- 期刊
末期直腸癌護理：一個案報告
Nursing of Terminal Rectal Cancer: A Case Report
摘要
本個案是一位罹患直腸癌末期中年婦女，面臨身、心、社會及靈性衝擊，照顧期間爲95年7月10日至95年7月20日，採Gordon十一項功能性健康型態評估作爲工具，經由直接照護，運用會談、觀察及生理評估等技巧，收集主客觀資料，過程發現病人有疼痛、噁心及嘔吐、睡眠形態紊亂、潛在危險性跌倒、預期性哀傷等五個護理問題。在照顧過程初期，團隊與病人因相互不了解導致治療關係未建立良好，互動變得很緊張，經由團隊用心陪伴處理症狀，才能與病人建立良好的信任感，進而了解病人及家屬對疼痛控制之看法，澄清疑惑，在適當的溝通後進行疼痛控制，改善症狀。也引導病人與家屬彼此分享內心的不捨及情感，能互相道別及交代後事，最後平順往生。本個案報告希望藉由書寫照顧經驗來分享，並提供護理人員日後照顧的參考。
並列摘要
The author reported the nursing experience in taking care of a female patient diagnosed of rectal cancer in terminal stage of disease. The experience focused on the physical, psycho-social and spiritual impacts the patient encountered. The duration of care provided was from 10 to 20 July 2006. Using Gordon 11-item functional health pattern for nursing assessment to evaluate the patients problems, the author collected subjective and objective data through direct care-providing, interviewing, observation and physical assessment. The author found that the patient encountered 5 major nursing issues, including pain, nausea and vomiting, sleep disturbance, potential falling injury, and expected bereavement. In the initial stage of care-giving, the patient and the team members were not familiar with each other, and hence there was tension between each party. Through attentive companionship and meticulous symptom management, the team members built a trusting relationship with the patient and the family, and were then able to understand the views on the patient and the family towards pain management, to clarify doubts and worries about analgesics and to control the pain more effectively after appropriate communication. At the same time, the author helped the patient and her family to share their feeling in letting go and affection towards each other, to bid farewell and discuss about the propriety in arrangements afterwards. The patient passed away peacefully. In this report, the author shares the experience with the patient and her family and hopefully provides an example in giving nursing care in the future.
延伸閱讀
- 林幸姿、王淑貞、石世明、王英偉（2006）。末期淋巴癌之護理：一個案報告。安寧療護雜誌，11(3)，299-311。https://doi.org/10.6537/TJHPC.2006.11(3).7
- 鍾儷薇（2022）。一位直腸癌末期病人安寧善終之加護照護經驗。志為護理-慈濟護理雜誌，21(1)，110-118。https://www.airitilibrary.com/Article/Detail?DocID=16831624-202202-202203010010-202203010010-110-118
- 彭淑惠、賴芊孝（2017）。一位直腸癌末期病人善終之照護經驗。領導護理，18(4)，48-58。https://doi.org/10.29494/LN.201712_18(4).0005
- 吳淑芬、詹慧珠、傅家芸（2009）。一位直腸癌末期患者之護理經驗。領導護理，10(1)，94-105。https://doi.org/10.29494/LN.200904.0010
- 蔡佳容、鄭碧芬、潘慧娟（2022）。The Nursing Experience of a Terminal Patient with Rectal Cancer to Face Death Positively。高雄護理雜誌，39(1)，182-194。https://doi.org/10.6692/KJN.202204_39(1).0015