叙述、形塑与纾解：末期癌症患者的疼痛研究—身体社会学的视角

发布时间：2018-06-15 08:53

本文选题：末期癌症患者 + 疼痛　；参考：《华东理工大学》2017年硕士论文

【摘要】：近年来,癌症作为一种高危和多发疾病,给人类健康带来极大的威胁和挑战。患癌作为一个负性生活事件给患者及其家庭带来沉重的影响和打击。癌症,尤其是末期癌症,以其不可逆的发展特点摧毁和改变一个人的生活。对于末期癌症患者来说,经历了积极治疗的无效和内心的苦痛挣扎之后,为了缓解身心的痛苦,一部分人选择来到临终关怀病房接受舒缓疗护服务。疼痛和不适作为大部分末期癌症患者主要的身体症状,给他们的临终生活带来了不可估量的影响,导致了大部分癌末患者处于非本真的存在状态。临终关怀服务以减轻病人的疼痛为重点,旨在为病人创造一个舒适、安宁的临终生活,因此,全面认识疼痛成为临终关怀服务的一项紧迫任务。本文运用质性研究的方法,以L医院临终关怀病房为研究地点,将临终关怀病房中的末期癌症患者(4位)、医护人员(8位)和社工及志愿者(6位)作为研究对象。采用半结构式访谈、参与式观察和文献分析等方法收集研究资料,旨在呈现末期癌症患者真实的疼痛体验和痛苦生活。同时,以身体社会学为理论分析工具,对作为身体“体现”的活生生的疼痛现象进行了深入剖析。全文以癌末患者诉说的疼痛体验-形塑疼痛的力量-纾解疼痛的方法为写作思路,阐释了末期癌症患者经历的疼痛体验和生活状态。在疼痛的叙述方面,主要从癌末患者的生理感受和心理感知两个方面阐述了病人的身心体验,进而分析了疼痛对病人的生理功能、心理和情绪、生命态度和生活空间的影响。在疼痛的形塑方面,重点分析了空间、关系和文化对疼痛的形塑作用,及由此导致的病人疼痛感受的不同。然后研究回归到疼痛的纾解上面,从医护人员、社工和癌末患者等主体对疼痛关注点的差异来阐述在疼痛的治疗和介入中存在的不足,并从社会工作专业的角度出发提出多主体团队合作、加强宣传和倡导、引入辅助性治疗方法等纾解疼痛的建议,以此呼吁各相关方加强对疼痛的关注和重视,推动临终关怀实务工作的深入,努力为癌末患者创造一个舒适的临终生活。
[Abstract]:In recent years, cancer, as a high-risk and multiple disease, has brought great threat and challenge to human health. Cancer as a negative life events to patients and their families have a heavy impact and blow. Cancer, especially terminal cancer, destroys and changes a person's life with its irreversible development. For patients with terminal cancer, after the ineffectiveness of active treatment and internal pain struggle, in order to alleviate the pain of body and mind, some people choose to come to the hospice ward to receive soothing care services. Pain and discomfort, as the main body symptoms of most patients with terminal cancer, have an incalculable effect on their terminal life, resulting in the majority of terminal cancer patients in a state of non-real existence. The focus of hospice care service is to reduce the pain of patients, aiming at creating a comfortable and peaceful life for the patients. Therefore, it is an urgent task to fully understand pain in hospice care services. In this paper, a qualitative study was carried out on the terminal care ward of L Hospital. 4 terminal cancer patients, 8 medical staff) and 6 social workers and volunteers in the terminal care ward were selected as the research objects. The methods of semi-structured interview, participatory observation and literature analysis were used to collect the data in order to present the real pain experience and painful life of patients with terminal cancer. At the same time, the physical sociology as a theoretical analysis tool, as the body "embodiment" of the living pain phenomenon is deeply analyzed. This paper takes the pain experience, the force of plastic pain and the method of relieving pain as the writing thought, and explains the pain experience and life state of the patients with terminal cancer. In terms of the narration of pain, the author expounds the patient's physical and mental experience from the two aspects of the patient's physiological feeling and psychological perception at the end of cancer, and then analyzes the influence of pain on the patient's physiological function, psychology and emotion, life attitude and living space. In terms of the shape and shape of pain, the effects of space, relationship and culture on pain are analyzed, and the difference of patients' pain perception is also discussed. Then the study goes back to the relief of pain. From the differences in pain concerns among health care workers, social workers and end-cancer patients, the deficiencies in pain treatment and intervention are explained. And from the perspective of social work professional point of view, put forward multi-body team cooperation, strengthen publicity and advocacy, the introduction of auxiliary treatment and other pain relief suggestions, so as to appeal to all relevant parties to pay more attention to pain and attention. To promote the practice of hospice care, and to create a comfortable terminal life for patients with terminal cancer.
【学位授予单位】：华东理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73

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