音樂治療與緩和療護
Scroll down for English!
文/ Lisa
今天敲敲帶大家來一窺音樂治療在緩和療護的應用，歡迎交流分享👇🎶
🕊️什麼是緩和療護？
緩和療護（Palliative Care, PC）由經過訓練的醫療團隊提供給診斷為重大疾病的病患，PC的終極目標是提升病人與家屬的生活品質，從生理、社會心理、精神屬靈層面，全面地舒緩因疾病造成的苦難。PC在疾病的任何階段都能發會效用，並不只限於疾病末期或臨終，病人可能同時接受治癒性治療（curative, disease modifying treatment）及緩和療護。
PC團隊由特殊受訓的醫師與護理師（nurse practitioner）作為核心成員，依各醫院不同，延伸的成員常有社工、營養師、疼痛控制專長人員、各類治療師、藥劑師、醫院牧師等。在緩和療護中，以病人為本，病人的意願主導治療方向，因此PC團隊需要與病人及家屬做全面且完善的溝通，提供充分醫學知識與社會心理支持，協助並尊重病人的意願與醫療決策。
很多時候，會診（consult）PC的原因是釐清照護方向（goals of care），團隊除了需要以病人能理解的口吻清楚描繪病情、可能的治療選項及預後，也需要頻繁與家屬、主治及專科醫師、當值護理師、個案管理人（case manager）、安寧機構聯絡人等參與病患照護的各類人員溝通個案現況。另一個常見的會診原因是症狀管理，例如疼痛、噁心嘔吐、疲憊虛弱等。
🕊️緩和療護與音樂治療
🎵個案評估資料來源：
🌼二手資料：醫療紀錄、PC團隊、當值護理師、醫師、家屬
🌼一手資料：治療中持續評估個案狀態
🎵可能治療目標：
🌼提供病患及家屬社會心理支持。
例如：減緩焦慮、提供表達抒發管道、幫助自我覺察、自身想法與感受的梳理與驗證（validation）、促進病人與親友間的正向互動與親密時光、提升生活品質、賦權、協助對失去的應對
🌼提升、維持認知功能與定向。
例如：透過聽覺、觸覺刺激提升昏迷中病人的喚醒程度
🌼改善、緩解身體症狀。
例如：穩定生命體徵（如降低血壓、提升血氧量、調節心率與呼吸率）、降低疼痛感以達到疼痛控制、協助放鬆、程序支持（如：拔管）
🎵可能的介入方式：
🌼接受式：音樂協助放鬆、病患取向的現場音樂協助症狀控制
🌼創作式：詞曲創作、遺作創造、專輯創作、心搏歌錄製
🌼再創式：歌詞分析與重寫、歌曲討論、治療性歌唱、樂器教學與玩奏
🌼樂器即興
♥️對待的不只是病，更是人
♥️有任何新的想法，歡迎與我們交流分享！
Amidst pain, embracing solace
English Translation/ Zoe
❓What is Palliative Care(PC)?
PC is a group of patients with critical illnesses diagnosed by a trained medical group. The ultimate goal of PC is to improve the living quality for both patients and their family from physical, psychosocial, and spiritual perspectives, and alleviate the pain and suffering from the illnesses. PC is not limited to the last stage of a certain diagnosis or hospice care. Instead, patients can possibly receive curative, disease modifying treatments and PC simultaneously.
The core members of a PC team are made up of doctors and nurse practitioners with specialized training. Different organizations have extended teams including, social workers, nutritionists, pain management specialists, various therapists, pharmacists, hospital chaplains, etc. PC is a patient-oriented medical service. Patient’s opinions and wills lead future treatments. The medical team not only provides sufficient medical knowledge and psychosocial support, but also assists and respects patient’s wills and medical decisions. Therefore, integrative and thorough communication between patients, family and the PC team are highly important.
The reason for consulting the PC team is to clarify the goals of care. The team will need a clear description of their own illnesses, possible medical options,and prognosis from patients, and constantly communicate patients’ current conditions with family, attendings, specialists, nurses on shift, case managers, hospice organization contact, etc. whoever participates in patients’ care. Another reason to consult a PC is symptom management. For example, pain, nausea, vomiting, weakness, fatigues, etc.
🕊️ Palliative Care and Music Therapy
🎵 How do we assess clients?
🌼2nd-hand resources: medical records, PC team, on-shift nurse, and family
🌼1st-hand resources: ongoing assessing clients’ conditions
🎵 Possible treatment goals:
🌼Provide clients and family psychosocial support. Ex. alleviate anxiety, provide an emotional outlet, assist self-awareness, organize and validate clients’ thoughts and feelings, improve the positive interaction and intimacy between patients and families.
🌼Reinforce and maintain cognitive function and orientation. Ex. Increase the arousal of comatose patients via auditory and tactile stimulation
🌼 improve and alleviate physical symptoms Ex. stabilize vital signs(e.g. Decrease blood pressure, raise blood oxygen, regulate heartbeat and respiratory rate), alleviate pain to manage pain, assist relaxation, procedure support(e.g. extubation)
🎵Possible interventions:
🌼Receptive: music assists relaxation, patient-oriented live-music to assist symptoms management.
🌼Creative: lyric and music composing, legacy creation, album production, music recording with heart pulse
🌼Re-creative: lyric analysis and re-write, song-discussion, therapeutic singing, musical instrument learning and playing
🌼Music improvisation
We are not only treating the illnesses, but HUMAN!
Let us know if you have any thought!
#音樂治療 #臺灣音樂治療 #敲敲音樂治療 #舒緩療護 #跨領域團隊 #全人照護 #人本 #以人為本 #社會心理 #症狀管理 #疼痛控制 #安適 #音樂 #musictherapy #musictherapytaptalk #taiwan #palliativecare #interdisciplinary #goalsofcare #psychosocial #symptommanagement #comfort #support #family #music
Comments