813 386
ၡāāࢋ
ᙯᔣෟĈ়ঽአዋ ( Disease adaptation )
ីّ ( Spirituality )
ីّᜪ ( Spiritual care )
༊ঽˠତצ̼ጯڼᒚ̈́ٸडڼᒚޢ̪୮ซणĂᗁरಶ࣎९ᖼ̬ගێីˠࣶĄඕڍ ঽˠయَᗁरсଯගҾˠĄགྷϤێីˠࣶᄃᗁर۞၆ྖ༊ۢ̚Ăᗁर˘ؠౌົనڱڼ ᒚঽˠĂҭߏזྮ۞ႽᐝॡĂΪрсᖼ̬Ąҭঽˠݒᛇсܧ૱ܫЇ۞ᗁ᜕ˠࣶٸୢ˞
сĄсืࢋ۞ߏᗁरৌ၁͚̈́۞ྖᄬĂ̙ߏێីˠࣶĂӎсᑕྍтңΝԱזྕ၁ࢬ ၆Ѫ˸۞˧ณâтсϠ݈۞ܫهĄ
д՟ѣੜྮ۞ଐڶ˭Ăԧࣇ࠻זͧԧࣇࣧАٙᒢྋՀૻิ۞ˠّώኳć࠹ͅ۞Ă֗ࠎ ᗁ᜕ˠࣶ۞ԧࣇืࢋͅෛҋ̎۞ऻᛵᄃ˧ຏĄЯࠎঽˠᄃԧࣇ࠹۞ॡมͧێីˠࣶᔘ ܜĂࣇ၆ٺԧࣇ۞ܫЇᄃഇޞ˵ߏΞפ۞ᘦĄ
дᗁᒚ૱ఢ̚Ăԧࣇҋ̎ڱཉ۞ঽˠ௫ၚّ۞ᖼ̬ගЪዋ۞ᗁरᄃࡊҾĂҭ༊
়ঽڱଠטٕࢬ၆ঽˠӈ൴Ϡࢦ̂ಉεॡĂԧࣇ̙അጯ௫ᄃ̙ۢٙନĂࠤҌᅅن˞ҋ
̎˵ѣᘦؠ͔̈́ጱঽˠ͕ី۞ਕ˧Ą
݈֏
ᗁᒚࡊԫڼᕽ˞ధкຏߖা̈́ПचϠ۞়
ঽĂҭؕڱаඍঽˠགྷ૱೩̈́۞યᗟĈĶ়
ঽ̈́Ѫ˸۞ຍཌྷķĄᗁ᜕ຽ၆ٺঽଈᜪ۞
நຐੵ˞ڼᒚঽˠăቤྋাېᄃؼܜϠγĂᆧ ซϠ߿ݡኳ˵ߏԧࣇ۞ࢦᕇĄ̚Ă༊Βӣౖ
ҡঽˠ֭аඍѣᙯᗁᒚ᜕̈́நࢦࢋયᗟ۞ਕ˧Ą
༊೩זڼᕽᄃೇࣧ ( cure and heal ) ॡĂ̂छ၆ٺ
༱ਕ۞ࡊԫు႙யϠኳႷĄڼᒚᑕྍߏፋវ۞Ă Βӣ֗វă͕ந̈́ីّ۞БˠĄѩБˠᜪੵд
᜕நࢍ൪̚གྷ૱జ೩זĂ˵జనࠎ᜕நᜪ̝
૱ఢĄдੑဥڱˠᗁੰෞᝥၱᗁᒚݡኳඉซົ
( ᗁඉົ ) ଯण˘ాҚ۞˘ਠᗁጯିֈቚ̚Ă
˵ૻአБˠᜪ۞ࢦࢋّĄ̚Ă֗វጡءᄃ়
ঽ۞ႾീᄃڼᒚĂٕాొЊ൏ᇋᄃݖ๋۞щ ᇬĂߏԧࣇ૱֍۞ཉćҭីّયᗟ̈́ីّ
ᜪ۞̰உߏ̦ᆃâۡޝ͌ѣˠᛈ̈́Ą
ϤٺĶីّķѣޝૻ۞࣎ˠ̼मள̈́ᔳռ
ّĂ҃࣎ˠ៍۞ၗޘ˫ޝᙱͽމ៍۞၁រᙋ ၁ĂтѩՀឰιᙱͽଯणҌᓜԖᑕϡĄдᓜԖঽ ଈᜪ̚Ăࡶѣ೩̈́ីّ۰Ă˵̂кะ̚дϐഇ ঽˠćҭӈֹдщှঽٗෞᝥॡĂѣֱ؎ࣶ˵ົ
ֶፂෞᝥࢋՐĂЯࠎᗁੰ̰՟ѣ؟ିर۞నཉ҃
ԲෞᗁੰᗁᒚဥฤĶ͌ីّᜪķĄҭৌ၁т ѩĉՏ࣎ঽଈᄃϠ࣌х۞ីّâؠืࢋགྷ࿅
؟ିर۞Ķ ᜪᄃฟϯķ ̖ົјܜĂ̖ზᜪ
ĉ֤ᆃ᜕ந૱ఢ̚۞͕֗ĶីķБˠᜪĂߏ ӎᇢ࿅ࠧͷ͉̙ۢณ˧˞Ăᑕ̟ੵд᜕ந᜕
ቑᘞ̝γĉᗁඉົଯҖ۞БˠᜪΪߏ͑࠹۩
ኘĉԺֱٕٙᏜ۞छώ֗ಶᄱྋ˞ីّ
ᜪĂٕ̙ᄮࠎᗁ᜕ˠࣶ˵ѣ࣎ਕ˧֭ͷΞͽ ೩ֻីّᙯᘃᄃᜪĉ
Տ࣎ˠдјܜ࿅̚ĂϠҁঽѪߏߊؠࠎˠ ಶڱᔖҺ۞Ąˠд֗វҁ̼۞ТॡĂംᇊ
˵дጯ௫јܜĄ༊Ă়ঽ۞൴Ϡ̂ొЊᄃѐࡔ ҁ̼ѣᙯĂтڍਕૉᒢྋҁ̼۞࿅̈́ሄ៍ࢬĂ
֤ᆃҁ̼Ξͽߏѣ౹ౄ˧֭၁ኹ࣎ˠϠநຐ
۞Ą࠹ͅ۞Ăҁ̼ಶΪߏҁᄃੜ̼۞ᛋੈĂឰ Ϡ߿Հΐӧᄃ݀ࢨĄઉܳซ̈́൴णѣड़ҋԧ
ᜪ۞ඉரߏ࣎ˠ ( পҾߏҁˠ ) ຏᛇض۞ࢦ
ࢋјЊĄˠҁ̼۞পᇈಶߏऴᄃϠঽĂТॡऻ
ᛵڱଠטҋ̎۞֗វ͕̈́ីĄचُѪ˸࿅
кٺѪ˸ώ֗Ąѣֱ࣎ˠ֗វ۞ੜΞͽីّ۞
