一位癌症病童生命末期躁動的陪伴經驗

目前在台灣安寧療護的領域中，面對兒童生命末期的照護，比較偏重於生理症狀的探討；當醫療出現極限時，如何提供病童的情緒照顧則較少被提及，彰顯臨床上兒童生命末期情緒照顧經驗應有更多討論的需求。本案是以安寧共同照護的方式，協助一名11歲罹患神經母細胞瘤的病童，在其生命最後一個月的臨終階段，產生情緒躁動狀況時，引導其經由對躁動的外化，進而對躁動情況命名、宣洩情緒到與情緒共處。病童主動表達出對末期自我逐漸失控的不安感，並表示「我是陽光小鬥士，怎麼現在會變這樣？」在團隊明白其內在心理的衝突後，得以在面對病童躁動時，除了用藥之外，同時提供心理情緒的照顧，使病童了解到自己的獨特及重要性，進而勇敢面對及與疾病共處。此結果亦是安寧共同照護在協助原團隊對病童的末期照顧中，所期待能發揮的角色與功效。

關鍵字

癌末；兒童；躁動；社會心理照顧；安寧共同照護

並列摘要

In hospice and palliative care for children, previous researches in Taiwan focused on subject about symptoms during end-of-life. Those however had less contents about children's emotional care. For care providers, caring children's mental and emotional requests represents a major and critical issue. We provide a case study in hospice shared care mode. The patient is an 11-year-old child who suffered from Neuroblastoma. In the patient's last month of lifespan, we assisted the patient to verbalize and nominate agitation. From the process of emotional disclosure to coexistence, the patient actively expressed the nervous feeling for being out of control self during end-of-life, and stated ＂I am a positive fighter! How can these happen?＂ By evaluating the internal confliction in the patient, hospice team provided mental care and led the patient understand more value of self-lifespan except using medication, and in advance the patient could courageously face to and peacefully coexist with the illness. When we review this case, under the shared care mode for children, the role which the hospice care team took and the efficacy is the result we expected.

並列關鍵字

terminal cancer ； children ； agitation ； psychosocial care ； hospice shared care

國際替代計量

一位癌症病童生命末期躁動的陪伴經驗

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