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class="post-1639 post type-post status-publish format-standard hentry category-the-corner tag-public-mental-health tag-hospice-care tag-tcpu">

減輕臨終親人身心苦痛 減少無效醫療資源


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減輕臨終親人身心苦痛 減少無效醫療資源

提高生命品質,陪伴親人無痛苦走最後一段旅程

面對親人生命交關的時刻,大部分家屬都會竭盡所能挽救親人生命,但是在一次又一次急救的過程中,往往也讓親人受盡苦痛,毫無生命品質可言,雖然家屬於心不忍,但也很難放手,病人與家屬內心的煎熬折磨可想而知。

中華民國諮商心理師公會全國聯合會理事長徐西森表示,生老病死是人生大事,也是無可避免的宿命歷程,近日「台灣醫療品質促進聯盟」結合十九個醫事團體發起「拒絕無效醫療」社會運動,期盼臨終關懷的病患家屬能放手、醫師能放下,鼓勵社會大眾能預先簽署放棄無效醫療的意願書,預約善終權。諮商心理師身為心理健康的助人工作者,有必要發揮助人角色與專業功能,讓臨終關懷病患安心、病患的家屬及其醫療人員心安。

長期投入諮商心理與復健諮商研究的徐西森教授說明,臨終關懷是指,協助照顧疾病無法治癒之癌症末期病人疏緩病痛、得以有尊嚴的走完人生旅程,以及減輕其家屬傷痛、度過失親悲傷時期的一種照護歷程。在此照護歷程中,諮商心理師最重要的職責與功能為「陪伴 (being present) 」與專業介入,對病人及其家屬宜多關注、多主動、多盡責、多開放、多傾聽、多敏感其身心需求、幫助家人與其相互道別、處理雙方的分離焦慮、協助其完成未竟事件(心願)等等。

馬偕醫院諮商心理師呂奕熹指出,大部分來到安寧病房的病人,在病情發展上大多不樂觀,因此希望藉著緩和治療來減低疼痛。不過,由於國人對於安寧緩和的瞭解並不深,且在傳統文化的概念中,若未能盡力救治,病人是長輩,決定者就要承受不孝之名;病人若是平輩或子女,則會被指責不仁。

呂奕熹認為,在安寧照顧的團隊中,非常強調團隊的合作。醫師主責病情與藥物上的控制,護理人員協助住院歷程的照顧,社工師則協助尋求相關資源的協助,而諮商心理師一方面可以照顧病人,通常病人在臨終前常有未竟事務,或充滿著各種情緒,或是憤怒上天的不公平,或是懊悔未能多給家人時間,情緒的不穩定也影響著病情。心理師在病床旁邊,對於不想說的病人給予陪伴,對於沮喪失志的病人給予支持,對於憤怒不平的病人給予情緒的宣洩,有助於讓病人的情緒穩定,進而可以放心地面對生死的問題。另方面亦可照顧病人家屬,家屬在長期照顧病人的歷程中,除了經歷生理上的疲累,也承受著心理上的壓力與挫折,也需要得到好的心理支持。

諮商心理師公會全聯會發言人林萃芬以為,很多家屬因為怕臨終的親人難過,常會強顏歡笑,忍隱滿腹悲傷情緒,或是在照顧臨終親人的過程中身心具疲,往往不堪負荷。最常見的狀況是,病人身體飽受折磨,家屬心靈備感矛盾,久而久之,很多家屬都出現憂鬱焦慮的身心症狀。此外,遭逢意外事故的病人家屬更是既震驚又難以接受突如其來的打擊,既混亂又不知道該如何是好。這個時候如果有心理專業人員協助家屬舒緩情緒,降低無力感,整理混亂的思緒,同時跟家屬討論後續的心理準備,可以讓家屬更有能量面對臨終的親人。

政治大學心理系兼任副教授及諮商心理師公會全聯會秘書長修慧蘭表示,每個人在生命末期均希望能統整自己生命,找到自己生命意義的答案,因此如何協助病人及病人家屬面對此人生重大課題,是醫事人員可以協助的部分。諮商心理師加入安寧團隊,不僅可以達到全人關懷的醫療目標,除了病患、家屬能夠獲益,亦能讓醫療團隊的功能發揮到極致,在推動避免「無效醫療」的歷程中,諮商心理師亦能達到讓人「安心」的效果。


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分類: 心知園地,標籤: ,作者: FannyEQ。這篇內容的永久連結
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