協助一位腎癌末期病患回歸離島故鄉善終之護理經驗

Good Death: The Experience in Assisting a Terminally Ill Patient with Renal Tumor to Return Home

王姿蓉(Tzu-Jung Wang) ； 林佑樺(Yu-Hua Lin) ； 李慧琦(Hui-Chi Li) ； 蕭雅惠(Ya-Huei Shiau)

《嘉基護理》 13卷2期 (2013/12) Pp. 36-41

摘要

本文乃是描述協助一位居住澎湖跨海來台求醫之腎癌末期病患，在經歷罹患癌症末期之手術與加護病房照護後返鄉善終之護理經驗。護理期間為2010年8月4日～2010年8月5日。筆者運用整體性健康評估為基礎，以觀察、會談、傾聽等方式收集資料後，依疼痛、體液容積過量和返鄉善終的遺願等三個問題作護理。筆者在護理過程中，給予舒適的擺位及適度的支托，以減緩疼痛不適及避免皮膚的受損，並藉由與個案、家屬、醫護人員及安寧個案管理師的合作，規劃如何讓個案能在生命即將到達終點前，克服交通工具上的問題，在家屬的陪同下回到離島家鄉，得到善終的遺願與協助生死兩無憾。

關鍵字

腎臟癌 ； 癌末病患 ； 疼痛 ； 體液容積過量 ； 善終

並列摘要

This article describes the nursing good death experience in a terminally kidney cancer patient who travelled across the sea from his home at Penhu Island to be admitted to a hospital in Taiwan Island for surgery treatment. The author's hospice nursing care experience with the patient was gained during the period from August 4th to 5th 2010 when assisting the patient to get back home. Through holistic health assessment, using observation, interview and listening skills, the author provided nursing care in pain, excessive fluid retention and patient's good death wish of returning home. During patient's hospitalization, the author provided him with appropriate bed positioning and tailored support to reduce pain and prevent skin ulcer. With the cooperation of patient, family, medical staff and case manager, the author formulated a plan of overcoming the problem of long distance across-sea transport to let the patient, accompanied by his family, to return to his island home before his life reached the end. The patient's good death wishes were fulfilled, leaving no regrets for both the dead and the alive.

並列關鍵字

renal tumor ； terminal case ； pain ； excess fluid retention ； good death