協助漸凍人撤除呼吸器之護理經驗：一個案報告

本文是協助一位肌萎縮性側索硬化症病人撤除呼吸器之護理經驗，在照護期間（2007年1月22日至3月13日）與團隊成員以會談、觀察其非語言及互動行爲、召開家庭會議等方法收集資料，進行整體性評估發現個案因疾病不可逆的失能狀態，導致生活無法自理、家庭關係間角色的衝突及生命存在無意義等因素，個案希望撤除呼吸器。透過適當的護理措施，提高照護品質滿足個案需求並與團隊成員引導個案生命回顧、同理個案情緒加強家庭成員間的溝通肯定其價值，讓個案和媽媽的母子關係改善；和案子的互動增加，順利完成托孤給二哥。由於身體被限制在病床上，再也不能爲人子、爲人父，這樣的處境是他堅決撤除呼吸器的主因。基於尊重不可治癒末期病人之醫療自主權前提下，於2月26日撤除呼吸器；3月13日病情穩定，出院接受居家照護，落實安寧療護之全人、全家、全程、全隊之「四全」照顧。

關鍵字

安寧療護；決策過程；撤除呼吸器

並列摘要

The purpose of this article is to present a nursing care experience to withdraw ventilatory support from a illness patient with Amyotrophic Lateral Sclerosis (ALS). The direct nursing care was provided by the author to this 32 year old male patient for two months period during the year 2007 at the hospice ward. The data was collected through the interview method and counseling skills. The discharge nursing care plan was applied to this patient since his first admitted. The holistic nursing care approach was practiced and did fulfill patient's needs. Base on the ethical principle of autonomy and patient's last will patient's ventilator was removed at end of February, 2007. Furthermore, he was discharged during the middle of the March at the same year due to the stable condition. Continuing home hospice care was introduced to this patient and family caregivers. The findings of this case study show that hospice care was fulfilling patient and family caregivers' need in time. Moreover, the ideal of hospice care approach was also well applied and practiced during the care of this patient.

並列關鍵字

hospice care ； decision making ； withdrawal ventilatory support

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協助漸凍人撤除呼吸器之護理經驗：一個案報告

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