死亡識能概念分析

Death Literacy: A Concept Analysis

死亡識能是一種幫助個人在生命末期獲取、理解並運用與死亡及末期照護相關知識的能力。雖然健康識能已有大量研究，但針對死亡識能的探討仍較為稀少。因此，本文運用Walker及Avant所描述概念分析的方式，界定「死亡識能」之定義性特徵，包括（一）具備與死亡、臨終照護相關的基本知識，並能理解其內容與意義；（二）具備溝通能力，能與家人及他人討論生命末期之臨終照護方式；（三）經由實際參與臨終照護與生命教育學習的過程，累積面對生死的經驗與智慧；（四）透過與他人分享個人親身體驗，由實踐累積的經驗，傳播生死智慧。透過典型案例、邊緣案例、相反案例及相關案例，以釐清概念、確認死亡識能之前置因子與後果、列舉現行的測量工具，以及在護理實務、護理研究與護理理論之應用結合，藉此增進護理人員對此概念的瞭解，提供護理人員臨床照護的參考，以助病人對生死議題的瞭解及重視，進而保障並提升病人臨終生活照護的品質。

“Death literacy”refers to the acquisition, understanding, and application of knowledge related to death and end-of-life care during the final stages of life. Although there is extensive research on health literacy, studies on death literacy remain relatively scarce. In this article, the conceptual analysis approach described by Walker and Avant is applied to define the characteristics of death literacy, which include: (1) the ability to possess and comprehend fundamental knowledge related to death and end-of-life care; (2) communication skills to discuss end-of-life care options with family members and others; (3) the accumulation of wisdom regarding life and death through hands-on experience in end-of-life care and experiential learning in life education; and (4) the dissemination of wisdom on life and death through sharing personal experiences with others. Using typical, borderline, contrary, and related cases, this analysis clarifies the concept, identifies the antecedents and consequences of death literacy, lists current empirical measurement tools, and explores applications in nursing practice, research, and theory. The overall goal of this article is to enhance the understanding of nursing personnel regarding this concept, provide a clinical reference for caregivers, increase public awareness of life and death issues, and, ultimately, ensure and improve the quality of end-of-life care provided to patients.