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A Research of Clinical Sociology on the Process of Dying and Listening in the Terminal Care of Cancer Patients

癌症临终关怀中临终与倾听过程的临床社会学研究

基本信息

批准号：
14510186
负责人：
OKUYAMA Toshio
金额：
$ 1.54万
依托单位：
University of Tsukuba
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2002
资助国家：
日本
起止时间：
2002 至 2004
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-14510186/
关键词：
Terminal Care Medicalization Dying Process Listening Good Death Individual Death Medical Sociology

项目摘要

Terminal Care has become one of the important special fields of medical care. It makes out it's own subject of medical control as dying process. This Research investigates how terminal care makes out the dying process as social and psychological one and how it controls this process. It analyzes narratives of cancer patients in the terminal care settings and gets important findings. First, it makes clear the characteristics of the social relations of dying patients to doctors, nurses, families and other peoples. It discusses the way how dying patients cope with their identity crisis in front of death in the context of those social relations. Second, the listening by doctors, nurses and families has influence upon dying patients. It encourages them to accept their own death and to find the meanings of their own life. So dying process is normalized as ideal pattern, ‘good death', which is made by terminal care professionals. Third, dying patients can barely recognize their own individual death by narrating personal experiences. Doctors, nurses, families and other people, these listeners around dying patients have expectation of dying role in advance under the influence of psychological knowledge, typically the five stage model of Kubler=Ross. They fix their therapeutic gaze on the inner subjective worlds of dying patients by listening. The inner worlds of dying patients are cast by narrative-listening communication and controlled by medical care. The establishment of terminal care as special fields of medical care means further expansion of medicalization.

临终关怀已成为医学护理的重要专业领域之一。它将自己的医学控制主体定位为死亡过程。本研究探讨临终关怀如何将死亡过程视为一个社会和心理过程，以及如何控制这一过程。它分析了晚期护理环境中癌症患者的叙述，并得到了重要的发现。首先，明确了临终病人对医生、护士、家属和其他人的社会关系的特点。它讨论了临终病人在这些社会关系的背景下如何应对死亡面前的身份危机。第二，医生、护士和家属的倾听对临终病人有影响。它鼓励他们接受自己的死亡，并找到自己生命的意义。因此，死亡过程被规范为一种理想模式，即由临终护理专业人员制定的“善死”。第三，临终病人通过叙述个人经历，几乎无法认识到自己的个体死亡。医生、护士、家属等人，这些临终病人身边的听众，在心理知识的影响下，对临终角色有提前的预期，典型的是Kubler=Ross的五阶段模型。他们通过倾听，将治疗的目光固定在垂死病人的内心主观世界上。临终病人的内心世界由倾听叙事的沟通塑造，由医疗护理控制。临终关怀作为特殊医疗领域的确立，意味着医疗化的进一步扩大。