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協助一位晚期胃癌病人的護理經驗
Nursing Experience for a Terminal Gastric Cancer Patient
摘要
本文旨在探討一位罹患晚期胃癌併發惡性腹水病人的生、心、社會、靈性狀況和健康需求。護理期間（97年9月29日至10月6日）以主動真誠的態度建立治療性人際關係，並運用會談、觀察、傾聽，與護理評估等技巧，輔以「Gordon十一項健康功能評估」來進行各項資料的收集，由資料分析結果，確立病人有疼痛、營養狀況改變、預期性哀傷等主要健康問題。於護理過程中，並運用安寧療護之「四全照顧」理念，透過關懷、接納、鼓勵與協助，讓病人及其家屬表達內心成受；當疾病進展至晚期，協助病人減緩癌症引起的不適，提供支持並指導家屬共同參與照護活動，減輕病人及其家屬哀傷反應，最後達至「身、心、靈」平安的過程。本文希望藉由此個案報告與經驗分享，能對日後照顧此類癌症病人之護理同仁有所助益。
並列摘要
This case report presents the nursing experience of a patient with terminal stage of gastric cancer during the period of hospitalization. From September 29 to October 06, 2008, the authors used Gorden's 11-item functional health patterns to assess the patient's physical, psychological, social, and spiritual aspects comprehensively and continuously. Data was collected through physical assessment, clinical interviews, and observation of family interaction. A number of health problems were identified as followings: (1) cancer-related pain; (2) nutritional deficiencies; (3) lose and complicated grief. During the nursing process, the patient was provided with the four whole concepts of the hospice care (the patient and his family-whole person, whole family, whole course of the disease, and whole medical team), the goal of which is to help the patient and his family experience comfort, peace, and contentment during their grieving period. It is expected this report will be a valuable reference and inspiration for nursing staff committed to providing high quality of care to the terminal cancer patients.
延伸閱讀
- 洪玉純、張煦婕、潘雪幸（2020）。照顧一位胃癌末期合併腸躁症病人的護理經驗。源遠護理，14(1)，56-61。https://doi.org/10.6530/YYN.202003_14(1).0007
- 吳苡綾、周憶珊、廖婉君（2022）。協助一位大腸癌末期病人臨終之護理經驗。高雄護理雜誌，39(1)，145-156。https://doi.org/10.6692/KJN.202204_39(1).0012
- 呂怡瑩（2020）。協助一位肝癌末期病人之全人照護經驗。安泰醫護雜誌，26(1)，27-39。https://www.airitilibrary.com/Article/Detail?DocID=18111955-202006-202006040006-202006040006-27-39
- 林蓮馨、陳孟君（2014）。協助一位胃癌末期合併肝轉移病人善終之護理經驗。榮總護理，31(3)，314-320。https://doi.org/10.6142/VGHN.31.3.314
- 莊涵淳、林素慧、黃春霞（2019）。The Nursing Experience of an End-Stage Rectal Cancer Patient。腫瘤護理雜誌，19(1)，77-89。https://doi.org/10.6880/TJON.201906_19(1).07