted the fact that counseling could improve grief responses and facilitates life meaning changes of the subjects. The significance of the study demonstrated that nurses could take active roles in nursing counseling.