一位愛滋病女性併癌末惡病質面臨死亡之照護經驗

Nursing Experience of an AIDS Female Patient Facing Terminal Cancer Cachexia and Death

李依鴻(Yi-Hong Li)；鄭碧芬(Pi-Fen Cheng)；蔡佩君(Pei-Chun Tsai)；王怡鑐(Ying-Ju Wang)；陳繪竹(Hui-Zhu Chen)

愛滋病 ； 癌末 ； 惡病質 ； 安寧療護 ； 生命回顧 ； cachexia ； HIV/AIDS ； hospice care ； life review ； terminal cancer

志為護理-慈濟護理雜誌

21卷1期（2022 / 02 / 01）

130 - 140

繁體中文

本文為一位愛滋感染併發肝癌末期轉移之外籍配偶，面對死亡之照護經驗，照護期間2018／12／12－2019／01／31，藉由觀察、會談及身體評估、團隊討論與查閱病歷等方式收集資料，利用生、心、社會及靈性等進行整體性評估，確立健康問題為營養少於身體所需、慢性疼痛及死亡焦慮。長期建立友好醫護關係，運用安寧療護四全照護理念，結合愛滋及安寧照護團隊等跨專業人員，在生命餘程給予個別性護理措施，如：與營養師討論個案喜好食物種類，團隊及志工的陪伴，生命回顧法化解與案女不睦關係，讓個案離世時能放心託孤，案女也道出感恩與感謝，達到死者無憾生者無愧。

We share the hospice care experience of caring for a foreign spouse with AIDS related terminal Hepatocellular Carcinoma cancer induced cachexia. Data was collected from 12th December, 2018 to 31st January, 2019, through observation, interviews, physical examination, group discussions and reviewing of medical charts. Several aspects were evaluated, including the patient's physical, psychological, and spiritual health, as well as social relations, to conclude the major health problems to be insufficient nutrition, chronic pain and death anxiety. Individualized care was provided by establishing a long-term trusting relationship with the patient and her family, forming a multidisciplinary care team of AIDS specialists and Hospice crew, and using four core values of hospice care. Additionally, discussions with the dietitian and family members established the type of food preferred by the patient, visiting time of the AIDS team and Hospice volunteers were coordinated, and we conducted life review method to harmonize the relationship between the patient and her daughter. The patient was able to leave without apprehension and regrets and family members were able to express respect and pay regards.

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