癌末病患及家屬接受安寧療護服務之分析--以佛教慈濟綜合醫院為例=The Analysis of Hospice Service for the Terminal Ill Cancer Patients and Their Family--In the Buddhish Tzu Chi General Hospital
Summary Since the development of hospice in the western countries in 1960 decade，the care for the terminally ill cancer patients is progressively emphasized in various medical care delivery systems. The hospice care in Taiwan has been promoted for 10 years and there are 15 hospice wards set up in various hospitals at present to offer the comprehensive care. However，what is the effective way of implementing the hospice care in the current medical delivery system to accomplish the ideal terminal care originated in the occidental concept? What are integrated during the transformation and transplantation of hospice from the western model and what conflicts are evolved? How do the patients and the family experience when they are treated in the hospice environment? All such issues are to be investigated in this study.
This study was based on the method of ethnography and carried out at the Hospice Ward of the Tze-Chi Hospital. The sampling was non-random and 8 patients with their family were selected for detailed interview and observation. The process was to investigate about the local experience in performing the hospice care and to learn the oriental Buddhist way of hospice service. The feeling of the patient and their family toward the hospice care were also analyzed.
The main results of this research can be summarized as follows： 1. Though patients were transferred to the Hospice Ward via various routes, all of the 8 patients did not understand hospice clearly and ask for it. 2. From the viewpoint of expectation and recognition，the patients and family showed most needs and expectation to pain control. Yet，they considered the Hospice Ward as the place to wait for dying. 3. After the hospice treatment，the patient and family graded the pain relief，humanity and spatial orientation of the ward completely different from what they experienced before. 4. There was complicating dilemma situation frequently existing between the patient and the family. The medical personnel played the important Communicating role in such interaction. 5. The simultaneous presence of the family in the ward for taking care of their patients allowed them to experience in the same condition of the patient and form an intrinsic supportive system. 6. Though there was the obvious contrasting dilemma between the hospitals' rules and the individuality of the patients, it was necessary to respect the autonomy of the patients and to satisfy their multi-disciplinary needs in face of the different culture and strategy of the medical institution
