照顧一位肝移植術後重生再次面臨胃癌末期瀕死之護理經驗

Caring for a Liver Transplant Recipient Faced with Dying from Gastric Cancer

鍾佳琳(Chia-Lin Chung) ； 孫凡軻(Fan-Ko Sun)

《高雄護理雜誌》 30卷2期 (2013/08) Pp. 84-94

https://doi.org/10.6692/KJN-2013-30-2-8

摘要

本文描述一位個案成功接受肝臟移植手術後，卻再被診斷為胃癌末期，面臨瀕死的護理經驗。護理期間為2009年4月1日至2009年4月9日，筆者經由會談、觀察等方式收集資料，運用羅氏模式的生理模式、自我概念、角色功能及相互依賴，做整體性的護理評估，確認個案主要的健康問題為營養狀況改變、慢性疼痛、預期性哀傷等護理問題。護理過程中提供適當的飲食維持足夠營養，利用按摩技巧、深呼吸運動及放鬆療法減緩個案生理上的疼痛，鼓勵個案訴說心中的感受、提供個案情緒支持、讓個案學習及面對接受死亡的事實。此外，會同家屬一起參與個案最後的人生旅途，幫個案完成最後的生日慶祝，使個案達到身、心、靈的滿足而無遺憾的離開人世。

關鍵字

肝臟移植 ； 胃癌 ； 瀕死 ； 癌症末期

並列摘要

This article describes a nursing experience of caring for a patient who was a successful liver transplant case after surgery, but then faced the risk of dying from gastric cancer. The nursing period was from April 1, 2009 to April 9, 2009. The data was collected through the author's conversations, observations, and other methods. Roy's model was used to assess the physical model, self-concept, role function, and interdependently confirmed cases included major health problems from the change in nutritional status, chronic pain, anticipatory grief, and other nursing issues. The nursing intervention of the nursing process provided proper diet to maintain adequate nutrition, used massage techniques, deep breathing exercise, relaxation therapy and other measures to reduce the patient's physical pain, encourage him to share his feelings and provide emotional support so that he could learn to face and accept the fact of death. In addition, family members joined together with him during his last journey of life, to help celebrate his final birthday, so that his body, mind, and spirit met without regret of leaving this world.

並列關鍵字

liver transplant ； gastric cancer ； dying ； end-stage cancer