照護一位肺癌末期併骨轉移個案之護理經驗

Nursing Care Experience of a Terminal Lung Cancer Patient with Bone Metastases

許姿均(Tzu-Chun Hsu) ； 吳慧絹(Hui-Jiuan Wu)

《腫瘤護理雜誌》 19卷增訂刊 (2019/03) Pp. 111-122

https://doi.org/10.6880/TJON.201903/SP_19.10

摘要

本文探討一位肺癌末期個案之照護經驗，筆者照護期間為2016年1月4日至2016年2月21日，透過觀察、面談直接照護等方式收集資料，以生理、心理、社會及靈性四大層面進行整體性評估及分析，確認住院期間有：低效性呼吸型態、疼痛及焦慮之健康問題。照護過程中筆者以噘嘴式呼吸及半坐臥的舒適臥位來幫助肺部擴張、適當的給予氧氣療法，並運用小電扇來增加空氣對流循環，降低呼吸喘感受，使個案能執行部分日常生活活動功能。疼痛處置：採取芳香療法可讓病患心靈安定使肌肉放鬆、按摩治療及撫摸治療以緩解疼痛壓力，並合併止痛藥物使用來緩解疼痛不適，使疼痛指數由10分降至5分。透過傾聽與陪伴及生命回顧方式讓家人跟他道謝，完成遺願向家人道愛，使個案在生命終了前製作了18張生日卡片給寶寶及錄了祝福影片給寶寶，公司方面也安排妥當，由案妻繼續經營公司運作，使家人生活無慮，讓他減少焦慮放心離世。藉此照護經驗分享，讓臨床護理人員在面對病患及家屬因癌末所導致之身心靈不適時，可給予個別性的護理措施，使護理人員獨特角色功能得以發揮。

關鍵字

肺癌末期 ； 疼痛 ； 焦慮

並列摘要

This article aims to explore the nursing experience of a terminal lung cancer patient with bone metastases. The authors collected data from January 4, 2016 to February 21, 2016 and identified chronic pain and anxiety as the major nursing problem through observation and interviews in the physical, psychological, social and spiritual aspects of the overall health assessment. After learning the patient's level and types of inefficient breathing through detailed physical assessment, we provided oxygen prescribed by the doctor and a small fan to increase the air circulation; we provided analgesic medication and used aromatherapy with massage to relieve muscle tension and relax the patient, which effectively eased the pain. By proactive accompanying and caring for the patient, as well as encouraging the patient to express his feeling, we helped the patient to realize the meaning and value of life. This article can be used as a reference for future care of similar patients.

並列關鍵字

Lung cancer ； pain ； anxiety

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