急性骨髓性白血病之照護：一個案報告

個案為一位34歲未婚男性，家中排行老三（有大姊與二哥），發病前曾擔任婚紗攝影師與專任司機的工作，自主性很強，因罹患難治性急性骨髓性白血病於血液腫瘤科病房住院接受治療前後半年多的時間，在病情難以改善、疼痛症狀不易得到控制的情形下對醫護人員失去信心與信任。當個案來到安寧病房時，對於用藥的要求與主觀選擇以及情緒上的反應，讓安寧療護團隊承受不小壓力，於十一天的住院過程中，經由團隊的努力獲得個案與家屬的信任，同時積極地用各種方法緩解其疼痛與不適，而後來個案意識昏迷、但案姊仍未自美國趕回台灣前，家屬著急地希望團隊考慮給予病人化療或白血球分離術(leukapheresis)時，團隊給予支持與適當的處理，並引導家屬作出對病人最好的決定；終於心願完成、全家團聚，最後達到善終與生死兩相安的圓滿結局。

關鍵字

急性骨髓性白血病；癌症末期；安寧緩和療護

並列摘要

This case was a thirty-four-year-old unmarried man with independent personality. During the half year of treatment for acute myeloid leukemia at the hemato-oncology ward, he had suffered from uneasily released discomfort and refractory condition. When he was admitted to our hospice, his subjective medical requests and emotional responses once stressed on the hospice care team. We actively gave him psycho-socio-spiritual support and relieved all his physical symptoms, which gradually earned the trust from this patient and his family. When he became unconscious, our hospice care team enhanced the support to his family and offered him the most proper management with the preference of the patient and his family. Through the eleven days of hospitalization, our hospice care team help this patient to accomplish his wishes and the family reunited. Our clinical Buddhist chaplain also delivered the end-of-life dharma speech. Eventually, the family received the great comfort and the good death was achieved as well.

並列關鍵字

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急性骨髓性白血病之照護：一個案報告

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