協助一位肺癌末期病人善終之護理經驗

End-of-Life Nursing Experience of a Terminal Lung Cancer Patient

王妍樺(Yen-Hua Wang) ； 童婉惠(Wan-Hui Tung) ； 潘慧娟(Hui-Chuan Pan)

《腫瘤護理雜誌》 19卷1期 (2019/06) Pp. 91-102

https://doi.org/10.6880/TJON.201906_19(1).08

摘要

本文描述一位肺癌末期個案面臨病情惡化，對於死亡迫近，透露希望能在生命的最後與失散多年的女兒見面及道別，為完成個案遺願得以善終，引發筆者想探討的動機。照護期間自2017年1月11日至1月21日，藉由身體評估、觀察、病歷查閱、會談等方式收集資料，並運用生理、心理、社會與靈性進行整體性健康評估，發現個案有低效性呼吸型態及慢性疼痛之生理層面的問題，且因面對生命末期，心中遺願未了，引發哀傷之心理層面的健康問題。護理過程中增進個案舒適，提供個別性的護理措施，並藉由陪伴、傾聽、接納個案的想法幫助個案圓夢，透過跨團隊醫療互相合作，運用社會及網路資源，使個案在臨終前與女兒見面並道別，協助生死兩無憾。因照護癌末病人對護理人員是一大挑戰，希望提升病人生活品質並有機會得以善終為最大目標，期望藉此個案報告經驗，作為往後照護此類病人的參考。

關鍵字

肺癌 ； 善終護理 ； 哀傷 ； 疼痛

並列摘要

This article describes a patient of lung cancer at terminal stage with rapid progression of the disease and impending death. The patient's wish was to have one last meeting with her daughter with whom she had lost contact for a long time. Therefore, we wanted to help her fulfill her wish by restoring the relationship between her and her daughter for the last time. We were able to help realize her dream. This is the reason that the author explored motivation. The nursing care period was from Jan. 11^(th) to 21^(st) of 2017. We collected data by means of physical assessment, observation, medical record review and interviews with the patient. We also arranged physical, psychological, social and spiritual health assessment. The patient's nursing problems included ineffective breathing patterns, pain, and her regret related grief. Through the nursing process, medical team, social and community resources, and online information, author provided individual nursing care, companionship, and listening, which helped the patient say goodbye to her daughter. Caring for the patients with terminal stage cancer is a big challenge. With our nursing experience, we hope to provide reference of clinical care to help patients pass away without regrets.

並列關鍵字

Lung cancer ； End-of-life ； Grief ； Pain

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