本文旨在探討照護一位肺癌末期病人身、心、靈至善終之護理經驗,護理期間自2010年11月29日至2010年12月22日止,筆者運用觀察、訪談收集資料及安寧療護指引評估病人,發現病人除了有疼痛、呼吸困難之身體層面問題外,在心理層面有預期性哀傷,靈性層面則有寬恕與和解等健康問題。照護期間筆者除了使用嗎啡藥物緩解病人的疼痛、呼吸困難情形外,並以薰衣草、迷迭香等精油做芳香療法按摩及薰香,另以穴位指壓、經皮神經電刺激器等方式減輕病人身體上的不適。針對心理層面則透過家庭會議及團隊力量,引導病人及家屬一起面對臨終的過程及完成病人的心願。靈性上則運用生命回顧的方式,統整病人過去對生命的經驗;此外,並運用「四道人生」引導病人與案妻、前妻及兒子們在有限的生命旅程中相互道歉、道謝、道愛及道別,達到平安善終的照護目標。對於未來若能發展獨特、創新、符合個別需求的舒適照護及另類輔助療法,可更加提升臨終照護品質。
This article described the nursing experience in dealing with the physical, psychological, social and spiritual needs of a lung cancer patient who received hospice care to enable a good death. During hospitalization from Nov. 29 to Dec. 22, 2010, the author used observation, listening, interview, and hospice guidelines to assess the patient. The health problems of the patient included pain, dyspnea, anticipatory grief and spiritual dimension of forgiveness. Through the nursing process, the author used opioids to relieve pain and dyspnea; aromatherapy with lavender and rose essential oils, acupressure, and transcutaneous electrical nerve stimulation were used to alleviate the patient's physical discomfort. Family conference was arranged and they were encouraged to accompany the patient in confronting death and saying goodbye. The author used life review to guide the patient through the entire experience of life and encourage the patient and family to express their love, thanks, apology and farewell to one another. If a unique, creative, individualized care and alternative complementary therapies are included, these will enhance the quality of hospice care.