以安寧療護理念照顧一位口腔癌末期病人之經驗

Providing Hospice and Palliative Care to a Patient with End-Stage Oral Cancer

蘇盈慧(Ying-Hui Su) ； 周佩君(Pei-Chun Chou)

《腫瘤護理雜誌》 16卷2期 (2016/12) Pp. 85-94

https://doi.org/10.3966/168395442016121602008

摘要

本文旨在描述以安寧療護理念照顧一位口腔癌末期病人之護理經驗，護理期間自2013年11月15日至12月4日，筆者運用整體性護理評估進行生理、心理、社會及靈性資料收集，依其惡性腫瘤傷口合併疼痛，加上面臨不知病情的母親存有遺憾與困擾，進一步確認病人有組織完整性受損、疼痛、心靈困擾之健康問題。照護此個案期間利用筆談、觀察、身體評估與個案及家屬建立信任關係，與個案和醫療團隊討論換藥方式，增加傷口舒適度；召開家庭會議讓個案在臨終前完成與母親見面的心願；同時在陪伴過程中同理個案感受並協助其回顧過去，肯定其對家人的付出努力，協助個案留下文字與影像資料，重新體認其生命意義，並安排宗教志工探訪陪伴、禱告，讓個案心靈安定及有所寄託，以達身心靈平安。建議末期病人照護應把家庭會議列為常規照顧內容，取得照護共識，協助病人及家屬進行善終準備，以達生死兩相安的境界。

關鍵字

安寧療護 ； 口腔癌 ； 生命末期照護

並列摘要

This study describes the nursing experience for a terminal oral cancer patient from November 15 to December 4, 2013. Holistic nursing assessment was used to collect data in the physical, psychological, social, and spiritual aspect. From the patient's malignant tumor and wound pain, as well as the patient's regret and distress over the mother who had been unaware of the patient's condition, it was further confirmed that the patient experienced impaired tissue integrity, pain, spiritual distress, and other health problems. Written interviews, observations, and physical assessment were completed during the nursing period. Furthermore, trust from the patient's family members was gained, and after discussing with the patient and medical team, wound dressing routine was established to increase comfort for the patient. In addition, a family meeting was convened so that the patient could see the mother before the final moment. The nurse accompanied the patient in assisting him in reminiscing on the past, recognizing and reaffirming the patient's contribution to the family; and also in assisting the patient in leaving written and recorded data, re-experiencing the meaning of life, and arranging visits from church volunteers who comforted patient and prayed to help achieve inner peace, spiritual sustenance, and physical and psychological contentment. It is advisable for future studies to include family meetings as a routine nursing procedure when taking care of terminal cancer patients for consensus on care, and assist patients and family members in preparing for death so that they may achieve peace.

並列關鍵字

Hospice Care ； Oral cancer ； End-of-life Care

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