照護一位胰臟癌末期病人之護理經驗

胰臟癌診斷時都是晚期或轉移，屬預後較差疾病，本文探討一位初次被診斷胰臟癌末期中年男性之護理經驗，護理期間為2017年6月7日至2017年6月28日，照護期間運用Gordon十一項健康功能評估，經由觀察、會談及實地照護進行資料收集，確立疼痛╱腫瘤壓迫、家庭運作過程紊亂／與疾病影響家庭經濟收入減少及運作、預期性哀傷╱面對死亡三項護理問題，透過關懷、傾聽及陪伴，建立信任的治療性關係，照護過程藉由採取舒適臥位及精油按摩技巧，搭配止痛藥物調整來緩解疼痛，引導個案說出對死亡感受，帶領家屬進行生命回顧，緩解個案對死亡焦慮，減輕家庭因失去個案的衝擊，期盼此經驗與護理同仁分享，提供日後臨床照護參考。

關鍵字

胰臟癌；末期病人；預期性哀傷；護理經驗

並列摘要

This article reveals the nursing experience of an adolescent girl with ovarian teratoma undergoing oophorectomy surgery. During the nursing period from November 27th to December 4th, 2017, the author collected information through observation, conversations, direct care, physical assessment, visits, and telephone contact. On the basis of Gordon's eleven functional health assessments, the patient exhibited acute pain and anxiety, and caregiver role strain was also identified. In response to the specific needs of adolescent patients, our individualized care measures included the following: building mutual trust by listening to the patient's needs and encouraging the patient and her mother to express their inner feelings, teaching the patient to divert her attention to obtain pain relief, using communication software to connect with peers to reduce separation anxiety, and using information software QR code scanning to provide postoperative wound care skill videos and health education leaflet. These interventions alleviated the concerns of the patient's mother. We hope this nursing experience serves a reference to improve nursing care.

並列關鍵字

expectant sadness ； nursing experience ； pancreatic cancer ； terminal patient

參考文獻

Pittroff, G. E.(2013). The humbled expert: An exploration of spiritual care expertise. Journal of Christian Nursing, 30(3), 164-169. doi:10.1097/CNJ.0b013e318294e8d3

王律凱、黃雅文、林益卿、蔡佩渝(2017)．肝腎衰竭安寧癌末病人的疼痛控制．安寧療護雜誌，22(1)，75-84。