The Research For The Existential State Of Terminal Cancer Patients And The Revelations To The Medical Social Work

With the development of Chinese health care reform, medical social work is becoming an overall service. The most important thing to the social worker is offering palliative care with the medical group and the volunteer organization. The existentialism concentrates on the people’s existence and focus on the living circumstances. The analysis to death from the existentialism could give social worker useful revelations and theory guiding in offering palliative care.Therefore, this research describes several cases to find the terminal cancer patients’ real existential state, concluding the awareness of self-existence, the definition of the life meaning, the expression of death anxiety, the mechanism of responsibility and bad faith, the passion and maintenance for dignity. And with the analysis from existentialism theories, useful guiding for local social work can be found to improve patients’ existential state. It must be good and suggested for social work practice.Participant observation, semi-structured interview are used in this research. The author had been accompanied with the patients, their families and the medical staff for 7 months, and also made thoroughly interview with patients and their caregivers. After summarized and inductively analyzed all these primary data, the author find the patients have weak existential state:1. The terminal cancer patients’ self-existence is low for the internal and external causes; 2. Every patient has different definition of the life meaning, and most of them lack the awareness of meaning; 3. The patients feel death anxiety and are anxious of being themselves, but they deny death fear. And the existential state is badly fettered by the outside word:1. Most of the patients have strong responsibility for their families, resultantly the guilt makes them not to change; 2. The patients are desire for dignity, but people always neglect their needs; 3. Chinese care make patients lose their true existence.Finally, based on the findings, the author presents the "existential state cyclical improve model". The model has five cyclical steps:fell the existential state-understand the existential meaning-catalyze the Chinese awakening experience-over think the existential meaning-change the existential meaning. And the model can be useful to the palliative care for medical social workers.