運用Peplau與Henderson理論協助肺癌末期病人面對死亡的護理經驗

The Nursing Experience in Applying Peplau & Henderson's Theories to a Patient with Lung Cancer in Hospice Care

10.30096/CSMJ.200606.0012

黃惠美(Hui-Mei Huang)；李選(Sheuan Lee)

肺癌 ； 安寧療護 ； Peplau理論 ； Henderson理論 ； 瀕死過程 ； Lung cancer ； Hospice care ； Peplau's Theory ； Henderson's Theory

中山醫學雜誌

17卷1期（2006 / 06 / 01）

109 - 118

繁體中文

末期病人常承受許多身體症狀，如：呼吸喘、疼痛等，且情緒錯綜起伏，加上對是否接受安寧療護態度猶豫不定，導致護理人員建立治療性人際關係發生困難，本文先應用Peplau理論架構，以愛、關懷及包容態度，以漸進方式建立治療性人際關係，於取得病人及家屬信任後，再應用Henderson理論架構評估與滿足病患14項基本需求，協助處理呼吸困難及疼痛問題之症狀控制；協助皈依宗教及達成捐贈器官的心願；於陪同病人及家屬共同經歷瀕死過程中，分享內心感受、肯定其存在價值與安排後事，病人在全人、全家、全程與全隊的陪伴下往生，家屬感到安慰。此經驗可作為安寧療護之參考。

Patients in the terminal stage are physically distressed, often in pain and suffering from dyspnea. They also experience emotional fluctuations and they are wary of accepting hospice care. All of this makes it very difficult for the nursing staff in a palliative care unit to establish a therapeutic relationship with the patients. The implementation of Peplau's theoretical framework enabled a nurse who provide of primary care for a lung cancer patient in terminal illness to gradually establish a therapeutic relationship with a loving, caring and accepting attitude, and to gain the trust of the patient and his family. Then, by implementing Henderson's theory to evaluate and meet 14 basic needs, the nurse was able to help control dyspnea and pain, showed compassion and remained with the patient and his family throughout the dying process. The patient passed away under peaceful circumstances which were of great comfort to the family. The nurse subsequently helped with the conversion rituals and to fulfill the patient's wishes concerning the arrangement of organ donation. This case report can make a contribution towards devising a hospice care model for use in a clinical setting.