本文探討一位年輕病人罹患肺癌末期的護理經驗。護理期間自2019年2月11日至3月2日止,護理期間筆者運用Gordon十一項健康功能評估,藉由直接照護、會談、觀察、身體評估及病歷查閱等方式,收集病人身、心、社會及靈性各層面資料,確立主要健康問題有低效性呼吸型態、疼痛及死亡焦慮。筆者在照護期間與病人建立護病關係,協助呼吸訓練及舒適擺位,改善呼吸功能通暢;教導家屬學習按壓穴位及按摩技巧,讓病人放鬆肌肉神經且轉移注意力以舒緩疼痛感受;並透過醫療團隊介入協助病人與家屬在生命末期,規劃生命的最後旅程,讓病人達到善終。建議醫療團隊在病人診斷末期時善用安寧醫療,儘早介入關心,以建立良好友善的關係,在有限的時間協助病人做好準備及面對死亡。
This article discusses a midlife patient care experience of terminal lung cancer who is at risk of sudden death at any time due to rapid deterioration of the disease. In addition to physical discomfort, at the same time to face the fear of death. During February 11th to March 2nd, 2019, a comprehensive assessment was made on the physical, psychological, social, and spiritual status of the patient during the hospitalized period using observation, interviews, empathy, physical assessments as well as Gordon's 11 functional health patterns evaluation. It was confirmed that the patient had been suffering from problems such as ineffective breathing patterns, pain, death anxiety. Through the nursing processes, Use drugs to relieve breathing difficulties and pain, Use a fan to relieve tachypnea, Teach acupoint massage to relieve discomfort during nursing. It is recommended that the medical team can make good use of palliative care at the end of the patient's diagnosis, intervene in care as soon as possible, to establish a good and friendly relationship, and to assist the patient to prepare and face death within a limited time.