一位癌末學齡前期病童之安寧療護經驗

本文為運用安寧療護於一位癌末學齡前期病童面臨癌症帶來的身體不適，及對死亡的焦慮、害怕，父母親面對失去病童所承受的哀傷情緒，給予身、心、靈及社會的支持及照護。筆者於實際照護過程中運用Gordon11項健康功能型態評估，確立病童有「慢性疼痛」、「死亡焦慮」、「案父母預期性哀傷」等問題。以安寧療護之概念，提供病童個別性的護理照護，在藥物及非藥物的輔助下緩解疼痛不適，結合安寧共同照護的團隊資源，建立與病童及家屬信任關係，傾聽陪伴，給予關懷並提供心理支持，引導病童及家屬說出感受及抒發哀傷情緒，讓病童及家屬減少死亡焦慮與哀傷反應，進而提升其身心靈安適。

關鍵字

安寧療護；癌末；學齡前期病童

並列摘要

This article was a nursing care experience about palliative care in a preschooler with cancer. We used hospice and palliative care to give care to body, mind, spirit and society support for child and parents, when child was unwell, anxious and fear of death as well as parents facing the pain of losing a child. The nursing period was from Feb 1, 2018 to Feb 22, 2018, and by using Marjory Gordon eleven functional health patterns, we collected the data of physical assessments, observations, conversation and medical chart review during the clinical practice. We found that the nursing assessment clarified certain nursing issues including: chronic pain, death anxiety, and anticipatory grief of parents. During the care process, we used the concept of holistic all-round care and integrated with the hospice team resources to provide individual care, relieve pain and discomfort with drugs and non-drugs, establish relationships with patient and family and gain their trust, listen and accompany, give care and psychological support. We also led patient and family members to express feelings and release sadness, so that they can reduce death anxiety and grief, and thereby improve their physical and mental comfort.