- 期刊
照顧一位肺癌末期病人身心調適之護理經驗
Nursing experience of physical and mental adjustment in caring for a terminal lung cancer patient
摘要
本文描寫一位被診斷為肺癌末期中年之男性，因離婚且無家人陪伴，難以接受病情、不確定感，並且同時造成身心衝擊之護理經驗。照顧期間自2021年4月30日～2021年5月13日，以羅氏適應模式針對個案進行生理、心理、社會及靈性四大層面評估，並藉由會談、觀察、身體評估及查閱病歷等方式收集資料，確立個案健康問題有：（一）身體心像紊亂與放射治療副作用有關；（二）營養少於身體需要與食慾不振有關；（三）無望感與治療、疾病進程有關。住院期間藉由個別性護理措施及醫療團隊介入，合併營養需求及皮膚照護，不僅成功解決個案生理問題，使協助擺脫負面情緒，讓個案願意融入人群；並運用關懷、傾聽、支持、陪伴、同理技巧，協助個案表達自己對生命的接受度，運用生命回顧法，與個案一同緬懷過去，協助接受身體改變的事實，改善其心理無望感；偕同安寧護理師、社工及宗教的力量，撫慰個案之靈性困擾，找到心靈上的依歸，使其重新肯定自我，找回生命價值。建議臨床癌症末期病人的照護，以健全照護指引及評估工具，再者運用跨團隊人員合作，提供資源及專業課程，使護理人員在專業照護品質提升，藉此落實全人護理。
並列摘要
This article describes the nursing experience of a middle-aged male diagnosed with terminal lung cancer. Given his divorce and lack of familial support, he grapples with the challenges of accepting his prognosis, navigating uncertainties, and concurrently enduring the psychophysical impacts of the illness. During the caregiving period from April 30, 2021, to May 13, 2021, a comprehensive assessment was conducted using the Roy Adaptation Model to evaluate the physiological, psychological, social, and spiritual dimensions of the individual. Through methods such as interviews, observations, physical assessments, and medical record reviews, data were collected to identify the following health issues for the individual: (1) Disruption in body image related to the side effects of radiation therapy; (2) Inadequate nutrition linked to anorexia; and (3) Feelings of hopelessness associated with the treatment and disease progression. During the hospitalization period, through individualized nursing measures and medical team interventions, combined with nutritional needs and skin care, not only were physiological problems successfully addressed, aiding in overcoming negative emotions for the individual, but also encouraging their willingness to integrate into society. Utilizing care, listening, support, companionship, and empathetic skills, the approach assisted individuals in expressing their acceptance of life. Life review techniques were employed, allowing individuals to reminisce about the past, helping them come to terms with the reality of bodily changes and improving their psychological sense of hopelessness. In collaboration with palliative care nurses, social workers, and religious support, the spiritual distress of the individuals was alleviated, providing a sense of spiritual belonging and reaffirming their self-worth. It is recommended that the care of terminally ill cancer patients be guided by comprehensive care guidelines and assessment tools. Furthermore, collaborative efforts involving interdisciplinary teams should be employed to provide resources and professional training, enhancing the quality of nursing care. This approach aims to implement holistic care, ultimately contributing to the overall well-being of the patients.