一位肺癌末期個案之護理經驗

本文敘述一位肺癌末期合併腦轉移個案之照護經驗，照護期間自2019年9月28日至11月6日，筆者運用Gordon十一項健康功能評估，經由觀察、會談及實際照護進行身體、心靈與社會方面資料收集，確立個案住院期間有低效性呼吸型態、疼痛、預期性哀傷三項健康問題。透過教導噘嘴式呼吸、腹式呼吸及使用小風扇來增加空氣對流循環，降低呼吸喘之感受；提供氣墊床及使用毛巾熱敷緩解肌肉僵硬，使用Fentanyl止痛貼片、搭配精油配合穴位按摩來緩解疼痛不適，使疼痛指數由7分降至4分；以主動陪伴、傾聽、理解個案對於即將死亡的情緒，透過醫療團隊協助舉辦生日會完成個案最後心願、引導個案及家屬完成生命回顧，使個案能安詳且無憾地走向生命終點。照護癌症末期個案的目標除了控制症狀以維持生活品質，更需彰顯其生命的意義，讓每位個案及案家都能達到身心靈的平安，希望藉由此經驗分享，提供日後同儕照護相似個案之參考。

關鍵字

肺癌；末期；腦部轉移；護理經驗

並列摘要

This article explores the nursing experience of a terminal stage lung cancer with brain metastasis patient. From September 28 to November 06, 2019, patient data were collected by observation, talks and actual care. Gordon 11 Function Health Patterns was adopted to evaluate patient's general condition. The care plan focused on insufficient respiratory patterns, pain and expected grief health problems. The resolutions included increasing circulation through pursed-lip breathing, abdominal breathing, and the use of small fans to reduce wheezing. Air cushion beds and warm towel were effective to relieve muscle stiffness. Fentanyl patches, essential oils and acuity massages were used to relieve to pain index from 7 to 4. The medical team accompanied, listened to and understood the dying emotions of the case, held a birthday party to complete the last wish of the case, guided the case and the family to complete the life review, so that the case was peaceful and had no regrets towards the end of life. The goal of caring for the terminal stage of cancer is not only to control symptoms to maintain a quality of life, but also to demonstrate the meaning of life to enable each case and their families to achieve peace of mind and soul. I hope to share this experience and provide the reference for future peer care of such cases.

並列關鍵字

Lung cancer ； Terminal stage ； Brain metastasis ； Nursing experience

主題瀏覽