直腸癌末期病人安寧療護之護理經驗－個案報告

Palliative Nursing Care Experience of a Terminal Stage Colon Cancer Patient: A Case Report

潘雯秀(Wen-Shiou Pan) ； 鍾若男(Ruo-Nan Jueng)

《北市醫學雜誌》 12卷4期 (2015/12) Pp. 397-406

https://doi.org/10.6200/TCMJ.2015.12.4.12

摘要

本文為描述一位直腸癌末期病患，在面臨癌末所引起的生理不適症狀與心靈困擾之護理經驗，護理期間為2013年9月2日至9月7日。筆者運用觀察、訪談及進行生理、心理、社會、靈性四層面評估，發現病患有「低效性呼吸型態/腫瘤轉移到肺部」、「疼痛/癌細胞轉移及腫瘤壓迫」、「靈性困擾/對家人愧疚及尋求寬恕與和解」等主要護理問題。筆者依據身體評估及疼痛量表，調整藥物、提供舒適臥位、教導放鬆療法及穴位按摩等方式，改善呼吸困難及緩解疼痛，並協同安寧醫療團隊，運用傾聽及陪伴，引導病患說出心裡的擔心，及運用生命回顧方式，修復與家人的關係，並且完善的表達內心的感謝、歉意與道別，讓病患體認到生命的意義與價值，使其達到身、心、靈平安的境界。

關鍵字

直腸癌末期 ； 輔助療法 ； 靈性護理

並列摘要

This report describes a palliative care nursing experience of a terminal stage colon cancer patient with symptom distress and mental stressors. The caring period was from 2 Sep to 7 Sep 2013. Physical, psycho-social and spiritual assessments were used to evaluate the patient's problems. During the nursing period, the authors collected information related to the patient's needs through observations, physical assessments, and in-depth interviews. Ineffective breathing pattern and pain were improved by drug adjustment, comfort positioning, relaxation therapy and acupressure massage according to patient's health and pain assessment. In coordination with the palliative team, we listened, accompanied and guided the patient to uncover worries in heart and repair family relationship by life review approach, express gratefulness, apologies and farewells adequately, so that the patient apprehend life’s meaning and value, and reached an equilibrium state in body, mind and soul.

並列關鍵字

Terminal Stage Colon Cancer ； Complementary medicine ； Palliative Care ； symptom distress