協助一位肺癌末期病人善終之護理經驗

An End-of-Life Nursing Care Experience of a Patient with Terminal Stage Lung Cancer

林妙穎(Miao-Ying Lin)

《嘉基護理》 14卷2期 (2014/12) Pp. 40-48

摘要

本文照護的對象是一位肺癌末期瀕死的個案，因呼吸困難入院。透過系統性身體評估、會談、觀察家庭互動後，確立護理問題有：呼吸困難、便秘、預期性哀傷。照護期間自2012年1月24日～1月26日共三天，筆者提供的個別性護理措施，包括：運用舒適擺位、身體清潔、按摩、播放詩歌、使用電風扇吹拂個案臉龐以減緩個案呼吸喘造成的不安及焦慮情緒。因使用鴉片類藥物及腹部無力用力引起的便祕問題，筆者則採取腹部按摩及肛挖的方式，協助個案解便及增加舒適感。至於家屬預期性哀傷的問題，則透過傾聽、陪伴關懷、以宗教信仰為指引的臨終照護，引導家屬面對個案即將死亡的事實，並彼此敘說內心對個案的感謝，做最後的道別，以及死亡準備。最後依個案宗教信仰作後事安排，讓個案在生命最後旅程中有家人的陪伴，與最親愛的家人告別，最後安然逝世。

關鍵字

呼吸困難 ； 臨終照護 ； 預期性哀傷

並列摘要

This case report described a nursing experience of providing end-of-life care to a terminal stage lung cancer patient. Through systematically physical assessment, conversation and observation of family interaction, the health problems were identified as follows: breathlessness, constipation, and anticipatory grief. The nursing care period was from January 24th to26th, 2012. In order to reduce disturbance and anxiety, the author provided nursing intervention including positioning, body cleansing, accompanying and end-of-life care. The author also help family prepare facing death through guiding them express their feelings and holding a farewell ceremony. In the end, the author help family arrange funeral ceremony according to her religious belief to have a good death.

並列關鍵字

breathlessness ； end-of-life care ； anticipatory grief