安寧療護與器官捐贈結合運用之經驗

Mutual Use of the Experience of Hospice Care and Organ Donation

蔡惠芳(Hui-Fang Tsai) ； 高偉堯(Woei-Yau Kao) ； 洪東源(Dueng-Yuan Hueng) ； 陳佳宏(Jia-Hong Chen)

《安寧療護雜誌》 17卷1期 (2012/03) Pp. 76-85

https://doi.org/10.6537/TJHPC.2012.17(1).6

摘要

前言：目前醫療對生命品質及末期照護觀念非常重視，安寧療護累積的價值概念與工作方式可以用來提供許多重症及末期照護的參考。器官捐贈的過程是一個陪伴家屬面對喪親失落的過程，在器官捐贈的過程中結合安寧療護的概念，更可以提昇整體的醫療照顧品質。病例討論：為了解在安寧療護環境下之癌症末期病患同意器官捐贈之情形，我們收集本院接受安寧療護之個案，在2009年1月至2011年12月期間執行器捐之癌末病人，評估癌症末期患者器捐之執行率並分析其相關因素。回溯分析資料在此期間於本醫學中心接受安寧療護而執行器捐之癌末病人共有三位病患，在安寧照顧的模式下，器捐的決定對他們以及家屬而言，呈現出不同的生命意義。討論：器官捐贈及安寧療護皆是在病人臨終階段的工作，用安寧的理念來協助器官捐贈的進行，可以豐厚器捐的價值內涵；也讓家屬感受捐贈過程中更多的尊重與陪伴。而將器官捐贈在安寧療護中推展，除了可以重新創造生命的價值與意義，也是一份力量來協助病人與家屬對生命終點的接受與哀傷調適的昇華。透過在安寧療護中對癌症病人的眼角膜組織捐贈的推動，除了可以增加眼角膜捐贈的來源，對於病人與家屬在面對生命末期的失落調適上，亦提供一個意義性的創造，開啟一扇窗，讓悲不再傷。

關鍵字

安寧療護 ； 器官捐贈

並列摘要

Object: Organ donation is the donation of biological an organ of the human body, from a living or dead person to a living recipient in need of a transplantation. Transplantable organs are removed in a surgical procedure following a determination, based on the donor's medical and social history, of which are suitable for transplantation. However, organ donation is not only getting the organ from the body but also a process to accompany family to deal with the loss and the bereavement. Hospice care is end-of-life care provided by health professionals and volunteers, that it gives medical, psychological and spiritual support and also provides services to support a patient's family. Care on quality of life and the concept of terminal care very importantly, the cumulative value of the concept of hospice work can be used to provide the reference of many severe and terminal care. We recommend the value and work model from hospice care experience to end-of -life care will be a great benefit to organ donation. Case presentation: In order to understand in the case of terminally ill cancer patients in hospice environment agreed to organ donation, we collect underwent hospice cases. We collected executive organ donation of terminal cancer patients in the period from January 2009 to December 2011, and performed the implementation of the assessment of patients with terminal cancer donation rates and analyze the relevant factors. Discussion: A retrospective analysis showed three cancer patients of terminal stage under the mode of hospice care performed corneal organ donation during this period. The donation decision for them and their families are showing different life significance. Conclusions: Our study suggested that the advocating for organ donation in hospice and the bereavement of end-of-life care will both do well.

並列關鍵字

Hospice care ； organ donation