灵性照顾与辞世教育

灵性照顾是临终关怀不可或缺的内容之一，同时也是辞世教育的重要内容和有效方式。灵性照顾可以帮助人们树立良好的人生观、价值观，可以帮助临终患者，可以安慰死者亲属，也可提高临终关怀工作人员的素质。     

灵性照顾与辞世教育

灵性照顾是临终关怀不可或缺的内容之一,同时也是辞世教育的重要内容和有效方式.灵性照顾可以帮助人们树立良好的人生观、价值观,可以帮助临终患者,可以安慰死者亲属,也可提高临终关怀工作人员的素质.     

临床工作者面对肿瘤患者照护需求的压力分析

在以实务为基础的研究上进行灵性多元观点的内容分析。对临床工作者进行焦点访谈,研究显示面对患者的死亡与未知的恐惧、患者的身心灵整合与情绪变化、家属的心理支持与情绪处理等,都会无意间增加临床工作者的压力困境。而当前存在的主要问题包括临床工作者认为灵性需求应该具备有意义的信念;临床工作者面对正负向情绪,透过修复自我的价值观与经验复制的分享,来协助家属适应与度过哀伤期;临床工作者并非仅是让患者得以善终,还必须着重改善照护质量。

     

医务社会工作介入的灵性视角：理论、实践与展望

灵性健康被学者视为所有健康层面中最深沉、最核心的部分,可以支持和影响其他的健康层面。不过,在当前中国的医务社会工作实践中,灵性资源相对匮乏,还没有得到应有的重视。在不同历史时期,医务社会工作中的灵性视角有着多层次、多维度的丰富内涵。在医务社会工作实践中,灵性视角的运用体现在非线性的介入策略、丰富的实务技术,重视服务对象的生命意义问题。灵性视角具有独特的意义和价值,与医务社会工作有较强的契合性。在医务社会工作实务、研究和教育中,需要加强对灵性视角的理解和自觉应用。

     

ICU护士伦理气氛认知与道德困境的相关性研究

采用量性研究方法对ICU护士进行调查分析,了解ICU护士道德困境和伦理气氛认知的现状,并探讨两者之间的相关性。结果显示,ICU护士道德困境总分为43.00分(24.00, 67.00),伦理气氛认知得分为(3.44±0.38)分。相关性分析结果显示：道德困境总分与关怀型伦理气氛呈负相关(r=-0.131,P＜0.05),与功利型伦理气氛呈正相关(r=0.297,P＜0.01)。护理管理者在临床工作中可采取积极有效的措施塑造关怀型伦理气氛,避免或削弱功利型伦理气氛的形成, 从而降低道德困境的发生。

     

灵性实践的误区与社会工作的介入

近年来,发生在一些地方、关涉灵性的实践活动,实际上陷入了各种误区。这表明,对于转型期中国社会中的个体成长来说,一方面是日常生活中大众对灵性资源的极端渴求,另一方面则是灵性资源的极其匮乏。灵性视角及其实践,是当代西方社会工作理论和实务领域中兴起的一个重要流派。作为积极介入生活实践的社会工作,应当在当代中国社会追逐灵性的"实践误区"中,发挥专业化的引导作用。     

围生期叙事照护与生育关怀叙事生态研究

围生期死亡并未引起医护人员和社会的重视与关注,往往导致失胎或失婴家庭成员陷入严重的创伤叙事闭锁。以生命健康叙事理念为框架,从创伤叙事闭锁之后的两种不同哀伤应对方式,即工具性舒缓和叙事性调节作为出发点,阐述由围生期胎儿死亡造成的哀伤剥夺给失胎和失婴家庭成员带来的巨大痛苦,进而倡导全社会积极创设关于失胎和失婴主题的良好叙事生态,旨在通过妇产科医护人员的叙事照护,引导“天使父母”分享自己的故事,再现痛苦历程,并藉由叙事赋能,得到关注、找到归属、重构身份,走出创伤叙事闭锁,开始全新的生命旅程。

     

基于伦理学视域的失能老人照护服务体系研究

研究失能老人照护服务体系问题,对于保障失能老人的生命尊严与生存权利、促进社会和谐发展等具有重要意义.基于失能老人生存需要的服务供给、人才培养、制度安排、组织监管等问题,是照护服务体系构建的基本元素.坚持人本理念以及资源配置的公平、公正与效益目标,是照护服务体系构建的伦理原则.     

