運用跨團隊模式協助一位下咽癌患者面對死亡恐懼之照護經驗

Nursing Experience from Caring a Hypopharyngeal Cancer Patients to Face the Fear of Death by Utilizing Cross-Team Model

10.29494/LN.202306_24(2).0010

王維敏(Wei-Min Wang)；葉美杞(Mei-Chi Yeh)

護理經驗 ； 下咽癌 ； 死亡恐懼 ； 跨團隊模式 ； nursing experience ； hypopharyngeal cancer ； fear of death ； cross-team model

領導護理

24卷2期（2023 / 06 / 01）

130 - 144

繁體中文;英文

當癌症惡化時病人不僅必須面臨生理症狀，更必須面對即將死亡的內心恐懼。如何使病人及家屬獲得安適，是護理角色功能之一。此病人的護理期間2019年11月24至12月21日，依據生理、心理、社會及靈性等層面進行整體性評估，確立了呼吸道清除功能失效、組織完整性受損及死亡恐懼的健康問題。透過全人照護理念及運用跨團隊模式，與團隊成員共同擬定照護計畫，探究病人死亡恐懼的癥結點，藉由團隊協助降低病人的恐懼。建議所有護理人員必須認識各專業成員的角色功能，並培養溝通及協調能力，善用跨團隊模式於護理實務，讓各專業的醫療成員發揮最大的作用，並「以病人為中心」提供個別化的照護措施，以達全人照護之成效。

Apart from facing physical symptoms, the patients also face the fear of forthcoming death when cancer progresses. One of an important function of the nursing role is to create comfort for patient and their family. The nursing period for this patient was from November 24 to December 21, 2019. Based on the overall assessment of physical, psychological, social and spiritual, health problems identified include airway clearance failure, impaired tissue integrity, and fear of death. Through the concept of holistic care and the use of a cross-team model, a care plan was formulated with team members to explore the crux of the patient's fear of death, and to help reducing the patient's fear. It is recommended that all nursing staff requires to understand the roles and functions of each professional member, in order to cultivate communication and coordination skills, make good use of the cross-team model in nursing practice, allow each professional medical member to play their role effectively, and base on "patient-centered" orientation, provide individualized nursing measures to reach the effectiveness of holistic care.

1. 吳孟蓉,黃雅鈴(2020)。一位深頸部感染病患初次接受氣切手術之護理經驗。若瑟醫護雜誌，14(1)，47-58。
   連結：
2. 姜瑤娟,李亭亭(2018)。護理人員使用跨團隊照護資訊系統的成效探討。護理雜誌，65(4)，49-59。
   連結：
3. 陳美君,陳宛榆,崔宛玉,張桂玲,洪敏瑛(2018)。整合跨團隊資源之個案管理照護方案提升癌症病人重返治療率之改善專案。護理雜誌，65(2)，75-84。
   連結：
4. 熊誼芳,蔡秀鸞,王怡人,李英芬(2016)。癌症病人害怕疾病進展之因素、評估與照護。腫瘤護理雜誌，16(增訂刊)，43-56。
   連結：
5. Pfister, D. G.,Spencer, S.,Adelstein, D.,Adkins, D.,Anzai, Y.,Brizel, D. M.,Bruce, J. Y.,Busse, P. M.,Caudell, J. J.,Cmelak, A. J.,Colevas, A. D.,Eisele, D. W.,Fenton, M.,Foote, R. L.,Galloway, T.,Gillison, T. M. L.,Haddad, R. I.,Hicks, W. L.,Hitchcock, Y. J.,Darlow, S. D.(2020).Head and neck cancers, version 2. 2020, NCCN clinical practice guidelines in oncology.Journal of the National Compre hensive Cancer Network,18(7),873-898.
6. Sanghavi, P. R.,Queenjal, A.,Patel, H.,Singh, R.,Ghoghari, M.,Kikato, C.,Patel, B.(2019).Management of Malignant Fungating Wound in Palliative Care-A Nursing Perspective.International Journal of Oncological Nursing,5(2),28-34.
7. Sharpe, L.,Curran, L.,Butow, P.,Thewes, B.(2018).Fear of cancer recurrence and death anxiety.Psycho‐oncology,27(11),2559-2565.
8. 陳力揚,連景峯,黃澤人(2016)。以開放性部分咽喉切除手術治療早期原發部位下咽癌之成效、功能及生活品質分析。臺灣耳鼻喉頭頸外科雜誌，51(3)，142-150。
9. 賴思瑜,黃思緯,江淑娟,吳美娟,謝嘉琪(2019)。一位乳癌復發個案面臨死亡恐懼之案例報告。秀傳醫學雜誌，18(2)，137-146。
10. 謝念芝,陳幼貴(2021)。照護一位乳癌病人合併惡性傷口之護理經驗。台大護理雜誌，17(1)，27-39。