新冠肺炎疫情期間運用安寧照護於一位乳癌末期病人的護理經驗

Nursing Experience in Providing Hospice Care for a Patient with Terminal Stage Breast Cancer during the COVID-19 Pandemic

林佩真(Pei-Chen Lin) ； 簡翠薇(Tsui-Wei Chien) ； 陳依琳(Yi-Lin Chen)

《志為護理-慈濟護理雜誌》 22卷2期 (2023/04) Pp. 96-105

摘要

本文描述一位乳癌末期合併骨轉移之98歲女性病人，於安寧病房的護理經驗。照護期間為2021年5月14日至6月2日，逢新冠肺炎疫情嚴峻期間，因防疫政策故家屬無法陪伴。藉由觀察、會談、身體評估及病歷查閱，並運用四大層面評估，確立健康問題有皮膚完整性受損、慢性疼痛及心靈困擾。運用止痛藥、遠紅外線、含銀離子敷料及芳香療法緩解生理症狀；然而個案為癌症末期，礙於防疫政策無法與家屬相聚，出現靈性困擾。筆者協助以視訊替代會面，亦運用靈性技巧協助表達四道人生，勇敢將愛說出口，使病人及家屬不留遺憾，達到安寧療護的目的。期望此護理經驗，能提供安寧照護相關人員於新冠肺炎疫情期間照護之參考。

關鍵字

新冠肺炎 ； 乳癌末期 ； 安寧療護 ； 靈性四面向

並列摘要

This article describes the nursing experience of treating a 98-year-old female breast cancer patient with bone metastasis in a hospice unit, including difficulties caused by Covid-19 pandemic prevention policies effecting the successful provision of end-of-life care. The nursing period was from May 14 to June 2, 2021. Data collection was performed through observation, interviews, physical examination, medical record review, and the four dimensions of assessment. The patient's primary health problems were impaired skin integrity, chronic pain, and spiritual distress. In addition to analgesic drugs, far-infrared, silver ion dressings and aromatherapy were used to relieve the patient's physical symptoms. However, the patient suffered from spiritual distress because her family could not visit her due to the epidemic preventive policies of Covid-19. By arranging video chat for the patient and her family, the author guided both of them to express the four themes of life (gratitude, apology, love, and goodbye) to each other in order to achieve the goal of hospice care. Hopefully, the nursing experience provides a reference for hospice caregivers in practicing end-of-life care during the Covid-19 pandemic.

並列關鍵字

COVID-19 ； four aspects of spirituality ； hospice care ； terminal breast cancer

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