臺灣地區安寧緩和療護志工角色•教育訓練及支持網絡之研究

NHUIR > College of Humanities > Department of Life-and-Death Studies > Disserations and Theses(M. A. Program in Life-and-Death Studies) > Item 987654321/22287

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Title:	臺灣地區安寧緩和療護志工角色•教育訓練及支持網絡之研究
Other Titles:	The Study of the roles, educational training and support network of Volunteers of Hospice and Palliative Care in Taiwan
Authors:	林姿妙 Lin, Tzu-miao
Contributors:	生死學研究所魏書娥 Shu-er Wei
Keywords:	安寧志工;整體性支持網絡;臨終整體性生死教育;教育訓練 education and training;holistic support network;holistic end-of-life death education;hospice volunteers
Date:	2006
Issue Date:	2015-08-04 09:55:49 (UTC+8)
Abstract:	臺灣地區92年度的死亡人數約有三分之二的人死於慢性病，其中以癌症為第一大死因。安寧緩和療護運動發微時期，是基於提升癌末病人及其家屬之照顧品質，故而整合志工。而由於社會結構的變遷與醫療的專業化現象，促使現代民眾缺乏認識臨終過程與學習臨終照顧的機會，當面臨醫療極限與隨之而來的死亡時，才呈現出人們對於這個切身問題的陌生與窘困。安寧志工角色的運用，對於面臨照顧窘境的病人及其家屬而言，可以提供輔助性的照顧與陪伴。然而，志工能否成為安寧團隊有力的輔助性角色，重要關鍵在於其相關的教育訓練過程。而通過教育訓練之後，有哪些要素可以支持安寧志工持續的提供服務呢？另外，由於安寧志工難免要面對臨終情境，當安寧志工提供臨終陪伴與照顧時，可能促發什麼樣的生命回饋呢？這是本研究所欲深入探討的。　　　本研究採深度訪談及紮根理論研究法。主要是以負責規劃安寧志工教育訓練課程的安寧社工人員作為分層立意抽樣的對象。在資料收集方面，除了半結構式開放問卷的訪談逐字稿外，還包括其相他關文獻、書面訪談，以及田野觀察紀錄等。在歷經開放性譯碼、主軸譯碼、及選擇性譯碼等三個階段後，發現安寧志工隨其所處場域及情境的不同而扮演著各種不同的角色。在教育訓練方面，職前教育訓練會隨著安寧志工的服務過程而與在職教育訓練共同形成螺旋式向上循環成長的歷程。在此歷程中知識、技巧、態度，以及團隊運作默契也都會隨之提昇，其中也包括來自病人的「臨終整體性生死教育」回饋。然而，這樣的回饋，其實是透過持續服務及整體服務生態底下的支持網絡所共同形成的。而這個「整體性支持網絡」則是由來自個人、同儕、團隊成員、成就感、自我成長，以及大環境等六大支持要素所共同交織而成的。整體而言，教育訓練很重要的目的，是讓這個整體服務生態底下的支持網絡更為密實。而安寧志工的支持網絡越密實，成為資深安寧志工的可能性就越高，與團隊間的運作默契也會越好，越能成為高效能的安寧志工。這樣的研究結果，可以提供安寧團隊在規劃安寧志工教育訓練課程時之參考。　　In Taiwan, the leading cause of death is cancer, and there were about two third of mortality subjects dying on chronic disease in 2003. In the incipient phase of the hospice and palliative care movement, the integration of volunteers is based on enhancing the quality of care for the terminal cancer patients and their family. Owing to the change of social structure and the phenomenon of medical professionalization, modern public lack the knowledge of dying process and the chance of learning about dying care. Therefore when we are facing the medical limitation and the coming death, we will feel so strange and awkward in these issues. The utilization of the hospice volunteers can provide the auxiliary care and sharing the journey to the terminal patients and their family. However, whether the hospice volunteers can become the efficient auxiliary of the hospice team, it depends on the related education and training course. Which kinds of important factors can support the hospice volunteers to provide their services continuously after passing the education and training course? Additionally, it is because that the hospice volunteers are hard to avoid facing the dying situation in their practice, what kinds of life feedback may be enlightened during their services? This study aims to explore these two subjects.　　　In-depth interview and grounded theory method were used as the qualitative method of this study. The social workers responsible for the conception of education and training of hospice volunteers were the subjects of the stratified intentional sampling. Besides the transcripts of interview by means of semi-structured open questionnaire, the associated references, the written interview, and the field observation records were also included in the data collection. After through the three stages of open coding, the axial coding, as well as the selective coding, we find that the hospice volunteers play the various roles according to the different field and situation. In the aspect of education and training, the pre-occupational education and training of the hospice volunteers following with their service forms the spiral-pattern upgrading course together with their in-service education and training. The knowledge, the skill, the attitude, as well as the tacit understanding of team work will be promoted in this course. Certainly, it has also included the feedback of holistic end-of-life death education from the patients. For all that, such promotion is actually through continuing services and forms together by the support network under the whole service ecology. But this “holistic support network” is interwoven together by the oneself person, the colleagues, the team members, the achievement feeling, the self-growth, as well as the macro-environment and so on six big support essential factors. Generally speaking, the very important purpose of in-service education and training actually makes the support network under the whole service ecology much denser. The much denser of the support network of hospice volunteers is, the more possible to become senior and high efficient volunteers, and the tacit understanding within team work also can be better. Such study findings should be allowed to provide the hospice and palliative care team as reference of the conception of curricula of hospice volunteers.
Appears in Collections:	[Department of Life-and-Death Studies] Disserations and Theses(M. A. Program in Life-and-Death Studies)

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