一位大腸直腸癌末期病人之臨終照護經驗

Hospice Care for Patients with End-Stage Colorectal Cancer

10.6692/KJN.202408_41(2).0014

陳香君(Xiang-Jun Chen)；杜慧娟(Hui-Chuan Tu)；吳金玲(Chin-Ling Wu)；蔡麗琴(Li-Chin Tsai)

大腸直腸癌 ； 臨終照護 ； 無望感 ； 疼痛 ； colorectal cancer ； palliative care ； hopelessness ； pain

高雄護理雜誌

41卷2期（2024 / 08 / 01）

155 - 166

繁體中文;英文

本文旨在探討一位大腸直腸癌末期病人之臨終照護經驗，護理期間為2020年5月5日至5月17日，藉由臨床照護、身體評估、直接觀察、主要照顧者及會談紀錄與查閱病歷等方式收集資料，並以Gordon十一項健康功能型態評估架構作為依據，進行分析歸納後，確立主要護理問題為：低效性呼吸型態、慢性疼痛、無望感。在護理過程中，筆者運用專業知識及技能緩解個案因疾病造成之身體不適，並以傾聽、同理心與個案建立良好治療護病關係，透過跨團隊合作照護力量，給予陪伴及生命回顧，有效地改善個案的負向情緒，也肯定其生命意義與價值，讓個案及家屬的心靈均能獲得慰藉，能以正向態度來面對臨終過程，並獲得善終，期待藉此照護經驗分享，能提供臨床實務參考，給予適切的身、心、靈照護，以提升臨終照護品質。

The aim of this study is to discuss the end-of-life care experience of a patient diagnosed with end-stage colorectal cancer from May 05 to May 17, 2020. Data are collected through clinical care, physical assessment, direct observation, primary caregiver and interview records which are based on Gordon's eleven health functional pattern assessment framework. After analyzing and summarizing that the main nursing issues are ineffective breathing pattern, chronic pain, and hopelessness. Throughout the nursing process, the authors use professional knowledge and skills to alleviate the patient's physical discomfort and establish a good therapeutic nursing relationship with the patient through listening and empathy. Moreover, through the cross-team cooperative care, the authors provide companionship and life review which effectively improve the negative emotions of the patient, and affirm the meaning and value of the patient's life. Ultimately the patient and his family can gain comfort , face the illness with a positive attitude, and then achieve a good death. We look forward to sharing our care experience through this study that can provide clinical practice reference and provide appropriate physical, mental and spiritual care to improve the quality of end-of-life care.

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