јܜֽ҇វٙצ۞൭ࡴᄃࢨטć҃Ăѣ
ֱˠົЯࠎεΝԓ୕̈́ϠхຍԠ҃ऴ̼˞֗វ
۞ΑਕĄώ͛ڻᜈͽـ၆ٺĶីّă͕நჟৠ ᄃ؟ି̝मҾķ1̝ଣᄃĶኘីّᜪķ2̝͛
ౢĂဘྏᖣϤᓜԖ९ּᄲځីّ၆ٺˠᙷ়ঽአ ዋ̝ᇆᜩĂ֭ࢋᄲځᓜԖ˯ីّᜪ̝ྻϡĄ ԓ୕ώ͛ਕѣӄٺᗁᒚˠࣶ၆ٺБˠᜪ̝ે
ҖĂ֭ഇޞՀк۞ਫ਼ᜩĄ
९ּ
९ּ˘Ĉ˛˩α໐ҁ͉͉Ăπॡّ࣎ᔄ྿Ă ၆ҋ̎֗វଐڶؕٱΞͽѝᕇ֕ಶѝᕇ
֕Ă̙ࢋٳछˠĂ̈́Ѫ˸՟̦ᆃΞُ۞࠻ڱĄ сଈѣᎤԌঽͷܜഇ՟ѣޝр۞ଠטĂ˵̙ᙸຍ ତצफ৵ڦडڼᒚĄѣ˘͇ѝ˯ᏹֽॡĂсࡎ
ຏᛇν۳វͅᑕᏵนͷڱજᇅĂགྷछˠਖ਼
ާ෧ޢҝੰڼᒚĄҝੰܐഇଐڶإჍᘦؠĂৠᙊ
Ξͽ֏ᄬҭଐჰҲརĂՔᐵ̙ຑᄲྖĄ˘ฉ ޢĂጨԖ۞ঽˠঽࢦ࿅͵Ăछᛳࣵޝ๋͕Ą
͇ѝ˯ᗁ᜕ဥฤϹॡĂಶ೩זߑ͇˭̾̈؆
᜕̀ຏᛇҁ͉͉̙၆ݏĂតޝຑࣵĄ༊ॡ̈
؆۞᜕̀̈́छᛳ˵അགྷనڱયсࣧЯĂҭ࣎९
̙ؕаඍĄۡזϹޢ˘ాೀ͇Ăགྷ࿅ೀѨᄃ сԸ፟ኘֽ۞Тฏ᜕̀ϹኘޢĂ̖൴னࣧ
ώฟ६۞࣎९ੵ˞ົፉ͕ҋ̎ঽត̼γĂ˵ฟ
ؕፉֽ͕ـϠॡߏ̙ߏ˵ົညጨԖ˘ᇹѣ֤
ᆃкˠࠎсᙱ࿅Ă̈́छ̈̚۞̄̏གྷα˩໐
˞ᔘ՟ѣඕĂҋ̎۞యЇϏ˞Ą
९ּ˟ĈͳАϠ̣˩ˣ໐Ă۩͌ࢳءĂ
ۡབᒛ͘ఙЪ׀̼ጯڼᒚ̈́ٸडቢڼᒚޢĄд়
ঽѝഇତצ̼ᒚॡĂϤٺགྷ૱൴Ϡ⪰͕ăယФ̈́
̙ዋাېĂӈഅܑϯˠϠ߿̏གྷ՟ѣຍޥ
˞ĄˠࢋဗѪдጼಞ˯Ăт̫ݒӧд˘ૺԖ
˯Ąޢֽ׀൴˞۱ొᖼொĂ˵അڇϡ˞рڈ̓
ଯᖧڼᒛ۞̣زᎾᙷĂҭঽଐ̪୮ซणĄຏ ז୕Ăԓ୕ᗁरਕ߉̟щሄѪĂ֭གྷ૱ᄲĶ߿
၆ԧ̏གྷ՟ѣຍཌྷ˞Ăࠎ̦ᆃ̙ਕឰԧщሄ ѪķĄঽˠ۞ূ൭̙֭ځពĂূ൭ᇴࡗ˘ז˟
̶Ă֏ኘมৠംϺޝĂޝਕᄃᗁ᜕ˠࣶኘኢ ˠϠ۞࠻ڱĄѣ˘͇Ăঽٗ۞؟ିर݈ـଣෛ࣎
९Ăٺ֏ኘมᄲז࣎९۞ຽᅪϏ˞Ăٙͽ়ঽ̈́
ূ൭̖ົᜈхдĂឰঽˠޝϠঈĄ
९ּˬĈѣҜ̚ࢲҁĂЯࠎ̙̄ւĂ ٺҝੰೇઉഇม͕ଐؕҲརĄᙱѣ᜕ந̈́Ԡ
̍ˠࣶග̟ฟጱщᇬĂ͕ଐٺൾනπᐖĄ ᇴ͟ޢĂԠ̍࠻זсֽ̄ణᗓΝĂӈᐌ˾ྃ˯
˘ήĈĶݘĂಶ༊үߏ݈ዅ̄ͣ۞ๅӐĊķĄ ͽޢĂঽˠଐჰ˫ฟؕᚑࢦЄĂ၆̄՟ѣጯ рؕѣޝஎ̷۞ປຏĄ
ីّົᇆᜩ࣎ˠ۞়ঽአዋ
ϫ݈ጯ۰၆ٺីّ۞ؠཌྷ࠻ڱ̶ڡĂѣֱઐ Ш؟ିĂѣֱͽҋԧјܜ ( ವՐຍཌྷ̈́јܜ )
̝៍ᕇග̟ؠཌྷ3Ąҭͧྵࠎ̂ొЊጯ۰ٙତצ
۞ؠཌྷߏĈĶ࣎ˠ၆Ϡᆊࣃٙિ۞ܫه
ٕܫЈķ ( a dimension of a person that is concerned with ultimate ends and values )ķ4Ăಶߏ࣎ˠ࠻ޞ ˠϠ۞ࣰጯ៍ᄃᆊࣃ៍ĄѩؠཌྷྵࠎᇃཌྷĂѣҾ ٺ็؟ି̝៍ᕇĄֶѩؠཌྷĂីّᄲځ˞࣎ˠ Ϡ߿ăۤົ̈́ჟৠ̝ຍཌྷᄃϫ۞Ąિܫ۞ந هົᇆᜩ࣎ˠְ۞ၗޘ̈́ҖࠎܑனĂ˵ົᇆᜩ
࣎ˠϠ߿۞አዋԫμᄃˠᅫᙯܼ5ĂࠤҌ͕֗ઉ
Ąីّߏ࣎ˠ̰д۞ਕ˧ᄃ˧ณ۞ߵĂߏ࣎
ˠ۞៍གྷរĄιჯ˞࣎ˠϠ۞ԆፋّĂ˵