基于伦理学视域的失能老人照护服务体系研究

研究失能老人照护服务体系问题,对于保障失能老人的生命尊严与生存权利、促进社会和谐发展等具有重要意义。基于失能老人生存需要的服务供给、人才培养、制度安排、组织监管等问题,是照护服务体系构建的基本元素。坚持人本理念以及资源配置的公平、公正与效益目标,是照护服务体系构建的伦理原则。     

居家照护的多元社会保障：国际经验与启示

为疏通我国老年人居家照护与医疗保险、长期护理保险资金之间存在的“梗阻”,从德国、日本、美国和新加坡居家照护社会保障体系中总结得出完善社会保险和商业保险并行发展的多元社会保障体系;健全预防保健为主、全方位保障的老年人医疗保险制度;构建以居家护理优先为原则的长期护理保险制度;引导管理商业健康保险和长期商业护理保险发展并给予政策优惠等经验。建议我国推进以“健康保险”为理念的医保改革,拓宽保障覆盖面;建立以居家护理优先、覆盖广且给付方式多元的长期护理保险制度;发展衔接居家医疗的商业健康保险和长期商业护理保险。

     

Perceptions of Spirituality and Spiritual Care in Occupational Therapy Practice

Occupational therapists view human occupation as active engagement in that which brings meaning to the life of the patient. Spirituality is understood to be one important construct in the creation of meaning in the lives of human beings. This study examined the attitudes toward the use of spiritual care in occupational therapy. The study sample consisted of 310 occupational therapists. Data were collected through the use of a secure web-based survey tool. Analysis was conducted to determine the significance of relationships between several important constructs (e.g., education, theory base, definition of spirituality) and perceptions regarding the use of spiritual care.     

Spiritual well-being,burnout and trauma in counsellors and psychotherapists

Burnout represents a potential risk for counsellors and psychotherapists in their work with distressed clients. In the research reported here, the relationship between spiritual well-being and burnout was explored, with attention paid to clinicians’ perceptions of trauma. Eighty-nine Australian counsellors and psychotherapists (71 females and 18 males) completed a demographic survey, the Maslach Burnout Inventory, and Spiritual Well-Being Scale. It was found that existential well-being accounted for some of the variance in MBI subscale scores, and buffered the effect of trauma on emotional exhaustion. In addition, clinicians who reported high levels of existential well-being reported being better able to avoid emotional exhaustion when working with severely traumatised clients.     

Spiritual Care: Recognizing Spiritual Needs of Older Adults

SUMMARY

This paper explores aspects of spiritual needs and assessment, while emphasizing the importance of aged care providers being spiritually self-aware. The context of this exploration is meaning in life, spirituality and quality of life as experienced by older adults. Depression and dementia are frequently seen among older adults in residential aged care with resultant lowered quality of life. Pastoral and spiritual care may be used effectively to help alleviate depression and support older people who have dementia. However, to be able to provide appropriate spiritual care, spiritual needs should be assessed. Ways of assessing spiritual needs are suggested.     

The Personal and Social Correlates of Spiritual Well-Being Among Primary School Teachers

A sample of 311 primary school teachers completed the Spiritual Health in Four Domains Index alongside the abbreviated revised Eysenck Personality Questionnaire and measures of religiosity. The data demonstrate that higher levels of spiritual health are found among older teachers who record low scores on the psychoticism scale and who practice religious faith through church attendance and personal prayer.     

Guidelines to Integrate Spirituality and Spiritual Care in Occupational Therapy Education: A Modified Delphi Study

This modified Delphi study aimed to develop educational guidelines for integrating spirituality and spiritual care into occupational therapy education. The first round comprised a self-administered questionnaire, the second round used a face-to-face workshop, and last round reviewed the developed educational guidelines, which reached the highest agreement and median values greater than 3.25. A panel of 18 comprised occupational therapy educators, clinicians, and nursing experts were recruited. A total of 126 out of 142 items reached the highest agreements from the panel participants, categorized based on the content knowledge-based, importance, skills, ethics, pedagogical approaches, teaching and learning strategies, and assessment of student learning.     

Spiritual Inquiry and Well-Being in Life-Limiting Illness

ABSTRACT

Introduction: End of life, as a developmental phase, is accompanied by inner resources as well as losses. Spirituality is a potential inner resource for integrating illness that often occurs during this time. Despite the increase in spirituality research, how spiritual perspectives are used in life-limiting illness remains under-investigated. Better knowledge about this process may be useful for health care providers, family caregivers and patients themselves to enhance well-being at end of life. This study describes the process of how patients and family care-givers use their spiritual resources to facilitate well-being at the end of life.

