照護一位卵巢癌末期病人之護理經驗

A Nurse's Experience of Caring for a Terminal-Stage Patient with Ovarian Cancer

李慈萱(Tzu-Hsuan Lee) ； 李昂璉(Ang-Lien Lee)

《腫瘤護理雜誌》 18卷2期 (2018/12) Pp. 35-46

https://doi.org/10.6880/TJON.201812_18(2).04

摘要

本文探討一位卵巢癌末期病人之照護經驗，筆者照護期間為2015年8月17日至2015年9月15日，運用觀察、會談、直接參與照護等方式收集資料，並以Gordon十一項功能評估為基礎，確認個案住院期間有：疼痛、營養狀況改變：少於身體需要及預期性哀傷之健康問題。照護過程中筆者以精油按摩、請家屬準備拼圖和聽音樂的方式轉移其注意力來緩解疼痛不適，在營養師及團隊協助下提供營養照護計畫，包括：提供飲食資訊、衛教家屬可準備個案喜歡及熱量較高的食物、搭配週邊靜脈營養劑注射來改善個案營養缺失的問題，在不引起腹脹的狀況下滿足個案的營養需求，最後透過傾聽與陪伴，協助個案向最親密的母親及家人表達內心想法，宣洩其哀傷情緒，使個案在接受疾病惡化已不可逆和生命已到末期的時候，能以平靜的心情面對死亡的到來，最後家屬同意個案捐贈眼角膜之遺願，讓生命以另一個方式延續，藉此照護經驗之分享，讓臨床護理人員在面對病人及家屬因癌末所導致之身心靈不適時，可給予個別性的護理措施，讓每位個案都能達到善終的目標。

關鍵字

卵巢癌 ； 末期 ； 疼痛 ； 預期性哀傷

並列摘要

This article describes the nursing experience of caring for a terminal-stage patient with ovarian cancer. Data were collected through observation, interviews, and direct care during intensive care hospitalization from August 17^(th) 2015 through September 15^(th) 2015. Data evaluation was done using the Gordon's 11 functional health assessment. The patient’s health problems included pain, negative nutrition condition change, and anticipatory grief. The author distracted the patient and lifted some pain through aroma oil massage, a jigsaw puzzle and music. The nutrition improving plan included information on food preparation agreeable to personal taste and caloric needs, and parenteral nutrition infusion. Patient was able to express sorrowful emotions to her family through the help of author. She accepted her terminal condition and the coming of death, and finally she wished to extend her life in a different form by donating her cornea. We hope to share this experience so that perhaps other nurses can learn more about the individualized interventions when caring for similar terminal cancer patients.

並列關鍵字

Ovarian Cancer ； Terminal-Stage ； Pain ； Anticipatory Grief

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