胃癌末期病人善終－個案報告

Terminal Gastric Cancer at the End of Life: A Case Report

許芬蘭(Fen-Lan Hsu) ； 潘奎靜(Kuei-Ching Pan)

《安寧療護雜誌》 14卷2期 (2009/07) Pp. 208-217

https://doi.org/10.6537/TJHPC.2009.14(2).8

摘要

病人是一位罹患胃癌末期中年婦女，面臨身、心、靈及社會衝擊，照護期間爲97年4月7日至97年8月3日，期間共住院8次，筆者以關懷護理師的身分，於每次住院時藉由會談、觀察收集資料，照護過程中發現病人有身體、心理、思想上的不平安，在身體上的不平安爲飲食上的不滿足、心理上的不平安爲病人預期無法陪伴女兒成長的遺憾、在思想上的不平安爲因家屬不知如何跟病人談病情與死亡，導致病人處在相信化療完病就會好，但卻經驗病情的惡化，讓病人思想不平安。筆者在照護期間，經由每次入院，主動關懷病人、傾聽病人主訴、陪伴病人等方式，在與病人及家屬建立信任感後，以善終的照護概念幫助病人及家屬共同面對無可避免的死亡事實；希望藉由本報告的分享，提供護理人員照護臨終病人的參考。

關鍵字

善終 ； 末期病人 ； 胃癌

並列摘要

This report described the nursing experience of caring a mid-aged female with terminal gastric cancer, who suffered from physical, psychological, social and spiritual distress. The nursing care duration was from April 7th to August 3rd, 2008 and it was an eight times hospital stay. The author collected data by using observation, interview and physical assessment as pastoral care specialist during the hospital stay. The patient's health problems were identified included physical, psychological and cognitive discomfort. The physical symptom was dissatisfaction with the diet. Regret for being unable to see her daughter grow up was a symptom in psychological aspect. Due to her family did not know how to discuss her condition and death with her, she believed she will recover after chemotherapy. However, her worse condition caused her cognitive distress. After establish trust relationship with the patient and her family through caring, listening and accompanying during the caring period, the author used the end-of-life care concept to help the patient and her family face the reality of unavoidable death. The experience is to be shared with nursing staffs as an example about nursing care of end-of-life patients.

並列關鍵字

good death ； terminal patient ； gastric cancer