Method: A qualitative study was designed, based upon the grounded theory method, that entails theoretical sampling of concepts (not sampling of people as in quantitative designs), and the analytic technique of constant comparison of the data until conceptual categories are saturated with supporting data and a theory can be identified. The sample consisted of 12 respondents: 6 dyads of elderly patients with a life-limiting illness and family caregivers. Interviews occurred over a 2-year period.

Results: Data analysis generated a theory about a process called “transcending life-limiting illness,” which derived from two related themes: spiritual inquiry and end-of-life dimensions.

Conclusion: The results expand existing knowledge about how people, either as patients or as family caregivers of persons facing end of life, live with life-limiting illness. The process of transcending life-limiting illness goes beyond merely coping to tap resources for well-being. This resource is expressed through an ongoing dialectic process of spiritual inquiry about life and death as supported by six critical life dimensions.     

Issues in Publicly Subsidized Long Term Care Systems and Implications for the Religous Sector

Given the increasing numbers of elderly in need of long term care services and the harsh reality of finite resources, new models are required which define those elderly persons who should remain eligible for publicly subsidized long term care. If, in fact, a method is established for serving only a limited number of older persons, i.e., the truly vulnerable elderly, by way of the public system of long term care, a large constituency of older Americans will be left to exist on the margins. The church as an informal care system may appropriately assume the role of ensuring that the available public funds are used wisely and that service gaps inevitably left bewteen the increasing number of older persons and shrinking public support are bridged. In addition, the church must assist in improving all long term services by contributing to public policy formation.     

Spiritual Need Five: Providing Quality Pastoral Care as a Congregation

SUMMARY

Critical to the needs of older adults is the care and nurturing of the feelings and emotions that often offer context for the human spirit. Grounded in the history of pastoral care, this chapter explores an approach to pastoral care that is reflective of the author's study and experience in the parish.     

Ageing Health Care and the Spiritual Imperative: A View from Scotland

SUMMARY

This paper, given as a keynote presentation at the third international conference on Ageing and Spirituality 2004 in Adelaide, Australia, offers a perspective on ageing that makes central and fundamental the spiritual journey. Ageing is not confined to the old. We are all ageing all the time and whilst the imperative of ego integration (Erikson, 1986, 1982) is more pressing in old age, the march of time makes no exceptions. The paper starts with a consideration of the Scottish context and the current interest in Scotland in spirituality and health. Borrowing from the human developmental ideas of Frankl, Jung, Erikson, and Klein, the paper takes the view that we are all spiritual beings, and we are all trying to be successful, integrated reconciled and mature individuals. Ageing and spirituality is relevant to every individual. Successful ageing is fundamentally concerned with the successful self. The spiritual journey is bound up with the search for meaning. Ageing is part of the task of being human and it involves decline and loss. The spiritual journey–search for meaning–is unique to each one of us. The spiritual journey is made evident in the search for the ultimate destination of giving up self, transcending self. Remembrance and routine are methods by which the ageing and the spiritual journey can be facilitated. A successful ageing, according to this perspective, is therefore one that embraces and self-consciously embarks upon a spiritual journey. To take it further–the spiritual journey is bound up with ageing–and further still–ageing is a spiritual journey (Bianchi, 1984). The primary task of ageing is spiritual development. Spiritual development is helped by an appropriate societal context in which ageing as spiritual journey can flourish. This has implications for health and social care services.     

姑息治疗及其在肿瘤学中的地位

本文对姑息治疗的历史及概念作了详细的介绍,解释了其不同阶段的内涵,作为医学学科之一,姑息治疗的内容主要包括了疾病伴随或治疗所致症状的诊断评估、预防和治疗,心理和非癌性躯体疾病的预防和治疗,姑息治疗的科研、教学和教育以及终末期病人的治疗和护理等,特别纠正了对“安乐死”的看法。在肿瘤学中,经过40多年,它已从治疗中的辅助角色迅速成为肿瘤综合治疗中的主角,且贯穿于始终。它倡导多学科协作,与抗癌治疗完整结合,对无法治愈的晚期癌症患者以缓解症状、改善生活质量为主要目标,在全球范围内,很大一部分晚期肿瘤病人已从姑息治疗中明显获益。它的有力实施,也是我们创建和谐社会的重要反映。