д࣎ˠϠх८͕̚Ă೩ֻ˞࣎ˠϠх۞ຍཌྷĄι ߏҋ็̼͛ă؟ିăିֈă̈́࣎ˠϠ߿གྷរ
۞ጯ௫ᄃᏉЪĄՏ࣎ˠ۞ីّಶညՏ࣎ˠ۞ຏજ
̈́ќᘥĂι۞̰̼̈́ᇆᜩ࣎ˠϠ߿۞ޘౌ̙Ⴝ
࠹ТĄТᇹгâІְଐົயϠӧᕘ۞ޘĂ˵
ົЯࠎ࣎ˠܫه۞ઐેޘ҃ѣ̙ٙТĄੵ˞͟
૱Ϡ߿̚ځពΞ֍̙ТܫЈޘ۞؟ିˠٕ̀߆ ڼઐેЊ̄γĂ۞मளд˘ਠϔிٕдᓜԖ
˯˵གྷ૱Ξ֍ĂּтᎮଈТᇹ۞়ঽĂҭՏ࣎ˠ
۞൏ᇋݒЧѣ̙ТĄࣇٕߏ၆ٺ়ঽώ֗
۞ރăٕߏ়ঽֽٙ၆ٺ࣎ˠϏֽ۞ᇆᜩă
ٕߏ၆ٺछˠགྷᑻ۞ᑝӄăٕߏౄјঽˠ̈́
छᛳ̢જ˯۞ӧဩăٕߏޢᜈ̄̃ᜪᄃְ
ຽ۞યᗟăٕߏܑঽˠܜ˳ߙ̰дཋೋຏ۞
ᘂჳಡೇඈඈĂຍཌྷౌΞਕᇆᜩঽˠତצڼ
ᒚ۞ຍᙸᄃೇઉ۞ຍԠ˧Ą९ּ˘̚ҁ͉͉ᓑຐ זࢬ၆ҋֽ̎ĶـϠॡߏ̙ߏ˵ົѣޝкˠࠎ сᙱ࿅ķ̈́Ķ̈̄ᔘ՟ѣඕߏҋ̎۞యЇ Ϗ˞ķĂѩᄃсϫ݈ĶϠঽአዳķ۞ࢦࢋّĂ֤
࣎ͧྵᐹАĂͧྵࣃᇎ͕ĂΞਕᗁ᜕ˠࣶٕ
ঽˠ۞ၗޘౌ̙Ⴝ࠹ТĄ҃९ּ˟̚Ăࢳء ຏצĶˠώҒķᄃЯĶ়ঽ҃ѪдঽԖ˯ķ
̝ᆊࣃᅅࢦ۞ͧྵĂ̈́Ꮎᙷڼᒛड़҃୕ඈඈ
۞়ঽགྷរĂ˵ᇆᜩ͕ី˯۞πщĄ༊Տ࣎ˠ Ϡ̚൴Ϡࢦ̂ШְІॡĂּтࢦ়̂ঽăണ ᆿٕѪ˸ăٕயॡĂѩඈຍཌྷ۞ᄮۢᄃᆊࣃࢦ
ࢋّ۞યᗟಶົঙனĂᐹАึԔ۞ࢦፋщଵߏ ӎዋ༊Ăົᇆᜩ࣎ˠߏӎΞͽࢬ၆ᑝ۞ਕ
˧Ă˵ົᇆᜩ࣎ˠତצ়ঽᄃڼᒚ۞ၗޘĄࡶ
ཉ̙༊Ξਕౄј়ঽአዋ۞ࢬᇆᜩĄٕᄃ
͇͛ேϒঈႇ྆۞Ķॡ༼˜֍Ă̜͕ѭܦķ ѣ࠹Ҭ̝Ą
ីّᜪ۞ቑᘞ
Ϥٺីّໄ߁˞࣎ˠநّ̈́ຏّ۞ٙѣ̰
உĂ༊˵ົᇆᜩ࣎ˠޥຐăҖࠎ̈́ଐჰ۞ܑ
னĂ̚˵Βӣ˞࣎ˠ۞ᗁঽᙯܼᄃಶᗁҖࠎ ( ּтତצ็ᗁᒚ۞௫ၚăٕࡗර֍ᙋົܫ व۞١Ꮾҕၗޘ )ĂЯѩ˵ົᇆᜩ࣎ˠ়ঽ
ந۞͞ё ( ֗វᜪ ) ̈́ଐჰܑன ( ͕நᜪ )Ą ЯѩĂԧࣇֶፂᓜԖ၁ϡ̈́௫ၚ۞҂ณĂͧΔ
᜕࡚ந෧ᕝĂĶីّᜪķࠧؠࠎĈĶቤྋঽ ˠ͕ីӧᕘ۞ᜪķߏޫ༊۞6ĄтѩĂΪܲ
˞Ķరࡍ࣎ˠፋវăЪ֭࣎ˠϠۏ͕நۤ
ົ̰உ۞Ϡࣧצז̒ᕘķ۞Ķ͕ីӧᕘķ5 ࠎᜪ۞ቑᘞĄٺѩĂĶីّᜪķ۞ቑಛྵব
ĂᓜԖ˯˵ͧྵटٽፆүć҃ԧࣇ˵Ξͽޭೇ
ז̂छͽـ௫ၚ۞ᄮۢ̈́˾ཱི -- Ķ͕֗ីķ۞Б ˠᜪĄтѩ៍ᕇᄃͽ؟ି៍ᕇ̈́Ѫ˸ଣ۰̝
Ķ؟ିᜪķߏځព̙Т۞Ăι۞ࢦᕇдٺϠ
ࣧ۞ЪĂ̚Βӣ࣎ˠ ( intrapersonal )ăˠ ᅫ ( interpersonal ) ̈́ҋԧ ( transpersonal ) ˬ࣎
ᆸࢬ۞Ъ7Ą
ݑ˚ॾႬᄮࠎីّߏՏ࣎ˠώ֗ಶѣ۞̰
дĂߏ়ঽೇࣧॡஎˢᄃሕд۞ࢦࢋྤĄ҃
MaslowኢˠᙷᅮՐ̝ᆸѨ۞Ķҋԧ၁னķ
̚Ă˵ᄮࠎՏ࣎ˠౌѣฟ൴ҋ̎ሕਕ۞้ШĂ҃
ីّӈߏˠᙷሕд۞ਕ˧Ăιхдٺ؟ି̝݈8Ą ᗁ᜕ˠࣶଂְঽଈីّᜪ̝ϫ۞Ă˜ᖣϤঽଈ
ᜪ̚Ăᒢྋঽˠ۞̙щĂણᄃ၆ĶϠ۞ຍ ཌྷᄃϫ۞ăԓ୕۞ຏᛇă̈́၆ҋ̎ᄃਕ˧۞ܫ هķ̝ଣĂᒢྋҋ̎۞๋च֭ଣ৶ࣧЯĂ྿ז Ω˘࣎Ԇፋ̈́πᏊĄ
ីّᜪ۞̰உ
ࡶࢋᄲБˠᜪĂ֤ᆃីّᜪಶߏι۞ૄ
Ϯ9Ąঽˠᜪ۞ૄώჟৠΒӣ˞Тந͕ăୂຏ
