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末期病人撤除維生醫療—安寧共同照護介入之經驗

Withdrawing Life-Sustaining Treatment in Terminal Illness Patients: An Experience of Intervention with Combined Hospice Care in a Medical Center

摘要


撤除維生醫療為減輕及免除末期病人之痛苦、維護病人最大利益、尊重末期病人醫療自主意願,其主要目的為維護病人尊嚴、達到善終。安寧共同照護的介入,運用同理心溝通技巧透過緩和醫療家庭會議,提升病人及家屬疾病認知、使病人及家屬獲得支持,滿足其身體、心理、社會、靈性的需求,並完成善終準備。本文藉由文獻查證了解末期病人撤除維生醫療的相關概念、國內外撤除維生醫療之現況、相關研究,並以本院安寧共照團隊介入談末期病人撤除維生醫療之經驗,期能讓護理人員了解更完善的撤除維生醫療過程,提升末期病人的照護品質。

並列摘要


The aims of withdrawing life-sustaining treatment (WLST) are eliminating the suffering and maintaining the best interest of patients with terminal illness while showing respect to the patient’s free will, safe-guarding dignity and delivering the highest quality of end-of-life care. Through combined hospice care, empathic communications and family meetings during palliative care, the patient and the family can gain insight into health condition and seek help. Ultimately, all details of end-of-life care can be well prepared and understood in the physical, psychological and spiritual aspects. This article discusses and shares the current concepts and protocols of WLST for terminally ill patients through literature reviews of recent researches and the WLST experiences in our hospital with hopes that nursing specialists can appreciate the purpose of WLST and subsequently improve their practical skills and knowledge of quality of end-of-life care.

參考文獻


Chand, P., Gabriel, T., Wallace, C. L., & Nelson, C. M. (2013). Inpatient palliative care consultation: Describing patient satisfaction. The Permanente Journal, 17(1), 53-55. doi: 10.7812/tpp/12-092
Chou, W. C., Hung, Y. S., Kao, C. Y., Su, P. J., Hsieh, C. H., Chen, J. S., ... Wang, H. M. (2013). Impact of palliative care consultative service on disease awareness for patients with termi nal cancer. Supportive Care in Cancer, 21(7), 1973-1981. doi: 10.1007/s00520-013-1733-7
Dale, C. M., Sinuff, T., Morrison, L. J., Golan, E., & Scales, D. C. (2016). Understanding early decisions to withdraw life-sustaining therapy in cardiac arrest survivors: A qualitative investigation. Annals of American Thoracic Society, 13(7), 1115-1122. doi: 10.1513/AnnalsATS.201511-751OC
Damghi, N., Belayachi, J., Aggoug, B., Dendane, T., Abidi, K., Madani, N., ... Abouqal, R. (2011). Withholding and withdrawing life-sustaining therapy in a Moroccan emergency department: an observational study. BMC Emergency Medcine, 11, 12. doi: 10.1186/1471-227x-11-12
Kao, C. Y., Cheng, S. Y., Chiu, T. Y., Chen, C. Y., & Hu, W. Y. (2013). Does the awareness of terminal illness influence cancer patients’ psycho-spiritual state, and their DNR signing: A survey in Taiwan. Journal of Clinical Oncology, 43(9), 910-916. doi: 10.1093/jjco/hyt095

被引用紀錄


游淑幀、葉惠玲(2022)。一位轉移性子宮內膜癌自殺病人之重症照護經驗長庚護理33(3),112-120。https://doi.org/10.6386/CGN.202209_33(3).0010

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