結合安寧共照照顧一位癌末患者之臨終加護經驗

The End-of-life Intensive Care Experience of a Terminal Cancer Patient Combined with Hospice Care

王昭雲(Chao-Yun Wang) ； 陳姿妃(Tzu-Fei Chen)

《志為護理-慈濟護理雜誌》 11卷5期 (2012/10) Pp. 101-110

https://doi.org/10.6974/TCNJ.201210.0101

摘要

本文主要敘述在加護病房以安寧共同照護模式照顧一位癌症末期個案之臨終護理經驗。照護期間為2009年11月20日至2009年12月8日，運用Gordon十一項功能性護理評估、觀察及筆談等方式收集資料，確立個案有疼痛、呼吸喘、心靈困擾等問題。運用非傳統藥物治療方式及輔助療法，緩解個案疼痛、呼吸喘等不適；以真誠的陪伴、愛、關懷及包容的態度，接納個案及家屬情緒的表達；連繫安寧團隊及宗教師，透過溝通，使個案明白佛教的意義，克服對死亡的恐懼。藉此個案照護經驗，提供急重症醫療團隊在面對臨終患者時，應如何與安寧團隊結合，以期達成高品質的生命末期照護。

關鍵字

疼痛 ； 呼吸喘 ； 心靈困擾 ； 安寧共照

並列摘要

The purpose of the article was to present an end-of-life care experience of a terminal cancer patient with hospice care in an intensive care unit. The nursing period was from May 20th, 2009 to June 8th, 2009. Gordon's eleven functional health patterns were applied to evaluate and observe the patient, and data were obtained through a written conversation. We confirmed that the patient exhibited problems of pain, shortness of breath and spiritual disturbance. To relieve the symptoms of pain and shortness of breathe, nontraditional medicine treatment and adjuvant therapy were applied. The emotional expressions of the patient and family were embraced with wholehearted company, love, care and open-mindedness. The patient's fear of death was overcome through a joint effort of nurses, hospice care team and religious chaplain, and endow the patient with the essence of Buddhism via communication. Through this valuable care experience, we hope to serve as a reference for acute and critical care team ways to collaborate with hospice care and attain high quality end-of-life care.

並列關鍵字

pain ； shortness of breath ； spiritual obsession ； hospice care