探討醫務社工經歷案主死亡之正向主觀經驗

Abstract

本研究以七位任職於區域級以上醫院，負責過安寧、加護病房、腫瘤科、內外科、急診室與器捐等業務，並曾有經歷過案主死亡經驗之資深醫務社會工作者為研究對象，進行深度訪談。從正向主觀經驗的觀點出發，來探討醫務社工經歷案主死亡，所產生正向情緒與建設性經驗的經驗，了解其對於個人與實務的影響、正向主觀經驗的形塑過程，以及過程當中正向組織環境的影響。 本研究結果，首先，面對死亡議題的「情緒」反應，隨著經驗的累積，對於死亡處遇，從單純的情緒表現，漸漸走向多面向的體悟，有了許多正向情緒的嶄露。其次，為「建設性經驗」的部份，看到了醫務社工許多最適經驗的調適過程，以及對於專業和人生自我實現的成長感受。雖然經過這些調適的歷程之後，並不代表醫務社工面對實務處遇的能力已經達到完美的境界，但這個深刻的調適經驗，對於面對案主死亡的處遇，是相當重要的建設性經驗。 在面對許多實務挑戰的調適過程中，不僅看到社工本身的心理力量，更看到了正向的醫院組織環境力量，如正向的組織氛圍與制度，對於醫務社工面對死亡議題的重要性。這些正向主觀經驗，將是滋養社工面對個人生活與專業服務的挫折與挑戰後，持續向前邁進的重要力量。

The purpose of this study is to investigate the positive subjective experiences on clients’ death and dying for medical social workers in Taiwan. The in-depth interviews were used and the selection criteria for interviewers included: (1) those who worked in regional hospitals or teaching hospitals; (2) those who worked in the divisions of hospice, ICU, oncology, general medicine& general surgery, and department of emergency. Or those who got involved in organ donations. (3) those who had worked as medical social workers for at least four years. The research findings are as followings: (1) although social workers may had mixed feelings about clients’ death and dying, they will have positive emotion based on their accumulated working experiences and how they expected clients’ prognosis. (2) By means of the personal adjustment processes, social workers always can findthe optimal experiences in order to improve their professional performance. (3) As for the peak experience, social workers also can learn how to achieve self-actualization and to be a better professionals. And (4) Positive working institutions such as collaborative organization culture and integrative team work were very important for creating positive experiences for individual social workers.