護理人員喪親電話關懷實作經驗之研究～以中部某安寧團隊為例

Nurses' practical experience on telephone caring of bereaved families: A study for Central Taiwan palliative care unit.

世界衛生組織1990年主張安寧療護提供喪親關懷服務，應從罹病至死亡後提供家屬持續性照顧支持。臺灣安寧病房多安排護理人員以電話進行喪親家屬關懷，實作經驗中為何、面臨哪些困境與工作重點，是本研究欲探討目的。本研究方法以質性訪談中部某安寧病房主責喪親電話關懷的7位護理人員，探索其執行喪親家屬電話關懷例行工作的實作經驗為何？遭遇哪些困境？主要的工作重點為何？本研究結果發現其實作經驗與困境包括：1.依規摸索打陌生關懷電話難深入只能多談喪葬處理；2.事前預備並引導回想照護闢係及喪親家庭互動關係開啟話題；3.「還好嗎你辛苦了」是正視悲傷提供撫慰的有用話術；4.主動衛教自我觀照隱藏的悲傷情緒與舒壓法；5.不知如何參照現行指引但希望作更多悲傷輔導。綜整討論上述實作喪親電話關懷經驗工作重點，前四項多偏重於關懷「哀悼完成與否」，包括1、2項在關懷能否「接受喪親事實」及3、4項在關懷促進「宣洩悲傷情緒」；針對第5項想再作悲傷評估典輔導工作，建議訓練其增加關懷「復原完成與否」，嘗試關懷能否「適應喪親後生活」、「投入新生活重心」的兩項任務。最後建議可著重哀悼與復原兩大重點的五項工作與四個任務供作喪親電話關懷實作參考。

WHO (1990) mention about bereavement service should be provide from bereaved families facing dying and after death. Hospice nurses almost conduct this service in Taiwan. So the purpose of this study is to explore the practical experience of telephone care for bereaved family members by nursing staff. Use qualitative research method to interviewer 7 nurses of pa1liative care unit to explore their practical experience, difficu1ties and working point. The resu1ts of the study found that most nurses are not well trained to server telephone caring, they tried error to talk about funera1 issue. Preview medical record could help to create conversation topic, or try to using ‘Are you ok? It's hard work for you’ to explore their grief. Even they could try to provide self-care skill and evaluate their difficu1ty. They still have difficulty to provide grief counseling. Finally, this study analysis their telephone caring work only deal with grief work of bereaved families but not to caring about their recover work. And suggest to base on this two work to conduct caring and promote their four grief tasks, finger out five work points for the bereaved families. It is recommended to work with counseling psychologists to establish an integrated and feasible bereavement telephone care service process for nurses of palliative care.