運用靈性照護於一位腎臟癌末期個案之重症護理經驗

Spiritual Care for a Terminal Renal Cell Carcinoma Patient

10.6692/KJN.202208_39(2).0009

陳芳庭(Fang-Ting Chen)；王妍惠(Yen-Hui Wang)

腎臟癌末期 ； 靈性照護 ； Terminal Renal Cell Carcinoma ； Spiritual Care

高雄護理雜誌

39卷2期（2022 / 08 / 01）

101 - 112

繁體中文

本文為描述一位初診為腎臟癌末期個案之護理經驗，照顧期間為2018年6月19日至2018年6月28日。筆者經由身體評估、觀察、會談等方式，運用生理、心理、靈性及社會層面進行評估，確立個案健康問題有：1.疼痛／與癌症有關；2.抉擇衝突（家屬）／與不知道如何告知個案病情有關；3.靈性困擾／與面臨死亡而感到焦慮，及否定自我價值有關。筆者有感於罹患癌症對家屬的心理衝擊及個案因癌症造成身體的不適及對病情不了解所帶來的焦慮，協助處理個案疼痛不適，主動關懷、陪伴及傾聽，與個案及家屬建立信任關係，鼓勵個案提出對病情的疑惑與家人討論，另也引導家屬認同個案疾病及了解自我情緒，理解造成抉擇衝突的相關因素，最終召開家庭會議，使個案得知癌症事實，並採用靈性照顧方式，使之了解生命本質的意義及價值，能與家人朋友即時說出愛與道別，讓生命不留遺憾。藉此分享提供此類病人之護理經驗。

The article describes a nursing experience for an initially diagnosed terminal renal cell carcinoma patient during the caring period from June 19, 2018 to June 28, 2018. Th patient's health problems were identified including (1) pain associated with cancer, (2) family members decisions/conflicts associated with difficulty in recognizing states of illness, and (3) spiritual distress associated with the anxiety of facing death and denied for self-worth. The author used active nursing measures including accompanying and listening to build trustful relationships with the patient and family through resolving the uncomfortable feelings of pain. Finally, by being encouraged to obtain the facts about cancer, the patient was able to raise questions of blurry conditions to his family, guiding the family to understand the illness and admit their own emotions, analyze the factors of decision conflicts, and arrange family meetings to communicate the differences. Spiritual care was applied to the patient so that they could explore the essence, meaning and value of life, expressing love and bidding farewell to family and friends in time without regret. It is hoped this report could help clinical nurses increase their sensitivity towards spiritual needs of patients and enhance care quality.

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