協助一位結腸癌末期個案面對死亡焦慮之護理經驗

本文描述一位結腸癌末期個案面對死亡焦慮之護理經驗。護理期間為2012年12月27日至2013年01月11日。期間透過陪伴、會談及觀察家庭互動方式，作身、心、社會、靈性層面的整體性評估，確立個案的健康問題有疼痛、失眠和死亡焦慮。運用團隊照護模式，筆者利用熱敷、舒適臥位有效減緩疼痛，並藉飲食指導滿足個案進食的需求。營造居家睡眠環境、調整夜間護理活動及給藥方式改善失眠問題。針對死亡焦慮，筆者觀察個案雖是一般民間信仰，但認為上帝和菩薩都是愛人的，且不排斥禱告和唱詩歌，所以協同醫師於查房時，為其禱告、吟唱詩歌，使心靈有所寄託，引導生命回顧肯定人生的意義並協助達成心願。最後個案1/11出院後由安寧居家持續追蹤，1/19案夫電話告知個案在家人陪伴下於家中往生。此護理經驗可作為護理人員於臨床照護癌末病人面對死亡焦慮時之參考。

關鍵字

死亡焦慮；疼痛；失眠

並列摘要

AbstractThe paper described a nursing experience of a patient suffering from death anxiety during the terminal phase of colon cancer. The nursing period was from December 27, 2012 to January 11, 2013. Through compressive evaluation, accompany, consultation as well as observation of family interaction, we collected the data on physical, psychological, societal, and spiritual aspects of this patient and identified the following nursing problems, including pain, insomnia, and death anxiety. A model of interdisciplinary team was applied. During the nursing period, pain was eased by hot packing and comfortable position, and the dietary need was met by dietary instruction. The problem of insomnia also improved through developing a home-like environment, adjusting nursing routine and the routes of administration. To relieve the patient’s death anxiety, we noticed that patient did not reject prayer nor chant because she believed that both God and Avalokiteśvara are kind even though the patient had folk religion. Therefore, we prayed and chanted with the patient, guided life review, provided positive feedback to the meaning of life, and made the patient’s dream come true. The patient was under follow-up after discharging on January 11. According to the patient’s husband, we were told that the patient passed away at home with family accompany on January 19. The nursing experience could serve as a reference for nurses caring for patients suffering from death anxiety during the terminal stage.

並列關鍵字

Death anxiety ； Pain ； Insomnia

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