- 期刊
癌症末期住院病人自述需要的探討
The Perceived Needs of the Hospitalized Terminal Cancer Patients
摘要
本研究屬於描述性研究，在東部某教學醫院，立意取樣選取醫師確定只接受緩和治療，且ECOG performance score 3分以上的病人為個案。收案期間從民國84年6月15日至12月31日。研究者以護理人員角色，參與病人照顧，以半結構問題為導引，採深度會談法收集資料。共有十四位個案完成訪訪談資料以敘述體記錄整理，內容分析法進行分析。結果歸納出癌症末期病人自述身體問題有十九項，前四位依序是疼痛、食慾不振、嘔吐及睡眠型態紊亂。情緒反應則包括過一天算一天、擔心被遺棄及沮喪、無助、無望與自棄，而不確定感是情緒變化的誘因。自述需要有:釋疑、症狀控制、維持適當活動、傾吐與被人瞭解、親情溫暖與關懷、討論死亡、在家死方及找尋人生意義等九項。依據研究結果。發展出病人不確定感引發情緒反應的概念架構，提供護理人員瞭解癌症末期病人住院期間照護需要之參考，做為發展本土化癌症末期病人照護模式之藍本。(慈濟醫學1997;9:295-305)
並列摘要
This purpose of this study aims was to investigate the perceived needs of the terminally-ill cancer patients. The study was performed in a teaching hospital in the eastern region of Taiwan. Subjects were selected by purposive sampling of patients who received only palliative treatment as determined by their physicians, and whose ECOG performance scores were higher than 3. All subjects were recruited from June 15 to December 31, 1995. The researcher played the role of a nursing staff member and participated in patient care. Data collection was conducted through by in-depth interviews using semi-structured questions. A total of 14 patients completed the interview and the data were compiled and subjected to content analysis. The results concluded that of 19 physical problems were highly characteristic of terminally-ill cancer patients. The top four in order frequency were : pain, lack of appetite, vomiting and irregular sleeping patterns. Their emotional responses include : feelings of subsistencel, ignoring the illness, worry of abandonment, depression, helplessness, hopelessness and denial. A sense of uncertainty was the perceived cause of emotional changes. Needs described by the patients included : reassurance, control of symptoms , maintaining normal activity, sympathy understanding, love, warmth and concern, discussin the topic of death, dying at home and understanding the meaning of life. Based on the study results, a conceptual framework of patient’s emotional response induced by a sense of uncertainty was outlined and a process of relieving doubts and symptom control was proposed. The conceptural framework may provide nursing staff with a useful reference to understading the needs of the hospitalized terminally-ill cancer patients and serve as blueprint for developing a care model for thes patients. (Tzu Chi Med J1997;9:295-305)