陪伴癌症末期病人與家屬跨越生死長河之全人照護經驗

Nursing Experiences of End-of-Life Care for Patients and Their Family Members

潘雯秀(Wen-Shiou Pan)

《榮總護理》 34卷3期 (2017/09) Pp. 263-270

https://doi.org/10.6142/VGHN.34.3.263

摘要

在癌症末期階段，病人與家屬需要莫大的勇氣與支持，才能平安跨越生、死分離的長河。本文為一位青壯年男性病人及家屬因病情進展及對生命的不確定而引起複雜的身、心、靈層面困擾之護理經驗，護理期間為2016年07月1日至07月13日。筆者運用觀察及訪談進行生理、心理、社會、靈性四層面評估，確認病人有疼痛生理不適症狀及心靈困擾；家屬則有預期性哀傷問題。筆者依據身體評估及疼痛量表，調整止痛藥物，輔以個別性照護，緩解生理不適；協同安寧團隊傾聽及陪伴，引導病人及家屬說出心中感受；運用生命回顧，獲得自我統整與療癒，放下心中罣礙與不捨，獲得心靈的平安。同時，協助家屬完成病人心願與後事準備，在安寧團隊全心的照護下，病人善終，家屬圓滿。冀望藉此經驗分享，提供相關人員照護癌症末期病人與家屬之參考。

關鍵字

全人照護 ； 預期性哀傷 ； 心靈平安

並列摘要

This article is a describes nursing experience of treating young men with positive attitudes and their family members facing the progress of diseases and uncertainty in life caused by various complex physical and mental problems. The study period was from July 01 to 13, 2016. Based on observations and interviews, a four-level assessment of the patients' physical, psychological, social, and spiritual conditions was conducted to confirm whether the patients experienced pain, physical symptoms, or mental distress. The nurses faced many problems, including the initial expectation that family members would feel sad. Based on physical assessments and the pain scale, analgesic drug prescriptions were adjusted and supplemented by individual care to alleviate the symptoms of physical discomfort. The nurses coordinated with the medical team to offer listening and companionship services to guide patients and their families in discussing their feelings. Life reviews were conducted to analyze patients' self-integration and healing, thereby providing peace of mind to the patients in the face of such dismay. Furthermore, family members were guide to complete the patients' wishes and prepare for their funerals so that there would be no regrets. Finally, because of the peace of mind facilitated by the care provided by the team, patients and family members could make all relevant decisions about each patients' end of life care in a timely manner. We hope that these experiences can be shared to serve as references for clinical end of life care.

並列關鍵字

holistic care ； anticipatory grieving ； spiritual well-being

參考文獻

梁淑媛、丁熙安、李慧貞、盧玉嬴、高聖惠(2014)．疼痛對癌症病人的情緒衝擊．健康科技期刊，2(1)， 20-37。

陳雅琪、楊立華、張理君、廖珍娟(2011)．臨終癌症病患家庭之關懷．腫瘤護理雜誌，11(1)，1-12。

張惠甄、劉曉玫、李依純、陳萱芳、周培萱(2005)．穴位按摩臨床護理運用之文獻回顧．長期照護雜誌，9(3)，91-101。

趙可式(2015)．安寧療護是普世價值且為護理的本質．護理雜誌，62(2)，5-12。

鄭如芬、林雅卿、黃百后、韋至信、孫嘉玲(2014)．癌症末期病人靈性照護模式．護理雜誌，61(6)，93-97。