- 期刊
照顧一位胃癌末期病人面臨哀傷之護理經驗
The Nursing Experience of Caring for a Terminal Gastric Cancer Patient Going Through Grief
摘要
本文是敘述一位胃癌末期病人，在病況持續惡化，面臨疾病造成的身體不適及哀傷等問題之護理經驗。照護期間為2019年11月24日至12月28日，藉由直接照護、會談及觀察家庭互動等方式收集資料，並運用Gordon十一項功能健康型態評估，分析歸納出個案有疼痛、噁心嘔吐及預期性哀傷等健康問題。運用疼痛十分量表評估疼痛，超音波芬香噴霧器及音樂、追劇轉移注意力來減輕疼痛；教導漸進式肌肉鬆弛法、足三里穴位按摩以減輕噁心感；面對即將死亡的事實，藉由會談技巧及家庭會議，鼓勵個案與案母說出內心真實感受，引導案母敘說心中對個案的感謝及死亡的準備。照顧期間藉由與跨團隊建立雙向溝通與合作關係，為個案及家屬擬訂適切的照護計畫，筆者受益良多。因此，建議可將此次跨團隊整合照護經驗平行展開至其他病房，鼓勵人員參與團隊會議，學習各團隊間如何共同討論有益於個案的醫療照護措施，進而提升照護品質。
並列摘要
This article is about the nursing experience of caring for a patient with terminal gastric cancer. The physical discomfort and mental impact were noticed while facing disease in progression. The period of nursing care was from 24th, November, 2019 to 28th, December, 2019. By direct patient care, interview, and observation of family interaction, we collected data and utilized Gordon 11 Function Health Patterns to evaluate the health issues of this patient. Pain, nausea, vomiting and anticipatory grief were identified as the heath problem of this patient. Pain Numerical Rating Scale was used to evaluate the pain level. To relieve pain and distract the patient from the discomfort, the patient used perfume atomizer, listened to the music and binge-watched soap operas. We also taught the patient progressive muscle massage and Chinese acupoint massage to relieve nausea. In order to help the patient face the reality of impending death, we encouraged the patient to speak out the true feelings and share his deep thoughts with his mother while directing his mother to express appreciation to the patient by using communication skills in the family meeting. Through the multidisciplinary team meetings and collaborations, we devised an adequate treatment plan for the patient and the family. The author truly has learned a lot from this patient. Therefore, it motivated the author to share this article in hopes that we can promote the multi-department team collaboration to other nurse stations and encourage them to participate in the team meetings. By learning some better method of patient care from other teams, we can improve the overall quality of patient care.