以專科護理師的角色功能照護一位肺癌病人的護理經驗

Palliative Care to a Stage IV Lung Cancer Patient from the Perspective of Nurse Practitioner

游素英(Su-Ying Yu)

《安寧療護雜誌》 15卷3期 (2010/11) Pp. 358-378

https://doi.org/10.6537/TJHPC.2010.15(3).7

摘要

肺癌的不適症狀有許多，其中以呼吸困難對病人和家屬所造成的恐懼及焦慮是最大的，無論是腫瘤本身，肺部感染或是肋膜積水所引起的呼吸困難，多數的病因都是可以利用內科處理來獲得改善的。本文探討一位第四期肺癌合併有慢性阻塞性肺病的個案，因肺炎及慢性阻塞性肺病急性惡化而導致呼吸困難，病人藉由標靶治療、肋膜硬化治療、藥物控制和緩和支持療法讓生理上的不適和心理上的焦慮得到改善，在照護的過程中，專科護理師利用協同照顧的角色功能及職責，整合腫瘤內科、胸腔科和緩和醫療共照的團隊醫療方式來照顧病人，提升病人和家屬的生活品質，並且協助家屬解決後續將面臨的居家照護問題，以達到高品質的重症生命末期的照護。

關鍵字

專科護理師 ； 呼吸困難 ； 緩和醫療共照團隊

並列摘要

Patients with stage IV lung cancer disease may experience various distressed symptoms. One of the most feared signs of the patient and the family is dyspnea. Whether this is caused by tumor growths, lung infection or pleural effusion, they can all be treated by current medical intervention.
This article explores a case of a patient suffering from stage IV lung cancer with COPD. Because of dypsnea caused by chronic pulmonary blockage and pneumonia, the patient underwent target therapy and pleurodesis as well as drug control and palliative support care, which improved both his physical and psychological wellbeing. During this process, the advanced nurse practitioner cooperated closely with the department of Oncology, chest department and the palliative team to care for the patient and improved the quality of life for both the patient and his family. After the patient was discharged, the advanced nurse practitioner continued to provide support and educated the family about home care, thereby attaining a higher quality of life for the patient during his last stage.

並列關鍵字

advanced nurse practitioner ； dyspnea ； palliative care