[[alternative]]The Spiritual Care in Hospice World--A Hospice Volunteer's Perspective

[[abstract]] 本研究採現象學方法從志工的觀點探討安寧療護的靈性照顧。志工在照顧有的困難：1.不知何時介入。2.不知如何評估結果。3.對靈性的覺察不足（辨識靈性困擾的能力不足）。4.時間和空間的限制。訪談安寧志工呈現照顧經驗得到四個主題：（1）靈性照顧很難做－病人問題隨時間因素影響照顧做不好，志工跳過時間層次階段直接照顧病人內在靈性就會很難做。（2）與病人搭建親密關係－親密關係需要經營，在雙向溝通交軌共同世界中層層地往病人心裡面開展。（3）在交軌上與病人命運相逢－單面向照顧成果有限，照顧者沒有抓到病人問題是照顧的與病人命運不相逢。（4）似有還無的靈性照顧－傾聽與鼓勵病人尋求可期待未來，或真實面對死亡恐懼過程對自己生命態度做出一個決斷，我們說：「病人負責地決定未完成路途，志工已完成了那似有還無的靈性照顧。」靈性照顧的時序屬性及空間方位屬性結構，是靈性照顧上不可缺性徵。志工所要做的照顧是「如果疾病已是華陀在世亦束手無策、無法治療時，瀕死已不能免，讓我們給你最好的照顧。」[[abstract]] The purpose of this study was to investigate the spiritual care in the hospice world from a hospice volunteers’ perspective. A phenomenological approach was used in this case study. The survey explored some difficulties that hospice volunteers’ perspectives encountered in these four aspects: First, the volunteers did not know how to identify the appropriate time to care for patients. Second, the volunteers did not know how to evaluate the effectiveness of the care. Third, they lacked the awareness of demonic spirits and they did not have enough experience identifying spiritual problems. Fourth, time and space were limited. In overview, there were four viewpoints from interviewing hospice volunteers about their caring experience: (1) It’s tough to do spiritual caring -- if patients’ problems didn’t get proper care because of the temporality, volunteers will have problems doing spiritual care. (2) Developing close relationships with patients -- the development of close relationships needs time to cultivate, and to build two-way communication. (3) Interactive skills need to be recognized and connected with the patients’ psychological problems and their fate -- the effects of physical care are limited because the volunteers did not recognize patients’ needs and problems. (4) Thus far, spiritual care has not been effective in helping the patients to seek their appropriate fate when they face death. The hospice volunteers should listen to patients’ words and encourage them. We might say that “ The patients have to decide their way; the volunteers provide the spiritual nurturing.” Finally, it is absolutely essential to have the necessary temporality to provide proper spiritual care. When medical care system fails to heal the patients completely, the hospice volunteers provide the best spiritual care to encourage their spiritual life