- 期刊
運用安寧療護理念於食道癌末期個案之全人照護經驗
Applying Hospice Care Concepts on a Patient with Terminal Stage Esophageal Cancer: A Holistic Care Experience
摘要
本個案報告是描述運用安寧療護理念協助一位食道癌末期個案面對身、心、靈各層面苦難之全人照護經驗，護理期間自2009年6月2日至2009年7月2日，筆者透過實際參與照護，運用會談、觀察、同理等溝通技巧，進行整體性的評估，統整出個案各層面的問題，包括（1）生理層面：以呼吸系統障礙症狀、疼痛、吞嚥困難三個問題為主；（2）心理社會層面：標靶藥物使用與經濟負擔之衝突、案妻對個案後事處置之壓力；（3）靈性層面：尋求自我存在的價值感、受苦背後之意義；針對個案所出現之護理問題，過程中深入去聆聽、了解其需求，給予其個別性之護理措施，運用舒適護理措施，積極協助症狀之控制，透過家庭及醫護團隊的協商對話，對標靶藥物的續用與否找到可接受之平衡點，在安寧療護理念的照護下，個案開始積極自我照顧，接受疾病之苦難，展現珍惜生命的勇氣，使個案達到平靜、安詳、且無憾的善終，期盼分享此個案的照護經驗提供護理人員照顧此類似案例的參考。
並列摘要
The purpose of this article was to describe a nursing experience using hospice palliative care to relieve total suffering resulting from physical, psychological, social and spiritual aspects in a terminal patient with esophageal cancer from June 2 to July 2, 2009. Each aspect of problems was identified by means of direct participant care, interview, observation, empathetic communication and holistic assessment. Such included: (1) the physical aspect: distress caused by the respiratory disorder symptoms, pain, and difficulty swallowing; (2) the psychosocial aspect: faced the conflict between the pressure of stop using the targeted therapy and the economic burden of using the targeted therapy, the patient of the wife on the funeral of patient disposed of pressure; (3) spiritual aspect: pursuit of a sense of self-value of existence, and the meaning of suffering. For nursing problems to the nursing care, including in-depth to listen, to understand their needs, to give a individualized nursing interventions, the use of comfortable nursing care, actively assist the control of symptoms, family and medical team through consultation and dialogue, of targeted therapy of whether or not, to find an acceptable balance point. In the hospice philosophy of care, the patient began to actively take care of themselves, to accept the suffering of disease, show respect for life of courage, to make the case to achieve calm, peaceful, and without regret of the hospice. This nursing experience of holistic care may be shared for reference in future clinical nursing care.
延伸閱讀
- 王夢筑、鄭幸蓉、李紫綺（2022）。結合安寧共同照護一位食道癌末期病人護理經驗。腫瘤護理雜誌，22(2)，89-102。https://doi.org/10.6880/TJON.202212_22(2).07
- 李英芬、陳淑貞（2000）。一位接受安寧居家照顧之食道癌病患之護理經驗。安寧療護雜誌，5(1)，58-68。https://doi.org/10.6537/TJHPC.2000.5(1).12
- 張雅欣、董依真（2016）。運用關懷及安寧療護理念於胃癌末期病人之護理經驗。澄清醫護管理雜誌，12(4)，54-63。https://www.airitilibrary.com/Article/Detail?DocID=18136702-201610-201610040016-201610040016-54-63
- 許彣萱、李國箴（2015）。運用舒適理論於食道癌末期病人及其照顧者護理經驗。腫瘤護理雜誌，15(1)，59-71。https://doi.org/10.3966/168395442015061501007
- 洪怡蘋、蘇億玲（2012）。Hospice Care Nursing Experience of a Patient with Terminal Stage Esophageal Cancer and His Family。長庚護理，23(2)，219-228。https://doi.org/10.6386/CGN.201206_23(2).0009