肺癌是一種高致死率的癌症之一,在末期患者身、心皆受到極大衝擊。目前,國內外文獻中尚未對肺癌末期住院病患主觀經驗做進一步探討。本研究目的是探討一位肺癌末期病入院接受治療所面臨的壓力源及其因應策略。採用田野研究法,以連續性參與照顧,將所觀察語言及非語言的行爲寫成過程實錄共十一篇,並予內容分析整理歸納。結果發現病患所面臨壓力源-身體疼痛、呼吸困難、身體功能減弱、缺乏安全感;以及所採取因應策略-自我解釋、主動尋求改善策略、拒絕、祈求解脫、屈就命運。在整個過程中,護理人員藉由深入體認病患主觀經驗,且不斷將壓力理論運用於護理照護,來緩解病患再度住院之衝擊,更加呈現護理人員在醫療照護體系之功能和重要性。
Because lung cancer ranked as the most fatal among all forms of cancer, patients suffer both tremendous physical and psychological conflicts in their terminal stage of the illness. Advance discussion about patients’ self-perception were not found in the literature. The objective of this study was to investigate the stressors and coping strategies of one hospitalized patient with terminal stage lung cancer. Field study method was applied. Data were collected through nursing process recording, and then analyzed using content analysis. Results showed stressors included physical pain, dyspnea, loss of physical function, and sense of insecurity. The coping strategies included self- explanation, seeking for effective strategies, refusal, praying for extrication, and being under the constraint of fate. Nurses should realize the stressors that patients face and the coping strategies they use. Thus, more appropriate nursing care could be provided to help reduce the patients’ stress produced by the disease to promote patients’ quality of life.