一位肺癌末期病人的善終護理經驗

Nursing Experience of a Patient with Terminal Lung Cancer Who Received Hospice Care

洪語壎(Yu-Syuan Hung) ； 鍾淑媛(Shwu-Yuan Jong) ； 梁穎(Ying Liang)

《腫瘤護理雜誌》 17卷增訂刊 (2017/10) Pp. 55-67

https://doi.org/10.3966/168395442017101703006

摘要

本案係探討一位獨自返台接受治療之肺癌末期韓僑病人的善終護理經驗。護理期間自2014/4/22～5/17，筆者藉由觀察、會談、主動關懷及身體評估等技巧，就其住院時之生、心理層面問題，運用Gordon's十一項功能性健康型態進行整體性評估，確認個案有低效性呼吸型態、慢性疼痛、疲憊、無望感等健康問題。護理過程中，除提供直接臨床照護外，並深入探究病人與返台陪伴之家庭成員間不願面對死亡的深層內心想法，運用同理心陪伴、傾聽與支持，並結合安寧醫護團隊協助個案緩解因疾病帶來的不適，透過有計畫的善終關懷護理措施，引導敞開心裡糾結衝突，勇敢面對死亡，維持身、心最佳穩定狀態，與家人間真正表達彼此內心感受與道別，在台安詳走完人生的旅程。

關鍵字

肺癌末期 ； 善終 ； 無望感

並列摘要

The purpose of this report is to share the nursing experience of hospice care for a patient in terminal stage of lung cancer, who returned from Korea for medical treatment. The nursing service was provided during the period of April 22 to May 17, 2014. A comprehensive assessment was made on both the physical and psychological status of the patient during the hospitalized period using observation, interviews, empathy, physical assessments as well as the Gordon’s 11 functional health patterns evaluation. It was confirmed that the patient had been suffering from problems such as ineffective breathing pattern, chronic pain, fatigue and the feeling of hopelessness. In addition to providing direct clinical care in the process, the nursing team also tried to investigate the psychological issues, such as the reluctance to face death at the innermost part of the heart, experienced by the patient and some of the family members who returned from overseas to take care of the patient. Together with the hospice care team, the nursing team endeavored to ease the discomforts caused by the disease through chaperoning, listening and supporting. With help from the well-designed hospice nursing care program, the patient was eventually relieved of the mental conflicts, able to express his true feelings before bidding farewell to the beloved, and peacefully confront death without fear.

並列關鍵字

terminal lung cancer ； hospice ； hopelessness

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