一位肺癌末期個案面臨死亡焦慮之護理經驗

The Experience of Nursing Care for a Terminal Lung Cancer Patient with Death Anxiety

藍蕙娟(Hui-Chuan Lan) ； 謝春金(Chun-Chin Hsieh)

《長庚護理》 26卷1期 (2015/03) Pp. 91-100

https://doi.org/10.3966/102673012015032601009

摘要

本文描述一位62歲男性，罹患肺癌末期更面臨到因疾病過程無法預測而產生死亡焦慮之護理經驗。護理期間自2012年05月29日至06月15日，藉由整體性評估、觀察及會談方式，收集身、心、社會與靈性層面等資料，加以分析並歸納出個案有呼吸道清除功能失效、死亡焦慮及家屬意識到個案將不久人世而有哀傷之健康問題。以Waston關懷照護理論為基礎，對於呼吸道清除功能失效健康問題採取相關護理措施，包括噴霧治療以降低痰液黏稠度，並鼓勵運用深而緩慢的腹式呼吸及用力咳嗽以促進痰液排出。而在面臨死亡焦慮時，透過護理人員的陪伴與支持，引導個案及家屬說出內心真實感受，藉由家庭討論會，鼓勵個案說出未完成的心願，並協助家屬盡快安排完成。另提供家人支持系統，協助以正向態度來面對哀傷過程。期望藉此護理經驗的分享，作為往後護理此類病人的參考。

關鍵字

肺癌 ； 死亡焦慮 ； 哀傷

並列摘要

This article described the nursing experience on a 62 year old male with terminal lung cancer, who suffered from death anxiety due to unpredictable disease process. The nursing period was between May 29, 2012 and June 15, 2012. Through methods of holistic assessment, observation and interview, we collected data from physical, mental, social and spiritual dimensions. We analyzed these data and summarized that this patient faced problems such as failure of cleaning function in respiratory tract, death anxiety, and the sadness family members because of awareness of the patient will be numbered. Based on Watson care theory, we managed the problem of failure of cleaning function in respiratory tract with corresponding nursing measures in the nursing process. These nursing measures included aerosol therapy to decrease sputum viscosity, encouraging the use of deep and slow abdominal breathing, and forceful coughing to facilitate sputum discharge. About facing death anxiety, we leaded the patient telling the true feelings inside through the nursing staff's accompany and support. We also arranged family seminars, encouraged the patient speak out the unfinished wishes, and assisted family members to complete them as soon as possible. In addition, we provided the family members support systems for assistance in positive attitude to face the grieving process. We share this nursing experience and expect it as a reference for care of terminal-illed patients in the future.

並列關鍵字

lung cancer ； death anxiety ； sadness

參考文獻

王蔚芸、王桂芸、湯玉英(2007)。焦慮之概念分析。長庚護理。18(1)，59-67。

李秀如、陳美碧、蔡欣玲(2008)。癌症個案生病經驗及對精神科護理照護之反應。醫護科技學刊。10(3)，197-207。

李皎正(2007)。關懷照護。台北市=Taipei City, Taiwan, ROC:永大。

沈孟璇、陳海焦(2011)。一位白血病患者移植後復發面對死亡焦慮之護理經驗。長庚護理。22(2)，267-274。

徐香景(2008)。提升滿足臨終病患靈性需求之介入策略。諮商與輔導。275，5-12。