一位愛滋末期病人之安寧共同照護經驗

The Nursing Experience of Hospice Combined Care to A Terminally Ill Patient with AIDS

王素鴻(Su-Hung Wang) ； 曾淑梅(Shu-Mei Tseng) ； 周希諴(Hsi-Hsien Chou)

《安寧療護雜誌》 21卷3期 (2016/11) Pp. 329-340

https://doi.org/10.6537/TJHPC.2016.21(3).7

摘要

本文運用安寧共同照護於感染科病房協助一位31 歲愛滋病末期病人，面臨疾病逐漸惡化致身心靈承受苦楚的過程，尤以靈性困境縈繞自殺意念為主要照護重點。經原診療醫師啟動照會安寧共同照護，經整體性護理評估發現以下問題：（1）生理層面：肌肉關節疼痛、皮膚紅疹及併發多重感染（口腔念珠菌、肺囊蟲肺炎、闌尾炎、弓形蟲腦症）為主；（2）心理社會層面：個案不捨案四姊承擔家中經濟重擔，及多次未遵循住院規則致醫病互信關係改變；（3）靈性層面：承受疾病折磨自覺活著無意義、害怕面臨死亡過程症狀會極劇痛苦。筆者運用舒適護理與個案建立信任關係，經由繪畫活動瞭解個案內心感受，協調開跨科部團隊會議整合照護共識，增強家人間連結並感受到宗教的力量，促進個案於有限的生命中體會助人的經驗，跨科部安寧共同照護直至個案善終，家人及其醫護人員無憾。

關鍵字

愛滋病 ； 安寧共同照護 ； 靈性安適

並列摘要

This article was to describe a nursing experience using hospice combined care to assist a 31-year-old patient at the terminal stage of acquired immune deficiency syndrome in the infection ward. The patient faced both disease progression and also suffering from painful process. The suicidal ideation in a spiritual dilemma became the primary care focus. By holistic nursing assessment, we found the following problems：1. physical aspect：muscle and joint pain, skin rashes and concurrent multiple infections; 2. psychosocial aspect：the patient worried about his sister that bear the economic burden of the family; 3. spiritual aspect: suffering from the disease makes his life meaningless; fears of extremely painful dying process. Using the comfort nursing care, establishing a trust relationship, and through painting activities helped us to understand the feelings of the patient. The consensus through multidisciplinary integrated care team meetings improved 1. family links 2. Family’s feeling about the power of religion. 3. the patient to realize the experience of helping others in limited life. 4. Continuing hospice combined care until the patient died 5. Both the family and medical staff had no regrets.

並列關鍵字

AIDS ； Hospice combined care ； Spiritual well-being

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