肺癌合併骨轉移之末期照護：個案報告

本文描述照護一位肺癌併骨轉移病人之末期照護，照護期間為2020年10月4日至11月4日，藉由實際護理觀察、評估、會談、與個案及家屬之互動，應用Gordon十一項健康功能型態，進行生理、心理、社會、靈性層面之整體評估，發現個案有慢性疼痛、預期性哀傷、無望感等健康問題。運用團隊合作照護模式，出院後電話追蹤及門診追蹤方式，提供症狀治療，藉由藥物及非藥物之止痛方式，減輕疼痛，舒緩不適症狀；建立良好的護病關係，利用傾、溝通及同理心技巧，接受其情緒反應，運用生命回顧，使個案重拾對生命價值、意義及家庭成員之間的愛與關懷，改善無望感之負向情緒；藉由會談技巧鼓勵個案與家屬說出內心真實感受及面對死亡的事實，引導家屬敘說心中對個案的感謝及死亡的準備，促進家屬與病人相互道別與道愛，讓彼此都無憾。期望藉此個案報告之照護經驗，做為日後照護類似個案的參考。

關鍵字

肺癌；骨轉移；末期照護

並列摘要

This article describes the terminal care of a patient with lung cancer and bone metastases. The period of care is from October 4th to November 4th, 2020. Gordon's eleven health functions are used to integrate the physical, psychological, social, and spiritual aspects. The assessment revealed that the patient had health problems such as chronic pain, anticipatory grief, and hopelessness. Use the teamwork care model to provide symptom treatment, use drugs and non-drug pain relief methods to reduce pain and relieve uncomfortable symptoms; establish a good nurse-patient relationship, use listening, communication and empathy skills to accept their emotional responses, and use Life review enables the case to regain the love and care for the value, meaning of life and family members, and to improve the negative emotion of hopelessness; to encourage the case and family members to tell the truth about their inner feelings and the fact of facing death through the use of interview techniques. Family members narrate their gratitude for the case and preparations for death, and promote mutual goodbye and love between family members and patients, so that each other has no regrets. It is hoped that the care experience reported in this case can be used as a reference for caring for similar cases in the future.

並列關鍵字

lung cancer ； bone metastasis ； terminal care

國際替代計量

肺癌合併骨轉移之末期照護：個案報告

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