ّă̈́ΒटĂֱ˵ߏ೩͕̿ីπщ۞ࢦࢋ̍
Ą˘т Maslow ᛚˠᙷѣ̣۞ૄώᅮՐĂ
ֶጯ۰ଣĂˠᙷីّ˵ѣαᅮՐ1 0Ĉ˘ăߏ
ವĶຍཌྷķ۞ᅮՐĈঽˠΞͽགྷϤаᜪᄃ࠷ޥ ͽـགྷរֽ൴னຍཌྷĂࣇဘྏԱזᄃˠ۞
В఼ّć࿅̚གྷ૱ົ༥ז۞યᗟߏĈĶԧϨ߿
˞ĉķăĶࠎ̦ᆃߏԧϠ˞࣎ঽĉķăĶԧ۞
छˠڈ̓ߏިᆃຐԧ࣎ˠ۞ĉķĄᗁ᜕ˠࣶࢋ
ឰঽˠۢࣇߏࣃ۞Ă̙ߏЯࠎࣇ۞ј ಶĂ҃ߏࣇхд۞ώ֗Ąੵ˞ᄮΞ̈́ۺؠঽˠ
۞ᆊࣃĂᗁ᜕ˠࣶΞͽనڱםӄயϠឰঽˠĶޥ
৶ҋ̎Ϡ߿ຍཌྷķ ۞ᒖဩĂּтͽϠаᜪ͞
ёĂٕдᐌ፟ͷЪዋ۞ಞЪଐဩĂᒢྋঽˠЯࠎ ϫ݈۞়ঽ̈́ဩ˭Ăдᖚಞٕछल̚Ăߏӎய Ϡ˞າ۞֎Ғᖼតᄃາ۞ຍཌྷ̝ޥ҂Ą˟ăߏຏ צזኗྋᆵट۞ᅮՐĈವԱϠຍཌྷ࿅̚Ă ᙱҺົ࿃זཋೋຏ̈́ᑓྃ۞፟ົĂᗁ᜕ˠࣶืࢋ
ᄮᙊঽˠཋೋຏ۞ֽ֭םӄΝࣧኗٕזኗ ྋĂЯࠎ͔ጱฟु۞̍үώֽಶᅮࢋࣧኗ࿅Νă ତצ࣎ˠ֭كѩ̶ֳĄˬăߏຑ۞ᅮՐĈঽˠд జᜪ̚Ξͽຏצזజତצ۞ຏᛇĂ֭ͷᄮҋ ԧᆊࣃᄃᒔҋܫĂ҃ᗁ᜕ˠࣶυืጯ௫тңགྷ ϤТந͕̈́ࢦ࣎ˠ̰дᆊࣃ۞͞ёĂᄮ֭ۢ၆
ଐຏѣٙͅᑕĂТॡซˢࣇ۞Ϡ߿གྷរ̚Ą αăߏԓ୕۞ᅮՐĈԓ୕ߏˠᙷϠх۞পҒĂι జᄮࠎߏϠ۞̰д̮৵Ăߏˠ۞ௐ˟ϠĄι ೩ֻ࣎ˠϠ߿۞நϤĂ߿ޝр۞ຏᛇĂߏ֨
Ķ୕۞൭ࡴķ۞̍ĄЯѩ୕۞ˠົٸୢϠ
ߏޝЪந۞Ąᗁ᜕ˠࣶ̙ߏࢋΝ೩ֻ˘࣎۞
ԓ୕Ăҭдְ၁ࢬ݈ĂΞခᐽঽˠ᎕ໂгͽҋ̎
۞ܫهٕ؟ିΝჯԓ୕ĂЯࠎĶдজӃ۞୕
̚Ăˠ̙ົЯࠎצזࡴᙱ҃ഴऴĂҭϠ߿͌ຍ ཌྷᄃԓ୕ݒົឰˠऴķ11Ą
ីّᜪ۞͞ڱ
ፋវ҃֏Ăីّᜪ۞८͕ߏΡಓצ๋۰ҋ
ۢ ( self-awareness ) ۞ᒚ᜕͞ё12Ą҃ᗁ᜕ˠࣶី
ّᜪ۞ڼᒚ˧ณֽҋٺᄃঽˠ۞ాඕĂТॡ̶
ֳҋ̎۞צ᜕๋̈́གྷរĂҋ̎۞ऻᛵᄃ˧
ຏĂಉεᄃјܜĄֱాඕ̶ֳ࿅̚Ă้ă аᑕăሏ̈́ឰঽˠጾٱԓ୕ౌืࢋ఼ԫμĂ
ּтજ้ăྕᑗăྕ̈́ᒢྋঽˠাې̈́གྷ
።ඈඈĄдᜪ࿅̚Ă̙Ϊߏঽˠ̈́छᛳдࡴ
ᙱ̚ͽјܜĂᜪ۰˵ଂ̚ᄮᙊҋ֭̎ࢦາᑭ
ෛͽـԞ۞๋ஶĄ
Տ࣎ˠдᜪˠॡĂυืАᒢྋҋ̎۞
Ķ๋च̈́൭ķ֭ቚҋ̎тңҋԧវனĂ̚Β ߁ᗁ᜕ˠࣶώ֗ޝкΞ֍۞๋चᄃ˧ຏĂ֭А ଣᒢྋҋ̎۞๋˾ĄϤٺצ๋ᄃೇࣧ ( wound- ing and healing ) ώߏ˘វ۞Ăߏ࠹၆۞˵ߏكѩ
̢જπᏊ۞Ąᗁ᜕ˠࣶໂޘ۞˧ຏົౄј၆Т
ְٕঽˠᔳᖟّ۞ᇷ˧Ă҃࿅ޘࢦٺѩ๋च
ົౄј౫͢୕̈́՟ѣϠຍཌྷ۞ຏצĄڼᒚ۞
͞ёಶߏᖣϤഅགྷצ๋च۞ᗁ᜕Т̥ග̟ᑒӄĂ
֭צ๋۞๋ஶΞ֍̼ТॡΐͽෞҤĄᗁᒚˠࣶ
υืགྷ࿅ҋԧᄮᙊ̈́јܜጯ௫Ă̖ѣਕ˧ᄃঽˠ
ాඕ̶ֳ̈́Ą
ͽ˭ү۰ಶᓜԖགྷរᄃ͛ᚥಡӘ̚Ăтң ᄃঽˠాඕ̶ֳ̝̈́ࢦᕇၡࢋт˭Ĉ
˘ăᄃঽˠޙϲ։рᙯܼߏڼᒚ۞ௐ˘࣎ϫ ᇾĂѨ̖ߏયᗟ۞ྋՙĄЯࠎѣ։р۞ᙯܼ̖
Ξͽ൴೭ڼᒚ۞ड़ڍĄ
˟ăᜪॡĂᑕྍځϨঽˠߏӎᒢྋ়ঽΞ ਕֽ۞ࢦࢋᇆᜩĂּтണᅪăѪ˸ăछलགྷ ᑻă̈ޅᜪăҋ̎ืࢋˠᜪඈඈćтڍঽ ˠ̪ٺᔖ̙̈́ᙸࢬ၆ٕإϏତצ۞ӎᄮഇĂ ᑕםӄঽˠޘ࿅֭ซˢአዋĄ
