- 期刊
照護一位口腔癌末期病人之護理經驗
Caring for a Patient with Terminal Oral Cancer
摘要
本文探討一位口腔癌末期個案之照護經驗，此次因傷口照護問題入院，住院期間因臉上惡性蕈狀傷口的惡臭瀰漫病室，當個案得知病況進展至末期當下嚎啕大哭，引發筆者想深入探討此個案之動機。筆者照護期間為2018年3月13日至2018年4月10日，透過觀察、面談及直接照護等方式收集資料，以Gordon十一項功能性健康型態評估工具進行評估及分析，確認有組織完整性受損、慢性疼痛及心靈困擾等健康問題。筆者運用文獻查證資料，使用空氣清淨機及茶樹精油改善傷口異味，並提供合適的換藥方式改善傷口滲液，減輕腫瘤蕈狀傷口對個案帶來的困擾；針對慢性疼痛問題，除了依醫囑提供適當的藥物，也依個案喜愛的玫瑰精油給予穴位按摩，搭配深呼吸放鬆技巧，結果顯示個案確實能夠緩解慢性病疼痛；此外運用照片回顧及故事分享，提供個案及家屬正向支持與回饋，更重要的是共同完成生命末期的重要任務，舉辦婚禮了卻個案心願，使個案能夠感到心靈上的平靜、面對生命的終點，藉此個案照護經驗分享，讓臨床護理人員在面對病人及家屬因癌症末期所導致之身、心、靈不適時，可給予個別性的護理措施，使護理人員獨特角色功能得以發揮。
並列摘要
With this article we share our experience of caring for a patient with terminal oral cancer. She was admitted to the hospital for wound care issues. During admission, her poor condition of fungating wound caused foul odor. She burst into tears upon learning that her disease had progressed to the terminal stage. We cared for the patient from March 13^(th), 2018 to April 10^(th), 2018. Through observation, interview with patient, and direct bedside care, we assessed her health problems on the Gordon 11 Function Health Patterns, which revealed impaired tissue integrity, chronic pain, and mental disorder. According to the doctor's orders, we used air purifier and tea tree oil to improve the air quality around. We provided different types of wound dressing to decreased discharge from her fungating wound and other related wound issues. For her chronic pain, we gave adequate pain control as the doctor prescribed. In addition, we provided acupoint massage with rose oil according to her preference. Coupled with the deep breathing technique, her chronic pain was lifted a great deal. Furthermore, we used photographs and life's stories sharing to visit the memory lanes, which provided positive feedback to patient and her family. The most important thing is that we completed a significant task of her life - a wedding for her and her husband. The wedding fulfilled her wish and brought peace to her mind. She could finally face the end of her life. By sharing this case, we hope the nursing staff can learn how to provide personalized care to patients and their family when facing troubles of mind, body, or spirit, thereby the nursing staff can play a unique role in patient care.