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研究生:邱惠茹
研究生(外文):CHIU, HUI-JU
論文名稱:照顧歷程中靈性關懷對畢業照顧者復原力之影響
論文名稱(外文):The Effect of Spiritual Care in Caregiving Processes on The Resilience of Graduated Family Caregivers
指導教授:李孟芬李孟芬引用關係
指導教授(外文):Li, Meng-Fan
口試委員:石泱胡瑞芝
口試委員(外文):Shih, YangHu, Jui-Chi
口試日期:2020-05-26
學位類別:碩士
校院名稱:實踐大學
系所名稱:家庭研究與兒童發展學系高齡家庭服務事業碩士在職專班
學門:社會服務學門
學類:兒童保育學類
論文種類:學術論文
論文出版年:2020
畢業學年度:108
語文別:中文
論文頁數:91
中文關鍵詞:靈性關懷畢業照顧者家庭照顧者復原力
外文關鍵詞:spiritual caregraduated family caregiverformer family caregiverfamily caregiverresilience
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從擔任起主要照顧者開始,家庭照顧者即面臨生命中重大的衝擊、改變及抉擇。許多家庭照顧者彷彿按下了自己生命的暫停鍵,在照顧的路上踽踽獨行。本研究的目的在探索家庭照顧者從照顧歷程到責任終了後,靈性關懷介入,對其照顧復原力的影響為何。
本研究以質性研究半結構式深度訪談進行資料蒐集,研究對象為曾擔任家庭主要照顧者,且結束照顧責任一年至三年。計訪問6位畢業照顧者,性別各半,年齡層分佈在23歲~64歲,5位基督徒及1位一般民間信仰。訪談大綱經專家效度確認,研究者本身在研究期間完成靈性關懷師之培訓,訪談逐字稿以內容分析做資料處理,編碼經專家效度及一致性之確認。
研究發現照顧者在照顧歷程中,照顧資源取得不易、生活型態受影響、照顧價值觀及生命反思隨著照顧歷程有所變化,而信仰在照顧歷程中一再受影響及挑戰。他人提供靈性關懷需有一定關係(朋友或家人)、在對的時間,提出合宜的關懷,如身心安適陪伴及被同理與尊重。另外,照顧者的復原力可分內在及外在,自我靈性照顧,深深連結於個人的信仰信念或社會規範中,是重要的復原力因子。基督徒個案其靈性上原有的信仰根基,能在照顧歷程中支撐其面對內在的孤獨,以及在結束照顧後成為其面對未來的盼望與力量;傳統信仰照顧者,在照顧歷程中較少尋求信仰的力量,結束照顧責任後,信仰在生命復原力上的作用也不顯著,社會規範的孝道回報的照顧信念則有較多的作用,能給予其照顧價值及其靈性支撐力。
本研究建議親友對家庭照顧者的靈性關懷,需持續至其結束照顧責任後。日常的主動陪伴與連結,能預防畢業照顧者因失落而放棄生存意志。專業助人者在提供靈性關懷時,需將家庭照顧者與被照顧者有所區分,視其為獨立需被關懷的個體;並以同理心的融合、積極的投入以及情感分離等,在不同的階段有效的運用。照顧者本身要能主動向外與他人連結,向內接納自我,向人與至高者敞開心靈的通道。未來研究可朝靈性掙扎與悲傷五階段相關性,探討各階段的靈性關懷如何介入及對復原力的影響。