ˬăីّхдٺϠ߿̚ՏІְଐĂӈֹߏ
̈۞ְĄι̙˘ؠᛳٺ؟ି۞ቑᘞĂ˵̙ߏϐഇ ঽˠ̖পѣĄঽˠٗม۞ҶཉĂ؟ିݡٕछᛳ ม఼۞၆ྖĂણᄃٕԩ١؟ି߿જĂౌߏ೩ֻ
ីّᜪ۞ྖᗟᄃಫ̬Ą
αăኡ̖ዋЪፉЇីّᜪ۰ĉঽˠಈᝌ ᄃѣ࠹Ҭࡦഀ̈́ˠϠವ۞ˠВТଣ৶યᗟĂವ ՐຍཌྷĂӈֹߏ၆ৠ۞ВТᘃႷĄЯѩĂ۞
ᜪ۰Ξͽߏᗁᒚဥฤјࣶ̚۞ЇңˠĂּтᗁ
᜕ăԠ̍ăٕۤ̍؟ିˠࣶĂٕᄃঽˠٕछᛳԸ ቡͷ͚ࣇ۞ˠĂтڈ̓ăछˠăٕૣ
۞ˠĄဥฤˠࣶᑕ̟ࢦĂឰঽˠѣҋᏴፄ۞
፟ົ ( т९ּ˘ᄃҁ͉͉ТฏͷԸቡ۞᜕̀ͧ
ˠࣶՀዋЪ̶ֳс͕ី۞ӧᕘ )Ąঽٗ྆Ă᜕
நˠࣶͧ؟ିˠ̀ՀዋЪ೩ֻីّᜪĂЯࠎঽ ˠѣᅮࢋॡĂ᜕நˠࣶᓁߏдௐ˘ቢͷᐌॡΞͽ ೩ֻםӄĂ҃؟ିˠ̀Ξਕѣপؠॡม۞ࢨט
ٕຽਕ˧۞યᗟ ( ኛણ҂९ּ˟Ăᒛাঽˠᙯ ڦ۞ߏˠϠຍཌྷ۞યᗟᄃ֗វֶᏥ۞ӧᕘĂ
؟ିरݒͽ࣎ˠຽ۞௫ၚྋᛖঽˠ۞ঽ൭˜
ຽᅪֹ )Ą
̣ă఼ԫμĈᑕͽୂຏ۞͕ڦຍঽˠଐჰ
۞ͅᑕ ( ཋೋຏă൏ᇋăϠঈăᇲຍăҽ႐Ąт ९ּ˘តຑࣵ ) ̈́ۤົ͕நયᗟ ( ӣঽˠă
ˠᄃᒖဩ۞ᙯܼ )Ăٕ֗វ̼ٱީĄְֱ
І۞ࡦޢགྷ૱ሕдីّ۞ӧᕘ ( ӈីّ൭Ąኛ ણ҂९ּˬĂঽˠ̰͕၆̄ϏጯрѣஎՔ۞ປ
ຏĂౄјঽˠ۞̙щć҃Ԡ̍۞ۢ̈́චຍ۞
щᇐ҃ͅౄј˞๋च )Ąঽˠ၆ĶϠăхдă צࡴăѪ˸̈́ܫЈ۞ኳႷķӈߏ͕ីӧᕘ۞ۡ
ତܑ྿Ą้ᄃ఼۞၁ચĂಶߏĶ ҡౖķ ᄃ Ķ̶ֳķĄĶҡౖķΞͽഴ͌࣎९జछᛳăڈ̓ă
ٕৠୢ۞ຏᛇĂ҃Ķ̶ֳķߏҋԧᄃˠ̈́
͵ࠧాඕࠎ˘វĄĶ ̶ֳķ ಶඈТĶ ҡౖķ ̈́ Ķઇঽˠ۞ڈ̓ķĂ˵ಶߏីّᜪ12ĄགྷϤ࿅
̚Ă̢࠹ᒢྋăЪүăࢦܑ̈́ϯᙯᘃ۞ਕ˧Ă тѩಶΞͽயϠϠ˧ೇࣧ۞˧ณĂಶߏីّ
۞˧ณĄ
̱ăᜪ۰ᑕٱ۞ၗޘᄃࣖநĈĶᙯᘃă ΒटăܫЇᄃࢦķߏីّᜪ۞८͕Ą೩ֻ
ᜪॡԧࣇᑕྍͽΒट۞͕ତצঽˠĂࢦՏ࣎ˠ
ౌѣ۞मளّ̈́ҋᝋĂдᙯຑᜪౖ̈́ҡ
˭Ăዮঽˠ۞ܫ͕֭ጾٱԓ୕̈́ѣຍཌྷ۞ຏ ᛇĂͽ྿ז͕ဩπಈሄ۞ϫ۞Ąтѩͽᜪމࠎ
͕̚Ăࢦঽˠ۞ᅮࢋĂ͌ᕇҋԧጱШ۞͔Ă
ഴ͌ᄲڇঽˠ۞ЋဦĂᔖҺઐጱ؟ି۞ᑅ˧ ( т ९ּ˟̈́९ּˬ )Ąѣॡ࣏Ă̙ืࢋࠎঽˠᄲ̦
ᆃٕઇ̦ᆃĂдҡౖ࿅̚ĂঽˠಶΞͽԱזҋ
̎۞ྮĄ၆ٺ՟ѣᏱڱᔖ۞ְ၁ĂĶᄮᄃ ତצķߏአዋυགྷ۞࿅Ą
˛ă͞ёᄃ̍ĈϠаᜪăࢰሄڼᒚăᄅ ᔏٕᘱ൪ڼᒚă۾ࢶڼᒚඈඈౌߏីّᜪٕܳ
ซ఼ᒢྋঽˠޝр۞̍Ą˵Ξͽචΐྻϡ
ԛវ۞͞ёĂּтࡆᘤăࣚຐăីّ͔ăஎ ᆸംᇊă̈́ܫЈᆇёཱིٕඈඈĄᜪ࿅̚Ă ԧࣇΞͽᖣϤೀ࣎યᗟᒢྋ࣎९ࣧѣីّ۞̰
உĂּтĶϠ̚അགྷѣ࿅ࢦࢋ۞ˠְķăঽ ˠĶࢦࢋ̶ֳ̈́ᏙྙˠϠຍཌྷ۞၆෪ķăĶߏӎ ຐ࿅Ϡຍཌྷ̈́ᆊࣃķăĶ؟ି၆Ϡ۞ࢦ
ࢋّķĄҭޝкॡ࣏Ăᗁ᜕ˠࣶΪࢋಏ৷۞ౖҡ ಶ֖ͽᑒӄঽˠז͕ី۞ှᐖĄΩγĂ၆࣎ˠ
̈́छल۞ᒢྋăග̟ခᐽ̈́֍ᙋă̶ֳӧᕘ̈́ಈ
ॆăٕ͔ܫЈ۞хдăٕԁචྻϡঽˠࡆᘤৡ
