死亡與臨終=Death and Dying; 安寧療護=Hospice Care; 臨終關懷=Terminal Care
摘要
本文主對天主教耕莘醫院『聖若瑟之家』安寧病房內，宗教死亡觀裏融合一般台灣民間信仰之患者或家屬，以參與觀察法和深度訪談，進行追蹤性的資料蒐集. 該期間則以Glaser與Strauss所提之『紮根理論』，為資料分析與解釋的參考依據，並參照Lincoln與Guba所提之『可信度』指標，加強研究的嚴謹度. 目的在了解一般台灣民間信仰之宗教死亡觀，如何影響患者或家屬面臨「臨終階段」之種種行為與心理歷程，及其對安寧病房的場域概念認知，和「死亡地點」選擇之影響，從中建立一般台灣民間信仰的「臨終關懷」相關資料. 再者，因安寧病房為特殊研究場域，研究主題敏感，故本文將特別強調研究倫理的議題，及研究者本身之研究經驗的提出. ● 研究發現： 研究參與者 (指患者或家屬) 則因「生命品質取向的差異」.「生命力的認同」.「治療方針的落差」及「場域概念的強化」等因素,而視安寧病房為一『等死』處; 基於「臨終尊嚴」訴求. 資源分擔考量及現實環境便利等原由，選擇進入安寧病房為臨終場域，建構出其所認知的『全方位』之專業照顧模式. 其次，於此過程中，由患者. 家屬及安寧療護團隊間，共同建構出的『臨終真實』過程模式，展現患者與家屬如何將死亡內化的心理歷程，及其在宗教上的運用. 關於死後靈魂歸處方面，因受到佛教興盛影響，故建構出整合型的『死後靈魂歸處觀』模式，內容包括祖先崇拜信仰，及融合佛教臨終儀式概念，使亡魂有所依歸. 故藉本文對道教及一般台灣民間信仰者的死亡觀，及其在「臨終過程」所展現面貌的深入性了解，將有助安寧療護團隊人員，有深一層的認識，更能幫助臨終者及其家屬，安然渡過死亡關口，以達生死倆無憾. [Abstract] This research delves into how patients of Cardinal Tien Hospital Saint Joseph Hospice or their family members, who are adherents of Taiwanese folk religions, face death. Through participation observation method and in-depth interview method，it gathered data from follow-ups with the respondents. During that time，the grounded theory method proposed by Glaser and Strauss was employed as the basis for data analysis and interpretation. Lincoln and Guba’s trustworthiness indicator was referenced to enhance the rigor of the research. ● purpose: The purpose is to understand how the perspective of Taiwanese folk religions concerning death affects the behaviors and mental experiences of patients or their family members faced with the “dying stage”，as well as the way they perceive the hospice room in and choose their “location of death”. A databank pertinent to the hospice care of traditional Taiwanese religions is established thereby. Due to the fact that hospice is a special，sensitive research topic，this research will emphasize moral issues, with the attention fastened on the author’s research experience. ● Findings： Research participants (patients or their family members) see the hospice as a place to “wait for death” because of “differences in orientations of quality of life”，“identification with the dynamic of life”，“discrepancies in policies of medical care” and “intensification of the locality concept”. But，based on environmental convenience and the need to maintain the dignity of the dying and to share the responsibility of providing resources, they select the hospice as the place of death and according to their perception construct an all-round professional care routine. In this process patients, their family members and the hospice care team work together to form the pattern of “the reality of dying”，which demonstrates the psychological process in which patients and their family members internalize death and how this process affects their religious practice. Under the influence of Buddhism，which is currently the predominant religion in Taiwan，an integrated concept concerning where the souls of the deceased rest is established. Its content includes ancestor worship and an idea that incorporates a Buddhism deathbed ritual for the repose of the soul. Through this research’s in-depth understanding of how Taoism and other Taiwanese folk religions perceive death, as well as the role this perception plays in the “course of dying”，the hospice care team can better grasp this process and more effectively help the dying and their loved ones through the final journey with no regret. 論文
