運用Swanson關懷理論於照護一位胰臟癌末病人及其配偶之護理經驗

本文為一位胰臟癌末期病人及其配偶在生命末期面臨身心靈困擾之護理經驗。於2020年9月15日至11月18日，藉由直接的照護觀察、持續的會談及身體評估進行資料收集，依生理、心理、社會與靈性四大層面做為評估指引，確立個案有疼痛、死亡焦慮及配偶預期性哀傷等健康問題。以Swanson關懷理論為主軸，包括了解、在旁陪伴、為他做某些事、使他能夠及維持希望信念等過程提供個別化的照護。運用非藥物止痛方式緩解個案之疼痛及症狀不適，透過同理之溝通技巧及生命回顧肯定其人生意義，並藉由道謝、道愛及創造共同回憶，緩解個案的死亡焦慮與配偶照顧者預期性哀傷。期望本文可以做為臨床照護癌症末期病人及其照顧者之護理參考，協助達到善終及全人照護。

關鍵字

胰臟癌；末期照護；死亡焦慮；預期性哀傷； Swanson關懷理論

並列摘要

This article described the nursing experience of a terminal patient with pancreatic cancer and his spouse, who negatively impacted their mind, body, and spirit. The author collected all the data through direct care, observation, continued conversation, and physical examination from September 15 to November 18, 2020. Four dimensions, including physiological, psychological, societal, and spirit, were used as assessment guides to establish patient nursing problems, such as pain, death anxiety, and spouse's anticipatory grief. We provided individualized care based on Swanson's caring theory, including "knowing," "being with," "doing for," "enabling," and "maintaining belief." To use non-pharmacological methods to alleviate the pain and discomfort symptoms, affirm the meaning of life through empathetic communication skills and life review, and lessen the death anxiety and the anticipated grief of the spouse through gratitude, love, and the creation of shared memories. This article can be used as a clinical care reference for terminal cancer patients and their family caregivers, helping to achieve good death and holistic health care.

並列關鍵字

pancreatic cancer ； terminal care ； death anxiety ； anticipated grief ； Swanson's caring theory

參考文獻

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方俊凱、林子涵、畢世萱、李閏華、李佩怡（2017）･癌症末期病人的善終觀點･安寧療護雜誌，22（3），288-309。https://doi.org/ 10.6537/TJHPC.201711_22(3).003

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劉芊葳、楊婉萍（2017）･運用同理心溝通技巧提供年輕癌末病人靈性照護･安寧療護雜誌，22（2），213-227。https://doi.org/ 10.6537/TJHPC.2017.22(2).7

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