۞௫ၚٕপҾ؟ିᆇёඈඈĂౌѣӄٺ࣎ˠ͕
ី۞πщĄ
ˣă၆˘ਠ়ঽ҃֏Ăੵ֗វঽ൭γĂځϨ Ϡঽ၆ঽˠˠϠߏӎֽາ۞ຍཌྷĂ˵ߏᒢྋ࣎
९়ঽአዋ̈́ܫЈᆊࣃ۞͞ڱĄ
˝ă࣎ˠ۞ᆊࣃ̈́ၗޘߏજၗ۞Ąд়ঽ̙
Т۞ॡഇٕ̙Т۞ᚑࢦޘ˭ĂᅮՐ̈́វົ˵ົ
ᐌԼតĂЯѩ͕ីᙯᘃ۞ాඕᑕྍߏᜈ۞Ą
˩ăڱநॡĈ၆ٺҋԧ᜕ܲޝૻă̙ᙸ
̶ֳ̰͕۞ঽˠăٕᜪ۰൴Ϡͅொଐͅᑕ҃ຏ ז̙නڇ̈́ڱநҋ̎۞ីّયᗟॡĂᗁ᜕ˠ
ࣶᑕྍፍѣֱ֤Ξͽᖼ̬۞ຽĂ֭ග̟ዋ༊
۞ᖼ̬Ą
ಶώ͛ௐ˘࣎९ּ҃֏ĂഇޞĶـϠॡ˵
ਕצזிкᏐ̓۞ᘃهķ̈́Ķ̄ਕѝᕇඕķ
۰ᆊࣃ۞ࢦࢋّ̈́ৌ၁ّĂᄃсϫ݈ĶϠঽአ ዳķᐹАّ̝ͧྵĂੵ˞ืࢋώ˯ֽࣧᒢ ྋс۞ᄮۢ̈́ၗޘγĂᗁर˵ѣయЇӘۢϫ݈
়ঽߏӎтጨԖ֤ᆃᚑࢦĂߏӎ࿅ᇋ˞Ă̈́
ֽ֨̈́ઉܳซ۞͞ёĄ९ּ˟̚Ăࢳءϫ݈
ЯࠎĶ়ঽӧдঽԖķ۞൭ࡴ̈́ᎾᙷĶڼᒛड़ķ
۞୕҃ࢋՐщሄѪĂѩᄃˠିֈ၆Ϡ
۞ᆊࣃ̈́ၗޘ ( ីّ ) ᇆᜩѣᙯĄᜪࢦᕇੵ
˞ᒢྋᄃᒖဩᏐ̓۞ాඕĂ֭ϤϠགྷរ̚
ۺؠ࣎ˠᆊࣃ֭ᒢྋԓ୕γĂᗁ᜕ˠࣶΞ ͽГనڱᆧΐҋԧᜪਕ˧̈́ᆊࣃຏĄҭ၆ٺ
ྍЩ؟ିˠࣶĂᑕତצ࠹ᙯᜪ̝ቚĄ
ඕᄬ
၆ٺՏ࣎ˠјܜ۞࿅ĂϠߏԆፋ۞ٕߏ
୕ᕇ۞ᛉᗟĂؕᄃˠᙷҁ̼࿅̚ԱವϠ
ຍཌྷ۞ྮशߏ˘۞Ą࣎ˠܫه ( ٕৠ ) ˘
۞ຏᛇĂ̈́ᄃˠ۞ᏘΞͽֽ࣎ˠᏉԆ ႕۞ຏᛇĄՏ࣎ˠд࿃זࢦ̂क़Զ ( ּтࢦঽٕ
ണᆿ ) ٕҁ̼࿅ĂౌΞਕࢬ၆Ϡຍཌྷ۞П
፟ĂѩП፟˵ߏᖼ፟ć༊̙̙ࢬ၆ᚑࢦಉεт Ѫ˸ॡĂࡶࢋᚶᜈ݈ซĂಶυืጯົᄮᄃĶٸ
˭ķ ( let go ) ̈́ѣᄃҋТ̼۞ംᇊĄ ೩ֻ͕ីᜪߏ˘Іѣ߄ጼّ۞̍үĂТ ॡ˵ߏ˘Іѣаಡ۞̍үĄѣॡ࣏ົјΑĂѣॡ
࣏ΞਕεୀćҭιΞͽ႕֖࣎ˠ۞၁ኹĂ̙ኢߏ
̍ү˯ٕۤົᆸࢬĄϠ۞ຍཌྷགྷ૱̙ߏޝ
۞Ăҭಶညᇇ઼ࣰጯछκܚٙᄲ۞ĈĶ၆Ϡѣ ᘃႷ۞ˠΞͽٚצЇң۞ႷયķĄдԱವҋ̎۞
ីّ̝݈ĂЧҜΞͽАဘྏаඍͽ˭࣎યᗟĈ Ķಶ˘࣎ᗁᒚ᜕ٕநᜪ۰҃֏Ăԧߏኡĉķ
˘т࣎វ۞ࡼӴᄃҁĂីّ۞јܜߏ˘ዅ
̄۞ְĄԧࣇѣضдঽˠϠ়̚ঽࡴᙱ۞ॡ גĂග̟ঽা۞ቤྋᄃڼᒚγĂТॡᔘѣણᄃ
͕ីјܜ۞፟ົĄдᚮۋ፬ধᓾՐјड़۞ᗁᒚથ ಞ̚ĂϤٺϠх۞ᑅ˧Ăԧࣇբբᒉᒉٺᄦౄᒻ ड़Ăٕధԧࣇழن˞ঽĶˠķ͉˳˞Ą༊ѩᗁᒚ
ࠧᄃ᜕நࠧϒሤਾٺБˠᜪ۞ѩॡĂϒߏΐૻ
ីّᜪ۞ࢦࢋॡ፟Ăԓ୕ώ͛၆ٺѣԠٺˠّ
̼ᜪ۞ᗁ᜕ˠࣶਕѣٙӄৈĄ
ણ҂͛ᚥ
1.ՆځጙĄኘីّĄ᜕நᗔᄫ 2003; 50: 81-5.
2.ՆځጙĈኘីّᜪĄ᜕நᗔᄫ 2004; 51: 78-83.
3.Wink P, Dillon M. Religiousness, spirituality, and psychosocial functioning in late adulthood: findings from a longitudinal study. Psychol Aging 2003; 18: 916-24.
