醫務社會工作者對死亡議題之態度及因應行為研究

探討人類對於死亡的態度是重要的，因為死亡一直是人類無法避免且必須去面對的一項課題。隨著生命經驗中家庭、宗教、教育與社會文化是存在著普遍性與差異性，人們對於死亡看法也有不同的詮釋方式。 本研究目的旨在了解醫務社會工作者恐懼死亡因素、面對死亡之自我效能因應，以及面對案主死亡時的因應方式。本研究採用立意抽樣方式，並以改編相關研究問卷進行資料收集，依據衛生署新制醫院評鑑93-97年醫院名單所公佈之區域級以上的醫院，從北、中、南、東部分區共收集到105份有效樣本。 研究結果發現，受到文化因素、不同學科訓練、工作年資的影響，醫務社會工作者面對死亡態度分為「痛苦」、「和摯愛的人分開」、「生命的終止」、「失去今生的事情」四個面向，且「和摯愛的人分開」面向是最重要之因素。死亡因應自我效能研究顯示「臨終關懷」之自我效能為最佳，「哀傷因應」的自我效能仍需加強。在面對案主死亡時的因應方式與需求方面，在支持系統不變的情況下，隨著經驗的累積，醫務社會工作者對案主的死亡較能「處之泰然」；在需求的部份，對於工作技巧的增進仍覺得重要。 本研究提出面對死亡議題應該具備兩種因應方式，分別為(1)問題解決導向能力(2)情緒紓解能力，除了聚焦於問題解決之外，最重要的是醫務社會工作者應要加強自我照顧之能力。

Objective：The purpose of this study is to find out the medical social workers’ attitudes and coping methods toward death. Methods：Participants were selected from registers of social workers employed at hospitals recognized by the Department of Health in Taiwan. The revised questionnaire including the Reasons for death fear scale, Self-efficacy on Death scale, Hospice-related Death Coping scale, and demographic information is adopted as the research method in this study.Result：“Parting from loved one is the highest with a mean score of 8.89（SD＝1.68）and this is the most important factor for medical social workers to fear of death. Medical social worker’s self-efficacy the best is the「terminal caring」,and they were have the well performance with patients. There were several factors such as cultural, age ,working experience, department, and religion that influenced death attitude of medical social workers significantly. Conclusion：The study propose two coping style face to death：(1) problem-focused coping(2)emotion coping.Medical social workers apart from problem-focused ability, self-care ability is very important.