運用善終理念照顧一位卵巢癌末期病人的護理經驗

Nursing Experience in the Application of Good Death Concept in the Hospice Care of Terminal Ovarian Patient

洪玉純(Yu-Chun Hung) ； 施秀鈴(Hsiu-Ling Shih) ； 潘雪幸(Hsueh-Hsing Pan)

《源遠護理》 8卷2期 (2014/08) Pp. 63-69

https://doi.org/10.6530/YYN.2014.8(2).10

摘要

卵巢癌為女性癌症的第二位，症狀不易察覺，確定診斷後已進入疾病末期，難以忍受的疼痛，加上淋巴水腫使日常生活活動受限，並且因為疾病不可逆的進展而產生預期性哀傷，本文描述運用安寧療護善終理念在照護一位卵巢癌末期合併淋巴水腫個案的護理經驗。護理期間自2012年6月18日至2012年7月10日，以觀察、傾聽、會談及身體評估收集生理、心理、社會及靈性評估資料，發現個案有慢性疼痛、體液容積過量及預期性哀傷等護理問題，運用疼痛控制技巧及止痛藥物調整減輕個案的疼痛；同時也導入淋巴按摩與彈性褲緩解淋巴水腫；結合家人與個案充分溝通的機會，引入安寧療護善終理念降低個案的預期性哀傷，使個案及家人內心平安。藉此護理經驗的分享，建議在靈性照護中協助個案面對生命意義的過程，可轉介安寧共同照護，透過與安寧團隊合作討論，更能達成生死無憾，並提供臨床照護之參考。

關鍵字

卵巢癌 ； 善終 ； 安寧療護

並列摘要

This article describes the nursing experience of applying good death concept to a terminal stage ovarian cancer patient under hospice care. The patient had unbearable groin and leg pain, limited activity level due to lymphedema, and anticipatory grief from irreversible disease progression. Patient data was collected through observation, listening, interview, physical, psychological, social and spiritual assessment during a 23-day period in 2012. Three health problems were identified: 1) chronic pain, 2) excessive fluid volume and 3) anticipatory grief. Pain was control through pain management skills and pain medication adjustment. The use of lymphatic massage and elastic pants relieved the degree of lymphedema. By use of good death concept, the nurse guided the patient to communicate with family members to reduce her grief and to induce their feeling of peace. Through this nursing experience, it is recommended to include spiritual care when helping patients review their lives. The hospice team members may provide clinical care references to help patients achieve live and die without regret.

並列關鍵字

ovarian cancer ； good death ； hospice care