摘要
約有26%－44%的癌症病人在住院期間可能出現譫妄情形，其中約50%可經由醫療處置獲得改善。末期癌症病人的譫妄，通常是多重因素所造成。放射線或化學治療副作用、癌症副產物、顱內的疾病、電解質不平衡、脫水、器官衰竭、腫瘤附屬症候群（paraneoplastic syndrome）、內分泌疾病、感染、低血氧以及其他內科疾病：如：戒斷症狀、營養缺失、凝血功能障礙、貧血及多重藥物的使用等，均有可能引發譫妄。譫妄現象的早期發現、適當的診斷工具量表的應用以及一個具實證的譫妄標準照護的提供，將能預防高危險的合併症發生與改善譫妄。對於已發生譫妄的病人，臨床人員必須評值譫妄的發生頻率、症狀持續天數、譫妄對治療的效果和病人整體的生活品質。主要的護理處置則包括：（一）液體和營養的維持。（二）不要輕易改變環境。（三）要有固定家庭成員和工作人員來照顧病人。（四）應避免身體約束。（五）注意安全。（六）提供病人一個完整不受干擾的睡眠。
並列摘要
Around 26% to 44% of cancer patients may present with the symptom of delirium during their hospitalization. 50% of them may benefit from some existing medical treatment (Centeno, Sanz, Bruera, 2004). The development of terminal delirium in cancer patients are usually multi-factorial (Francis, 2014). These factors include side effects of radiation or chemotherapy, byproducts of cancer, intracranial disease, electrolyte imbalance, dehydration, organs failure, paraneoplastic syndrome, infection, and hypoxemia. Other medical conditions such as withdrawal syndrome, endocrine problem, coagulopathy, anemia, multiple drug use, and nutritional deficiencies may also induce the symptom (Bush & Bruera, 2009) To improve the symptom and prevent the related complications, early detection, accurate diagnosis by using a validated diagnostic tool, and standardized care are crucial. For the patients who develop delirium, there is a need to evaluate the frequency, duration, response to treatment, and patients' overall quality of life. Nursing interventions may include: (1) adequate support of fluid and nutrition, (2) maintain consistency and stability of the patient's environment, (3) have the same family member and staff to care for patient, (4) avoidance of physical constraints (5) patient safety, and (6) good quality of sleep at night (Mattoo, Grover & Gupta, 2010; 2013 NICE clinical guideline).