靈性照護於台灣住宿型長期照顧機構的落實

The Practice of Spiritual Care in the Long-Term Care Facilities in Taiwan

社會變遷及家庭結構的改變，使住宿型機構照顧模式成為老年人晚期生活的主要照護選擇。入住機構將會對長者造成生理、心理和社會層面上的衝擊，進而影響其靈性安適狀態，反之靈性困頓也會惡化長者的身體、心理和社會健康造成惡性循環；因此為加強全人照護的實踐，靈性評估和照護更需被落實於機構場域中。雖靈性照護已被列為住宿型機構的評鑑項目之一，但臨床上長者的靈性需求仍頻繁被忽略，過往文獻指出影響靈性照護落實的主要障礙乃為宗教和靈性概念的混淆、護理人員靈性自我意識較低、缺乏有系統的靈性教育規劃及護理人力不足這四大因素。為能突破實務上的瓶頸，促成靈性照護的執行，本文從住宿型機構長者未滿足的靈性需求及阻礙其住宿型機構執行靈性照護的因子談起，再介紹適用於住宿型機構長者的靈性評估與照護模式，最後立基於上述提出有助於改善住宿型機構落實靈性照護的策略，期望能透過知識分享，使實務工作者重視該議題，進而推動靈性照護於長期照護領域的落實。

Due to the social evolution and the change in family structure, the institutional care model has become the first choice of care for the elders in late-life. Long-term care settings may negatively impact elderly individuals’physical, psychological and social conditions and further affect their overall spiritual well-being. Conversely, spiritual distress may also deteriorate elderly residents’physical, psychological and social health, causing a vicious cycle. Therefore, spiritual assessment and care should be practiced in institutional settings to enhance the practice of whole-person care. Although spiritual care has been included in the accreditation survey of long-term care facilities, residents’spiritual demands are still ignored frequently. Previous literature demonstrates four main influences of barriers to spiritual care practice exist: confusion between religious and spirituality, low spiritual self-awareness for nursing staff, the lack of systematic spiritual education programs, and shortages of nursing workforces. To overcome obstacles for this problem in practice and promote the practice of spiritual care, this article presents a synopsis of the spiritual needs of elders, factors affecting spiritual care practices of institutions, and several spiritual assessment and care models developed for elders. Based on the above review, several feasible strategies are recommended to improve spiritual care practice in an institution. Through the sharing of knowledge, we expect that long-term care facility workers can pay attention to this issue and promote the implementation of spiritual care.