癌末病患臨終階段照顧之現象學探討－從躁動不安到擬象轉換

NHUIR > College of Humanities > Department of Life-and-Death Studies > Disserations and Theses(M. A. Program in Life-and-Death Studies) > Item 987654321/21534

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Title:	癌末病患臨終階段照顧之現象學探討－從躁動不安到擬象轉換
Other Titles:	A phenomenological inquiry on caring terminal cancer patient in dying phase--The dying agitation transformed into imagery playing
Authors:	林素琴 Lin, Su-chyn
Contributors:	生死學研究所龔卓軍 Jow-jiun Gong
Keywords:	生命史;擬象轉換;癌末病患;彌留者;躁動不安;回應倫理態度
Date:	2004
Issue Date:	2015-06-16 14:24:08 (UTC+8)
Abstract:	本研究旨在探討癌末病患臨終過程彌留階段躁動不安到擬象轉換，研究場域以台灣南部某醫學中心安寧病房的三十位彌留病患。　　　本研究以田野調查法和參與觀察法作為主要蒐集資料的來源，採用現象學方法分析其中五位主軸個案文本。研究結果發現，癌末病患隨著病程進展以及身體衰敗造成自我結構改變退出社會，彌留時的躁動不安透過回憶、想像、時間感、空間感的改變回到自身生命經驗作連結，而所構成的臨終世界由彌留者、護理人員和家屬三者互為主體呈動態關係，針對這樣擬象連接，照顧者在照顧彌留者躁動不安的態度上必須不斷的回應，才能夠發現新的互為主體的關係。　　　本研究認為，研究結果可以補充臨床實務者新的見解與新的倫理態度，以作為多變的臨終照顧情境之參考，並應將彌留者躁動不安與生命史締結的照顧模式、回應倫理態度納入安寧療護在職教育以及護理學校課程哩，讓癌末患者獲得更貼近的照顧方式。　　The purpose of this study is to explore how imagery playing and dying agitation are correlatively developed in the dying phase. Dying agitation is a common occurrence at the end of terminal cancer patients'lives. This type of agitation may physically appear as thrashing, involuntary muscle twitching or jerking, fidgeting or tossing and turning,yelling,or moaning. By conducting phenomenological analysis on five targeted cases,using filed method and participant observation method,this study emerges from field data collected from thirty dying persons in a hospice ward.　　　This finding shows that a terminal cancer patient will gradually shed his or her social identified ego parts,as a result of the progressive shutdown of multiple body systems which results in dying agitation. Dying agitation is associated with a dying person’s imagery playing, which is composed of flash memory, imagination and temporality of his or her whole life history.In the dying phase, there are three intersubjective players who construct the dying person’s life world: the dying person, his or her nurses, and family caregivers.Nurses can identify dying agitation by continuously responding to the dying person’s physical involuntary movements,whilst also seeking supportive information from family caregivers. Based on a sensitive understanding of the dying person, nurses can assist the family caregivers in helping the dying person prepare for the death.　　　This study explores another approach to dying agitation and offers assessment connection with imagery playing for terminal cancer patients in the dying phase.As a result,these research outcomes may be used as supportive materials in Nursing Practice such as hospice nursing,general nursing classes and the like.
Appears in Collections:	[Department of Life-and-Death Studies] Disserations and Theses(M. A. Program in Life-and-Death Studies)

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