一位中年男性面臨癌末惡病質及死亡之照護經驗

Nursing experience of a middle-aged man facing terminal cancer cachexia and death

10.6692/KJN.201812_35(3).0008

鄭碧芬(Pi-Fen Cheng)；王姮樺(Heng-Hua Wang)；潘慧娟(Hui-Chuan Pan)；陳繪竹(Hui-Zhu Chen)

癌症惡病質 ； 慢性疼痛 ； 安寧照護 ； Cancer cachexia ； chronic pain ； hospice care

高雄護理雜誌

35卷3期（2018 / 12 / 01）

83 - 95

繁體中文

本文為一位中年男性面臨癌末惡病質及死亡之照護經驗，藉由觀察、會談及身體評估與查閱病歷等方式收集資料，並依生理、心理、社會及靈性層面進行整體評估，確立主要健康問題為營養少於身體所需、慢性疼痛及預期性哀傷等。藉由安寧的四全照護理念，提供個案在生命餘程的個別性護理措施。制定專屬的客製菜單，提高個案進食意願；運用止痛藥物及非藥物的輔助療法，緩解因癌末引發的疼痛；利用生命回顧引導個案表達內心感受，讓個案及家屬能正向面對死亡。此外，協同社工師向政府及民間慈善團體申請補助，並運用人飢己飢及人溺己溺的力量進行募款，減輕個案及家屬的經濟負擔，期望藉由此個案照護經驗，提供臨床護理同仁照護類似案例之參考

In this article, we share the experience of caring for a middle-aged man's terminal cancer cachexia and his death care. Data was collected by observation, interviews, physical examination and reviewing the medical charts. The major health problems were confirmed to be insufficient nutrition, chronic pain and anticipatory grief by overall assessing the patient physically, psychologically, socially and spiritually. By the hospice and palliative care of the four whole care modes, we provided the patient with individualized measures of care for the remainder of his life, including making customized food to increase his appetite. The cancer pain was relieved by both medical and non-pharmacological treatments. The patient was guided to express how he really felt by reviewing his life, so that the patient and his family could find a more positive way to face his death. In addition to applying for subsidies from government and charities with the aid of social workers, we also carried out fundraising from all sectors of the community to reduce the economic burden. We hope this nursing experience can provide a guideline for clinical nurses caring for similar cases.