一位口腔癌末期病人之護理經驗

Nursing Experience of Caring for a Patient with Terminal Oral Cancer

方郁雯(Yu-Wen Fang) ； 陳玟伶(Wen-Ling Chen) ； 蘇以青(Yi-Ching Su)

《高雄護理雜誌》 41卷1期 (2024/04) Pp. 147-157

https://doi.org/10.6692/KJN.202404_41(1).0012

摘要

本文是照顧一位口腔癌末期病人的護理經驗，病人經歷疾病惡化，情緒沮喪，面臨生理及情緒雙重挫敗，引發筆者探討的動機。照護期間為2019年6月至7月，運用整體性評估中生理、心理、社會與靈性四面向以及身體評估、病歷查閱、觀察及會談等方式收集資料，發現病人有疼痛、營養少於身體所需及預期性哀傷等護理問題，護理師於照顧期間提供同理關懷，藉由個別性護理措施，結合藥物與放鬆技巧緩解病人骨骼轉移造成的疼痛；依據惡病質營養護理原則，鼓勵進食、維持體重；協同安寧共照團隊，給予病人及家屬心理支持，臨終關懷，避免無效性急救措施，接受癌末安寧照護，以達善終經驗。

關鍵字

末期癌症 ； 疼痛 ； 營養少於身體所需 ； 預期性哀傷

並列摘要

This report describes the nursing experience of caring for a patient with terminal oral cancer. The patient's deteriorating illness and depression, which caused him both physical and psychological challenges, motivated the authors to care for him. The care period was from June to July 2019. We conducted a holistic assessment of the physical, psychological, social, and spiritual aspects of the patient through physical assessments, medical record reviews, observations, and interviews. The patient frequently experienced pain, malnutrition, and anticipatory grief; therefore, empathetic care was provided during the nursing care process. The medical team provided individualized care to the patient with bone metastases by using a combination of medication and relaxation techniques to relieve his pain. Moreover, we encouraged the patient to eat and maintain weight based on cachexia of the principles of nutrition care. Finally, we collaborated with the hospital-based palliative care team to provide psychological support to the patient and his family, deliver hospice care, avoid ineffective first aid measures, and provide palliative care at the end of cancer to achieve a hospice experience.

並列關鍵字

terminal cancer ； pain ； malnutrition ； anticipatory grief

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