本文是探討一位罹患肺癌合併骨骼轉移的中年婦女,接受人工髖關節置換手術期間所面臨的身體不適、內心的焦慮與對死亡的恐懼。護理期間自96年8月22日至96年8月28日,筆者運用Gordon十一項功能性健康評估模式,及病史收集、身體檢查、觀察、會談與病人溝通互動,收集主、客觀資料,確立個案有:焦慮、哀傷、疼痛、身體活動功能障礙等護理問題。照護過程中,筆者運用提供舒適護理措施及疼痛控制技巧,與個案及家屬建立的良好互動關係,針對個案需求予個別性及獨特性護理計畫及衛教,使其能勇敢面對手術,且進一步配合治療、接受復健,使其早日恢復活動功能,回到日常生活;再者,筆者更以主動關懷、傾聽、陪伴等方式,幫助個案面對死亡的恐懼,並鼓勵個案與其家屬勇於表達對死亡的看法,以減輕哀傷反應,也期望藉此經驗,提供護理人員遇到相同個案時能兼顧身心靈照護之參考。
The article describes a nursing process of a lung cancer with bony metastases patient receiving total hip replacement. Communications, interviews, chart reviews and the Gordon 11 functional assessment tool were applied to collect subjective and objective data from August 22 to August 28 in 2007. The patient was confronted with anxiety, grieving, acute pain, and impaired physical mobility. During the nursing process, individualized nursing care provided by giving pain-released methods and offering a project of rehabilitation excises to recover patient’s mobility. In addition, caring, listening and accompanying were provided to assist the patient facing the fear of death and to reduce responses from grieving. This nursing experience of holistic care may be shared with other healthcare professionals. It is expected the nursing staff can not only develop nursing intervention to decrease physically discomfort but also improve psychological distress for patients with the same suffering.