一位罹患雙重癌症病人接受安寧療護之護理經驗

Nursing Experience from Caring a Patient with Double Cancer Receiving Hospice Care

10.29494/LN.202003_21(1).0006

劉奐嫻(Huan-Hsien Liu)；葉淑敏(Shu-Min Yeh)；洪玉龍(Yu-Long Hong)

雙重癌症 ； 癌症病人 ； 安寧療護 ； 羅氏適應模式 ； double cancer ； patient with cancer ； hospice care ； Roy's adaptation model

領導護理

21卷1期（2020 / 03 / 01）

63 - 76

繁體中文

本篇描述一位罹患雙重癌末病人，在短時間內病情快速變化，無法接受身體疼痛及對疾病不確定感到害怕，照護者缺乏照護知識及心理準備，護理期間於2016年3月24日至4月12日，藉由傾聽、觀察、溝通及病歷查閱等方式收集資料，並運用羅式適應模式評估個案主要健康問題有：疼痛、靈性困擾及照顧者角色緊張。筆者依病人之個別性、配合醫療處置及安寧緩和醫療，建立彼此間的互動與信任後，主動協助主要照顧者建立APP家庭群組溝通管道，以「家庭為中心」的照護理念，共同商議後選擇安寧緩和照護，並藉由信仰力量，以平靜的心靈體會人生意義，讓個案人生圓滿有尊嚴及平安的善終。期盼此護理經驗能提供護理同仁臨床照顧參考，以提升護理品質。

This paper describes a terminal illness patient with double cancer whose condition changed rapidly within a short period of time. The patient experienced intolerable physical pain and fear of uncertainty regarding the disease, and the caregiver lacks caring knowledge and mental preparation. The nursing period was from March 24 to April 12 in 2016, and data were collected from listening, observations, communication, and medical records review. Roy's adaptation model was applied in order to evaluate and diagnose the major health problems of the patient: pain, psychological distress, and caregiver anxiety. According to the characteristics of the patient, incorporate with medical procedures and hospice palliative care, the author established mutual interactions and trust with the patient. Subsequently, the author proactively assisted the primary caregiver by establishing a family group communication channel in an app. Using a ＂family-centered＂ care theory, hospice palliative care was selected after discussing with relevant personnel; eventually, through the strength of faith, the patient experienced the meaning of life with a peace of mind, enabled the patient to pass away peacefully with dignity. This nursing experience hopefully can serve as a reference for nursing personnel to improve nursing quality.

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