一位直腸癌末期病人安寧善終之加護照護經驗

A Nursing Experience of Caring for a Patient With Terminal Rectal Cancer at the End of Life in the Intensive Care Unit

鍾儷薇(Li-Wei Zhong)

直腸癌末期 ； 加護病房 ； 安寧療護 ； hospice care ； intensive care unit ； terminal rectal cancer

志為護理-慈濟護理雜誌

21卷1期（2022 / 02 / 01）

110 - 118

繁體中文

本文描述一位70歲男性復發直腸癌末期之加護照護經驗，照護期間，筆者進行護理評估，歸納個案健康問題：低效性呼吸型態、無望感、家屬預期性哀傷。除減緩生理病痛之護理措施外，更關切個案與家屬其心理問題，為達到病人善終、家屬善生之目標，家屬決定採就地善終。雖然加護病房為急重症單位，但安寧療護並非在安寧病房才可執行，應落實在需要的病人及家屬上，讓加護病房不再只是生死之間拉扯的環境，而是拉進病人及家屬之間距離的橋樑。相信醫療團隊經由多方努力學習下，亦能締造一個在加護病房讓病人暖心、家屬安心的關懷環境，故藉由此護理經驗，提供護理同仁之參考。

This article discussed the nursing care experience of a patient with terminal rectal cancer in the intensive care unit(ICU). From July 30th, 2018 to August 8th, 2018, we assessed the patient by Gordon's 11 Items Health Function and determined if the patient had an ineffective breathing pattern, hopelessness, and anticipatory grief of the caregiver. We provided appropriate care plans and interventions to meet the physical and mental needs of the patient and cared about the feelings of the caregiver. A consensus was made to let the patient pass away peacefully in the intensive care unit to reduce the caregiver's stress and to optimize the patient's end-of-life experience. Despite the critical care nature of ICU, hospice care could still be implemented successfully outside of hospice wards. We provided a sound supportive environment for the patient and his family in ICU, which was achieved through multidisciplinary teamwork. The author would like to share this nursing experience as a reference.

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