照顧一位口腔癌末期病人無望感之護理經驗

Nursing Experience of a Terminal Oral Cancer Patient with Hopelessness

陳雁梅(Yan-Mei Chen) ； 朱美玲(Mei-Ling Chu)

《高雄護理雜誌》 39卷2期 (2022/08) Pp. 138-149

https://doi.org/10.6692/KJN.202208_39(2).0012

摘要

本篇個案報告在探討一位口腔癌末期病人，所面臨的身、心理衝擊與調適過程的照護經驗，筆者於2017年9月17日至2017年9月25日照護期間與個案及家屬建立良好護病關係，透過個案筆談及主要照顧者會談、觀察、身體評估及直接照護等方式收集資料，運用Gordon十一項健康功能型態進行評估，確立個案有體液容積缺失、組織完整性受損、無望感的健康問題。護理過程中提供個別性的護理，監測傷口出血及體液容積變化，及時處理出血及補充體液；蕈狀傷口照護運用舒適技巧、傷口敷料應用等控制滲出液、惡臭與出血情形；利用關懷、鼓勵表達及陪伴，傾聽個案和家屬內心的感受，尊重病人自主權，增加自我控制感。透過此報告分享，以提昇護理人員對臨終病人心理靈性安適狀況的評估及照護技巧，提供適切的照護，讓病人有品質的善終。

關鍵字

口腔癌末期 ； 體液容積缺失 ； 無望感

並列摘要

The purpose of this report was to explore a nursing experience of patients with terminal oral cancer, suffering from physical and psychological impacts. The care period was from September 17th to 25th, 2017. Data were collected by written notes, interviews, observations, physical assessments and direct caring. The author found the main health problems included fluid volume deficit, impaired tissue integrity and a sense of hopelessness through using the Gordon 11 Function Health Patterns. In addition, the author offered individualized care to the patients like monitoring and coping with bleeding wounds and fluid volume, and in a timely manner, caring for fungating wounds with comfort, and controlling the malodorous and bleeding exudations by appropriate dressings. Through caring, encouragement, and accompanying to listen to both patient and their family feelings wwhile respecting the patient's autonomy for improving self-control, the results of this report indicated a beneficial strengthening of the clinical practice experience with sharing where nursing staff can be able to provide quality hospice and spiritual care to patients in appropriate ways.

並列關鍵字

terminal oral cancer ； fluid volume deficit ； hopelessness

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