Being the main family caregiver of a disabled family member involves major impacts, changes and choices in their lives throughout the entire caring process. Many family caregivers seem to have pressed the pause button on their previous lifestyles and walked the journey of caregiving alone. The purpose of this research is to explore the impact of spiritual care on individual caregiver’s resilience once they are relieved of their caregiving responsibilities.
Semi-structured in-depth interviews with qualitative content analysis were the main method of collecting research data. The subjects had taken the role as a family caregiver and had subsequently ended their responsibility for a minimum of one to a maximum of three years. Six former family caregivers were interviewed, among which gender was equally distributed. Ages ranged from 23 to 64 years old. Five cases come from Christian background and one from traditional folk belief. The validity of the interview structure and methodology were agreed upon by experts. The researcher herself completed certification as a spiritual care specialist during this research. The content of the interviews were transcribed and further analyzed into coding. The result of the coding are validated and found consistent by experts.
The research shows the subjects’ faith or their religion are constantly challenged throughout a difficult course of caregiving; the difficulty includes a lack of resource and change of lifestyle. Many experienced changes in their life values as well as their perspective toward caregiving. Requirements for providing spiritual care to former family caregivers include a certain depth of relationship with the subject and good timing, as well as an appropriate outreach approach. For example, using a mix of physical and mental companionship, respect, and empathy. In this research, the resilience of a caregiver is discussed from two perspectives: internal and external factors. The self-care for caregivers, which derives from the subject’s own religious faith and social norms, plays an important role in their spiritual recovery. Subjects with Christian background are found to more commonly draw on their initial faith in Christianity to deal with their inner loneliness during the process of caregiving. the same faith is reported to enable them to face their future with hope and strength in the aftermath of caregiving. Whereas the subject with traditional folk belief is found to be less inclined to seek inner help from religion. Religion does not become a key factor enabling their spiritual recovery. However, social norms such as filial piety becomes a key source of meaning in caregiving and further transforms into spiritual support.
This research suggests the spiritual care from family and friends should last beyond the end of caregiving. Proactive companion and outreach to former family caregiver prevents them from giving up on life after their loss. Spiritual care provided by professional helpers are advised to distinguish the need of the patient from the family caregiver, and further identify the caregiver as an individual case who also deserves to receive professional assistance. The caring cycle, which includes empathic attachment, active involvement, and felt separation, should be actively practiced through different caring phases. The caregivers are encouraged to actively build connections outwardly, make peace with themselves inwardly, and open up their spirit to receive help from people and the God most high. Based on this study, in the light of the similarity between spiritual struggle and the five stages of grief, future research may explore how spiritual care could help in the different phases of caregiving as well as its impact on family caregiver’s resilience.
謝致……………………………………………………………………………………i
中文摘要…………………………………………………………………………ii
Abstractv……………………………………………………………………iii
目錄……………………………………………………………………………………iv
表次……………………………………………………………………………………v
圖次……………………………………………………………………………………v

第一章 緒論
第一節 研究背景及動機…………………………………………1
第二節 研究目的及研究問題………………………………3
第三節 研究範圍與研究對象………………………………4
第四節 名詞釋義………………………………………………………5

第二章 文獻探討
第一節 靈性關懷………………………………………………………6
第二節 家庭照顧者的照顧經驗與靈性需求……9
第三節 復原力……………………………………………………………12

第三章 研究方法
第一節 研究設計………………………………………………………14
第二節 研究流程………………………………………………………15
第三節 研究對象………………………………………………………16
第四節 研究工具………………………………………………………17
第五節 資料分析………………………………………………………20
第六節 研究倫理………………………………………………………23


第四章 研究結果與討論
第一節 家庭照顧者的照顧歷程…………………………24
第二節 家庭照顧者的靈性需求…………………………34
第三節 靈性關懷………………………………………………………43
第四節 復原力……………………………………………………………59

第五章 結論與建議
第一節 結論與討論…………………………………………………78
第二節 建議………………………………………………………………82
第三節 研究限制………………………………………………………84

參考文獻
中文部份……………………………………………………………………………85
英文部份……………………………………………………………………………88

附錄
附錄一 訪談同意書……………………………………………………89
附錄二 訪談問卷-受訪者基本資料…………………90
附錄三 訪談大綱…………………………………………………………91


表 次
表3.1 研究者背景與訓練…………………………………………17
表4.1 照顧者基本資料………………………………………………24


圖 次
圖3.1 研究流程……………………………………………………………15
圖3.2 逐字稿文本………………………………………………………20
圖3.3 概念摘要表格整理…………………………………………21
圖3.4 運用Excel功能彈性排序……………………………21
圖3.5 概念項目查找索引…………………………………………22
圖3.6 概念分析及歸納………………………………………………22
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