一位年輕女性初次罹患肝癌末期之護理經驗

Nursing experience from caring a young woman with her first encountered terminal stages of hepatocellular carcinoma

林沛宸(Pe-Chen Lin) ； 陳芝文(Chih-Wen Chen)

《領導護理》 20卷4期 (2019/12) Pp. 94-106

https://doi.org/10.29494/LN.201912_20(4).0008

摘要

本報告探討一位肝癌末期年輕女性，在住院期間初次診斷癌末期的照護經驗，其病情告知身心反應與調適行為，個案期間自2016年8月10日至8月24日。筆者運用直接照護、觀察、會談及運用Gordon十一項健康功能型態為評估工具，確立個案有慢性疼痛、焦慮及預期性哀傷之健康問題。在護理過程中，筆者與個案及家屬建立良好信賴治療性人際關係，以個案為中心，考量個案處境、心理及情緒反應，依其需求、喜好、價值觀與自主權，以藥物及非藥物物理方法來緩解疼痛 ，以誠懇、尊重的態度，同時表達關懷、陪伴、支持，包容、同理心與接納，和個案及家屬溝通，引導個案與家屬坦然面對癌症，讓彼此說出心裡的想法；鼓勵個案能力可及下的計畫未來生活，給予實際的希望。故期望透過此次照顧經驗，提供護理人員在臨床上照顧此類病人之參考。

關鍵字

肝癌末期 ； 病情告知 ； 預期性哀傷

並列摘要

This article probes the nursing experience of a young woman being informed with terminal-stage of hepatocellular carcinoma as initial diagnosis during her hospitalization and hence observation of her physical and psychological reactions as well as her adaptation in the truth telling. The nursing period was from August 10th to 24th in 2016. The authors collected information through direct patient care, observation, and interview. Gordon's 11 functional health patterns were applied to assess the patient's nursing requirement. Three major health problems were identified as chronic pain, anxiety, and anticipatory grief. In the process of nursing care, we established good trust and therapeutic interpersonal relationship with the patient and family members. Based on the specific patient, we considered the situation, as well as psychological and emotional reaction. According to the requirement, personal preferences, values and autonomy, we used both drug and non -drug physical methods to relieve the pain, express concern, companionship, support, tolerance, empathy and acceptance with sincere and respectful attitude. We communicated with both patient and family to face cancer calmly and encourage both speaks out of their minds. We encourage the patient to conduct future plans with possible ability and deliver practical hope. This nursing experience can serve as a reference for other nurses who are taking care of patient with similar diagnosis.

並列關鍵字

terminal-stage of hepatocellular carcinoma ； truth telling ； anticipatory Grief

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