運用安寧療護於一位乳癌末期病患瀕死之護理經驗

本文描述一位乳癌末期合併多重器官轉移之個案，在生命末期時併發多方面生理不適及內心擔憂無法完成最終心願之照護經驗。照護期間為2019年7月16至2019年7月26日，以Gordon十一項健康功能型態為評估工具，藉會談、傾聽、病歷查閱及身體評估等方式收集資料，歸納個案健康問題有排尿型態障礙、低效性呼吸型態及預期性哀傷。依「四全照護」理念，運用舒適照護緩解呼吸喘感受；正確的清潔技巧與照護以維持舒適。以關懷、陪伴、同理及傾聽等方式，建立治療性關係，結合跨團隊合作，透過溝通對話及生命回顧，修復家庭成員關係，完成道謝、道愛、道歉、道別。而醫療團隊在個案逝世後仍持續給予家屬關懷，期望藉此照護經驗分享，提供臨床護理人員對此類個案照護參考。

關鍵字

安寧療護；乳癌末期；瀕死

並列摘要

This article describes a case of combining multiple organ metastasis at the end of breast cancer. At the end of life, the patient had multiple physical discomforts and worries about not being able to complete the care experience of the final wishes. The nursing period for this case was from July 16 to July 26, 2019. Gordon's 11 Functional Health Patterns were used as an assessment tool, collecting data through interviews, listening, medical record review and physical assessment. The major health problems were identified as impaired urinary elimination, ineffective breathing patterns and anticipatory grief. According to the concept of "fourfold holistic care" comfortable care was used to relieve the feeling of breathing while use of correct cleaning techniques and care to maintain comfort were introduced. A therapeutic relationship was established through caring, companionship, empathy and listening, combined with cross-team cooperation through communication, dialogue and life review in repairing the relationship between family members, enabling final wishes of giving complete thanks and love, apologizing, and goodbyes. Besides, the medical team continued to care for the family even after the patient had passed away, and it is expected this study could provide a reference for clinical nursing staff in dealing with similar cases by sharing this nursing experience.

並列關鍵字

Hospice care ； terminal phase breast cancer ； dying

參考文獻

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