叙事医学模式下的临终关怀——以阿图·葛文德《最好的告别》为例

在临终阶段,帮助患者克服对死亡的恐惧,与患者建立心灵和情感上的沟通,帮助其提高生命质量,有尊严、有意义地度过生命最后的时光显得尤为重要。运用叙事医学理论,结合阿图·葛文德《最好的告别》一书中的案例,分别从医护人员、患者、患者家属三个视角,探讨叙事医学对临终关怀发展的指导意义。相较于传统医学模式,叙事医学模式下的临终关怀能够引导医护人员和患者正确对待衰老与死亡、促进医护人员叙事能力的提高、鼓励患者自我需求的叙事表达、关注家属面对亲人离世时的心理护理、改善家属在医疗决策中的辅助作用。叙事医学对临终关怀的发展具有指导意义,有望进一步推进临终关怀的应用进程。

Hospice Care in the Narrative Medicine:Case Study of Being Mortal: Medicine and What Matters in the End by Atul Gawande

In the dying stage, it is of great significance to help patients overcome their fear of death, establish spiritual and emotional communication with the dying person, and help them spend a meaningful time with dignity through their last hours, as well as improving their life quality at the same time. Based on the theory of narrative medicine with the case study of Atul Gawande's Being Mortal: Medicine and What Matters in the End, this article, respectively from the perspectives of medical staff, patients and patients' relatives, analyzes the application of narrative medicine in hospice care, and figures out the advantages of narrative medicine in hospice care practice in comparison with the traditional medical mode. The advantages are guiding the medical staff and patients to recognize the significance of aging and death; improving the medical staff narrative abilities of empathy, communication and reflection; encouraging the patients' self-required narrative expression; paying attention to the psychological care to the relatives of the death; and improving family members' auxiliary role in medical decision-making. Narrative medicine is therefore of significance in guiding the development of hospice care and beneficial to the promotion and application of hospice care.