敘事旅程—癌症病人生命經驗之回顧與剖析

Abstract

本論文針對三位癌症病人採用敘說生命故事的方式，與病人建立共同的生命故事文本，統整出癌症病人生命脈絡之六個向度，分別為：1）疾病衝擊與生活改變、2）家人的愛、3）靈性提升、4）母親對子女的愛、5）疾病中的希望、6）疾病中無限的等待。 同時粹取出六項「全人照護觀點」，包括病人的「個人背景、疾病與治療的衝擊、與醫療資源的互動、內外在資源、遭遇威脅生命疾病的因應及未來的期待」六項，進行癌症病人照護需求之護理評估。 在護理專業與教育反思方面，提出5項重要核心概念：1）終身學習--護理照護能力、2）同理、關懷與溝通—以病人為中心的護理、3）專業角色—專業性治療關係、4）以家庭為中心的護理、5）護理倫理與法律，尤其是「以家庭為中心的護理」新概念，建議應納入護理教育。 對研究者而言，在研究過程中最大的收穫是產生自然的內在轉變，更具敏銳、同理、易受感動的特質，同時提升人性化護理能力，找回對護理臨床的熱誠。期待此研究肯定臨床護理人員工作的投入，也鼓勵所有醫療從業人員嘗試傾聽病人生命故事，讓陪伴、照護與關心，滋潤著護病關係，共同孕育出美麗芬芳的花朵。

My master thesis was written in the form of narration with the stories of three cancer patients’ life. It established the common-life story text with the patient, and approached the lives of cancer patients in six dimensions: 1) disease impact and life change, 2) family member's love, 3) spiritual promotion, 4) mother’s love toward children, 5) hope during illness, 6) endless waiting during illness. Simultaneously will emphasis on following six topics, patient's personal background, impact from disease and treatment, interaction between medical resources, internal and external resources, reaction to life-threatening illness and the future expectation, to proceed nursing evaluation based on ”holistic caring viewpoint”. In the aspect of nurse professional and introspection, five important key points are presented: 1) life time education – nurse caring ability, 2) empathy, concern and communication — patients as the center, 3) professional role— professional relationship, 4) caring base on family as the center, 5) ethics and laws of nurse. Especially, its 'family center care' is a new concept in nursing curriculum; recommend it to bring into nursing education. In the perspective of researcher, the greatest gains during the research are followings: natural intrinsic transformation; personal characteristics with more sensitivity, empathy and impressibility; simultaneously promotes the humanization nursing ability, retrieves to nurses clinical commitment. Hope that this research give recognition to clinical nursing staffs for the works and effort they put in and also encourages all medical care staff try to listen to patients’ life stories, keep accompany, care, concern, moistens nurse-patient relationship, and breeds the beautiful flowers together.