4.Speck P. Spiritual issue in palliative care. In: D. Doyle GWC ed.
Oxford Textbook of Palliative Medicine. 2nd ed. Oxford: Oxford University Press, 1998: 805-14.
5.Tu MS. Illness: an opportunity for spiritual growth. J Altern Complement Med 2006; 12: 1029-33.
6.North American Nursing Diagnosis Association. NANDA Nursing Diagnoses: Definitions & Classification 2001-2002.
Philadelphia: NANDA, 2001: 175-7.
7.Reed PG. An emerging paradigm for the investigation of spiri- tuality in nursing. Res Nurs Health 1992; 15: 349-57.
8 . B a m b e r y J K . S p i r i t u a l i t y a s a h e a l i n g f o r c e . I n : S . Ronaldsoned.Spirituality: The Heart of Nursing. Melbourne:
Ausmed 2000; 60-77.
9.Parran L. Spiritual care is elemental and fundamental to the heart.
ONS News 2003; 18: 4-5.
10.Schoenbeck SL. Called to care: Addressing the spiritual needs of patients. J Pract Nurs 1994; 44: 19-23.
11.Bush T. Spirituality in care. In: S. Ronaldson ed.Spirituality: The Heart of Nursing. Melbourne: Ausmed 2000; 78-97.
12.Ronaldson ed. Spirituality: The Heart of Nursing. Melbourne:
Ausmed 2000; 4-21.
Clinical Application of Spiritual Care
Ming-Shium Tu
Spirituality is an innate part of human. It will emerge out of people's attitude and behavior during individu- al's daily activity, especially when in confronting with a significant distress or loss. Spiritual growth is the promot- ing of one's spiritual strength through both the process of adaptation to the sufferings and the searching for the meaning of life. It helps people integrate their attitude of life and accomplish their meaning of life. In the practice of patient care, especially in front of severe or chronic disabling disease, patient's illness care plan, emotional anxiety and depression are all related to individual's attitude during the course of disease adaptation. In the pro- cess of medical or nursing education, we have been frequently mentioning the holism, but we are still accus- tomed to the disease management and, sometimes, psychological pacification. The spiritual care is yet insuffi- cient. This may be due to the ambiguity of the definition of spirituality and the uncertainty of the scope of spiritu- al care. This article demonstrates the significance of spirituality during one's trajectory of disease adaptation, and illustrates the contents and method of spiritual care. This article will be helpful to both the promotion of holistic care in medicine and the physicians and nurses devoted to a humanistic care. ( J Intern Med Taiwan 2008; 19:
318-324 )
Department of Family Medicine, Palliative and Hospice Care, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
