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系統識別號 U0026-1801201912341200
論文名稱(中文) 探討家屬經歷癌症病人留一口氣返家之經驗及需求
論文名稱(英文) Exploring the Experiences and Needs of Impending Death Discharge among Cancer Patients’ Families
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 107
學期 1
出版年 108
研究生(中文) 黃詩凌
研究生(英文) Shih-Ling Huang
學號 T26051026
學位類別 碩士
語文別 中文
論文頁數 83頁
口試委員 指導教授-賴維淑
口試委員-黃美智
口試委員-林鵬展
中文關鍵字 留一口氣返家  家屬  經驗  需求  現象學 
英文關鍵字 Impending death discharge  Families  Experiences  Needs  Phenomenology 
學科別分類
中文摘要 背景與重要性:華人傳統文化中家中往生是善終的象徵,然而臨終病人因種種考量無法接受居家照護,故存在著留一口氣返家的出院模式,而過去相關研究較少針對此現象進行深入探討。
目的:本研究之目的為探討癌症病人留一口氣返家其家屬之經驗及需求。
方法:採用質性研究現象學,以立意取樣選取實際參與癌症病人留一口氣返家的照護或決策之喪親家屬。於喪親事件後兩個月至一年內,以半結構式訪談大綱進行深度訪談,並運用現象學Colaizzi資料分析法。
結果:本研究共收錄五位家屬的經歷,發現留一口氣返家之經驗包含五個主題,(一)探測生命的底線、(二)落葉盼歸根、(三)心願與現實的拉鋸、(四)計劃趕不上變化、(五)達願而無憾;而家屬於留一口氣返家的需求包含五個主題,(一)有備無患防範未然、(二)幽谷伴行、(三)醫療後盾不斷線、(四)葬儀接手免煩憂、(五)逝者安詳生者安。
結論/建議:本研究發現留一口氣返家的病人及家屬需要醫療團隊協助締結家與生命意義的連結、及早且共同擬定留一口氣返家的出院準備計劃,並於返家後持續提供醫療後盾及持續性的幽谷伴行。藉由了解家屬留一口氣返家之經驗與需求,有助於提供文化適切性的照護及協助,達成在宅善終、生死兩相安的真諦。
英文摘要 Dying at home is a symbol of good death in Taiwanese traditional culture. The existing literature regarding impending death discharge is limited. Phenomenological study was conducted to explore the experiences and needs of families in impending death discharge for cancer patients. In-depth semi-structured interviews were conducted with five families who had the experience of taking care or making the decision in impending death discharge for cancer patients within two months to one year after their relatives’ death. Data were analyzed through Colaizzi's method. Five main themes emerged from the experiences of impending death discharge, including (1) detecting the bottom line of life, (2) home is where our heart is, (3) struggling between wish and reality, (4) planning can’t match the variety, (5) not regret to fulfill the wish. The five main themes of families’ needs, including (1) preparation prevent unexpectedness, (2) being-with, (3) cohesive medical assistance, (4) connect to undertaker without a hitch, (5) the dead peaceful then the living peaceful. It is contributed to provide culturally congruent care for bereaved families to arrive the goal of helping patient good death at home.
論文目次 摘要.......................................I
Abstract..................................II
誌謝.......................................V
圖表目錄...................................IX
第一章 緒論...............................1
第一節 研究背景及重要性....................1
第二節 研究目的...........................5
第三節 研究問題...........................5
第四節 名詞定義...........................5
第二章 文獻查證...........................7
第一節 留一口氣返家之概念..................7
第二節 留一口氣返家之前、中、後期照護需求....8
一、 前期之照護需求......................9
二、 中期之照護需求.....................10
三、 後期之照護需求.....................12
第三節 影響臨終病人於家中死亡之因素........13
第四節 總結..............................15
第三章 研究方法與過程.....................16
第一節 研究設計..........................16
第二節 研究對象..........................17
一、 取樣方法及樣本數...................17
二、 收案條件..........................18
第三節 研究工具..........................20
第四節 資料收集方法及分析.................23
一、 資料收集過程.......................23
二、 資料收集方法.......................24
三、 資料分析...........................28
第五節 研究嚴謹度.........................32
一、 可信性(credibility)................33
二、 可轉移性(transferability)..........34
三、 可靠性(dependability)..............34
四、 可驗證性(confirmability)...........35
第六節 倫理考量...........................35
第四章 研究結果...........................38
第一節 研究參與者基本資料描述...............38
第二節 家屬經歷癌症病人留一口氣返家之經驗....40
一、 探測生命的底線......................41
二、 落葉盼歸根..........................42
三、 心願與現實的拉鋸.....................43
四、 計劃趕不上變化.......................45
五、 達願而無憾...........................46
第三節 家屬經歷癌症病人留一口氣返家之需求.....47
一、 有備無患防範未然.....................48
二、 幽谷伴行............................50
三、 醫療後盾不斷線......................51
四、 葬儀接手免煩憂......................52
五、 逝者安詳生者安......................54
第五章 討論...............................55
第一節 留一口氣返家之人口學因素.............55
一、 家與生命意義的連結..................57
二、 天秤兩端的平衡......................57
三、 留一口氣返家的行前預備...............59
第三節 走~該回家了.........................60
一、 窺探時機,不如萬全準備...............60
二、 全程的後盾..........................62
三、 留一口氣返家的出院準備...............63
第四節 如願返家生死安......................64
一、 守護最後的承諾......................65
二、 全程跟著專業走......................66
第六章 結論與建議..........................69
第一節 結論................................69
第二節 研究優勢與限制.......................69
一、 優勢................................69
二、 限制................................70
第三節 研究結果之應用與建議..................71
一、 臨床實務應用.........................71
二、 護理教育之應用.......................72
三、 未來研究建議.........................72
參考文獻.....................................75
附件一 研究說明書...........................81
附件二 基本資料及研究筆記....................82
附件三 同意人體研究證明書....................83
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