一位縱膈腔卵黃囊瘤末期青年之護理經驗

The Nursing Experience of a Young Adult with Mediastinal Yolk Sac Tumor at Terminal Stage

王偉靜(Wei-Jing Wang)；楊淑慧(Shu-Hui Yang)

卵黃囊瘤 ； 青年 ； 末期 ； terminal cancer ； young adult ； yolk sac tumor

志為護理-慈濟護理雜誌

22卷2期（2023 / 04 / 01）

87 - 95

繁體中文;英文

本文為縱膈腔卵黃囊瘤青年於生命末期的護理經驗。護理期間自2018年12月26日至2019年1月28日，藉由會談、觀察、身體評估及病歷查閱，收集生心理、社會與靈性等資料，確立有噁心、疼痛及哀傷等健康問題。照護期間透過藥物及漸進式肌肉放鬆訓練減輕噁心，與疼痛控制小組合作並輔以聽歌、拼圖等方式分散注意力以緩解疼痛，運用跨團隊合作引領其調適面對死亡衝擊產生的哀傷及了解生命的意義與價值，最終，個案以平靜且珍惜當下的心做好即將道別的準備。建議臨床上可延伸討論預立醫療照護諮商，使病人擁有自行選擇接受或拒絕醫療的權利，達到尊嚴善終的目標。

This case report presents the nursing care experience during Dec 26th, 2018 and Jan 28th, 2019, of a 23-year-old male diagnosed with mediastinal yolk sac tumor at the end of life. The patient was evaluated on physiological, psychological, social, and spiritual levels through observation, interview, physical examination and medical chart review. We identified three major problems including nausea, pain, and grief. The patient's nausea and vomiting were treated by antiemetics and muscle relaxing technique. We used music therapy, puzzles, and other methods to relieve the patient's pain. Multidisciplinary approaches were applied to help the patient to accept death, as well as to affirm life. Finally, the patient was able to find his inner peace at the last stage of life. This case report lights up the discussion on the communication of advance care planning, letting the patient decide their directives, and to live with dignity at the end stage of life.

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