照顧一位肝癌末期病人之護理經驗

本文探討一位肝癌末期病人之護理經驗，護理期間自2021年4月13日～5月25日，運用生理、心理、社會與靈性四大層面進行整體性護理評估，發現個案有疼痛、身體心像紊亂、預期性哀傷三項護理問題。在疼痛部份，教導案子協助按摩、運用小枕頭採舒適臥位、給個案聆聽最喜歡的歌手音樂，達到放鬆的效果，緩解疼痛感；在身體心像紊亂部份，建立良好護病關係，讓個案能表達情緒及說出內心感受，正視身上引流袋的存在，並介紹相同個案與其分享經驗；在預期性哀傷部份，安排一個獨立空間，以同理心傾聽、陪伴，鼓勵個案訴說內心的擔心及不安，適時給予正向回饋，利用相片拍攝方式保存對彼此的回憶，並引導個案及案子完成四道人生，同時協助家屬完成病人心願與後事準備。

關鍵字

肝癌；疼痛；預期性哀傷

並列摘要

This study describes the nursing experience in a patient with end-stage hepatic cell carcinoma. During the healthcare period from April 13 to May 25, 2021, a comprehensive nursing assessment has been conducted for four major aspects including physical, psychological, social and spiritual areas. The subject was found to have three health problems including pain, body image disturbance and anticipatory grief. By applying relaxation techniques such as massage instructions, comfortable positioning with small pillows and playing preferred music, the pain issue was relieved. We also established a good nurse-patient relationship, helped the subject expressing internal feelings and facing the fact of drainage bag existence and introduced the support group to the subject to resolve the body image disturbance. As for the anticipatory grief, a separate room was arranged. Through empathic listening and company, the patient was encouraged to narrate what concerned and disturbed him/her, so that positive feedback was provided in time. During the nursing period, we used photo documentary to record the entire process and helped the patient complete his/her four life domains, fulfill his/her last wishes, so the patient and the family could be well-prepared for future challenges.

並列關鍵字

Liver cancer ； Pain ； Anticipatory grief

參考文獻

王曼玲、周韋翰、林峯盛、邱馨嬋、林至芃、孫維仁（2021）‧癌症疼痛的醫病共享決策‧台灣醫學，25(2)，250-255。https://doi.org/10.6320/FJM.202103_25(2). 0011

宋俊松、鄒美勇、何善台（2017）‧台灣從癌症疼痛控制到無痛醫院的進展對癌症病人的妥善治療‧聲洋防癌之聲，154，10-17。https://doi.org/10.6321/SYDF.201703_(154).0003

周韻元、施秀鈴、張煦婕、潘雪幸（2017）‧照顧一位子宮體癌症末期病人之預期性哀傷之護理經驗‧腫瘤護理雜誌，17(2)，107-119。https://doi.org/10.3966/168395442017121702009

林家惠、王枝燦（2017）‧探討癌症病人疼痛與失志狀態之關聯‧護理雜誌，64(1)，51-60。https://doi.org/10.6224/JN.000008

林沛宸、陳芝文（2019）‧一位年輕女性初次罹患肝癌末期之護理經驗‧領導護理，20(4)，94-106。https://doi.org/10.29494/LN.201912_20(4).0008

主題瀏覽