- 期刊
照護一位口腔癌末期病人接受安寧共同照護之護理經驗
The Nursing Experience of Hospice Combined Care for an End-Stage Oral Cancer Patient
摘要
本文旨在探討照護一位口腔癌末期病人接受安寧共同照護之護理經驗，個案因口腔腫瘤蕈狀傷口斷續出血滲濕及疼痛控制不佳，且面對病況不佳及死亡不確定感導致產生恐懼及擔憂，故引發筆者探討的動機。照護期間自2016年11月28日至12月9日，運用生理、心理、社會與靈性整體性評估方式收集資料，發現個案健康問題為慢性疼痛、組織完整性受損、死亡恐懼，照護過程運用安寧全人、全家、全隊、全程四全照護理念，提供個別性護理措施，改善腫瘤蕈狀傷口滲濕出血情形及緩解個案疼痛，進而使個案主動表達情感，並與安寧共同照護團隊合作，協助個案與家人互訴道謝、道愛、道歉、道別四道人生，了解生命的意義及價值，達到生理、心理、社會、靈性的平安，筆者於臨床照護中有感於臨床護理師於照護期間引領個案面對個案死亡恐懼及家屬面對臨終照護仍具有壓力，建議院方可增加臨終照護的擬真教學，讓醫護人員有更多機會可以了解如何應對死亡議題的溝通技巧，以提供末期病人更完善的照護品質，藉此個案護理經驗之分享，提供照顧此類個案之參考。
並列摘要
This article describes the nursing experience of applying hospice combined care to an oral cancer patient at the terminal stage. The patient suffered from fungating wound bleeding and poor pain control. The patient faced a rapid declined condition and the fear of death. The caring period was between November 28 and December 9, 2016. Data were collected through physical, psychological, social and spiritual assessment for a holistic health assessment. The patient's health problems were chronic pain, impaired tissue integrity and fear of death. The approach used the hospice concepts of the whole person, whole family, whole course, and whole team. Interventions included the care of the fungating wounds to reduce exudates and bleeding, and measures relieving pain. The care team assisted the patient and family members to express their feelings of love, gratitude, forgiveness, and grace toward each other. It provided them peace in aspects of physical, psychological, social, and spiritual, and in mitigating the fear of death. It is suggested that the hospital incorporate learning from this care experience and offer simulation training on hospice care and communication skill to intervene with a patient's fear of death in the end-of-life care.
參考文獻
延伸閱讀
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