题名

陪妳去看澎湖的海:運用生命回顧於肺癌末期個案之照護經驗

并列篇名

Let's See the Sea in Penghu: A Nursing Experience of the Application of Life Eminiscence for a Patient with Terminal Lung Cancer

作者

謝佩珊(Pei-Shan Hsieh)

关键词

肺癌 ; 精油淋巴按摩 ; 生命回顧 ; essential oil lymphatic massage ; life review ; lung cancer

期刊名称

志為護理-慈濟護理雜誌

卷期/出版年月

22卷3期(2023 / 06 / 01)

页次

107 - 117

内容语文

繁體中文;英文

中文摘要

本文為肺癌末期身心靈困擾病人之臨終照護經驗。護理期間運用Gordon十一項健康功能型態評估,經身體評估、觀察、會談、查閱病歷等方式,進行資料收集及分析,確立低效性呼吸型態、體液容液過量、預期性哀傷健康問題。在醫療團隊照護下,使用嗎啡、鎮靜劑等藥物及維持舒適臥位、精油淋巴按摩、遠紅外線等輔助療法,緩解低效性呼吸型態及體液容積過量問題;運用生命回顧,協助個案面對生命末期及引導向家人說出內心感受及期待,陪伴其及家屬一起回顧生命、重新審視生命的意義,合作完成臨終心願的過程,不僅留下珍貴回憶,也讓重新強化家庭連結肯定生命意義,互相道謝、道歉、道愛及道別,完成四道人生。期望藉此護理經驗分享,做為照護此類病人之參考。

英文摘要

This case report described the nursing experience of end-of-life care for a female patient with terminal lung cancer with physical and mental distress. During the nursing period, authors collected data through physical examination, observation, interviews, medical records, and Gordon's 11 functional health patterns to assess the patient's nursing needs. Authors confirmed that the patient presented the major health problems as following: ineffective breathing pattern, body fluid overload, and anticipatory grief. The medical team adjusted the patient's medication of morphine and sedatives, and assisted the patient to maintain a comfortable lying position, and gave the patient lymphatic massage with essential oils and the far-infrared therapy to improve the patient's health problems of the inefficient breathing pattern and body fluid overload. In addition, by using life review, authors helped the patient face the end of life and guided her and her families to express their feelings as well as expectations and also accompanied the patient and her families to review life and re-examine the meaning of life. The process of working together to fulfill the patient's dying wishes not only left precious memories to the patient and families, but also re-strengthened the connection among them to affirm the meaning of life that made the patient and families can carry out "the Four Principles of Life" to each other, including: gratitude, forgiveness, love and saying goodbye. We hope take this special nursing experience to share with everyone and provide an example of caring similar cases in the future.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. 黃建勳,劉育珊,陳冠儒,葉忻瑜,施銘峰,洪壽宏(2020)。緩和醫療的重頭戲-生命回顧: 以視覺影像述說病人的故事。安寧療護雜誌,25(1),66-79。
    連結:
  2. 黃詩凌,賴維淑,方素瓔(2018)。運用風扇緩解呼吸困難─系統性回顧與臨床應用。護理雜誌,65(4),84-93。
    連結:
  3. 藍雅渝,林玉菁,林晶晶(2018)。運用安寧療護於重症病房中照顧肺癌末期病人之經驗。長庚護理,29(4),647-656。
    連結:
  4. Abbaszadeh, R.,Tabari, F.,Asadpour, A.(2020).The Effect of lavender aroma on anxiety of patients having bone marrow biopsy.Asian Pacific Journal of Cancer Prevention: APJCP,21(3),771-775.
  5. Davies, C.,Levenhagen, K.,Ryans, K.,Perdomo, M.,Gilchrist, L.(2020).Interventions for breast cancer–related lymphedema: Clinical practice guideline from the academy of oncologic physical therapy of APTA.Physical Therapy,100(7),1163-1179.
  6. International Society of Lymphology, ISL(2009).The diagnosis and treatment of peripheral lymphedema 2009 consensus document of the international society of lymphology.Lymphology,42(2),51-60.
  7. Lim, R. B.(2016).End-of-life care in patients with advanced lung cancer.Therapeutic Advances in Respiratory Disease,10(5),455-467.
  8. Maeda, T.,Hayakawa, T.(2016).Combined effect of opioids and corticosteroids for alleviating dyspnea in terminal cancer patients: A retrospective review.Journal of Pain & Palliative Care Pharmacotherapy,30(2),106-110.
  9. Rockson, S. G.,Keeley, V.,Kilbreath, S.,Szuba, A.,Towers, A.(2019).Cancer-associated secondary lymphoedema.Nature reviews disease Primers,5(1),1-16.
  10. World Health Organization, WHO (2020). Why palliative care is an essential function of primary health care .https://www.who.int/publications/i/item/WHO-HISSDS-2018.39
  11. 李科,劉寧飛,章一新(2018)。遠紅外線治療下肢慢性淋巴水腫伴發淋巴管炎效果分析。上海交通大學學報,38(9),1059-1065。
  12. 林坤德,謝雅琪,楊鈺雯(2016)。鴉片類藥物在癌症患者的應用。家庭醫學與基層醫療,31(9),284-289。
  13. 董志明,程馨慧,蔡新茂,黃戊田(2016)。甜柑橘精油與音樂對人體生理參數及心率變異參數之影響精油與音樂的紓壓作用。實證自然醫學,2(2),13-26。
  14. 蔡孟修,柯獻欽(2017)。末期肺癌患者之安寧療護。內科學誌,28(6),325-333。
  15. 衛生福利部(2021,6月18日).109年國人死因統計結果。https://www.mohw.gov.tw/cp5017-61533-1.html
  16. 賴維淑(2011.4月13日).傾聽生命故事「我不是活在過去,是過去活在我心中」∼淺談生命回顧為何為安寧臨床所運用,及其意義與效果∼.財團法人中華民國(台灣)安寧照顧基金會。https://www.hospice.org.tw/content/2304
  17. 簡淑慧,廖美南,李淑慧,林永昌(2014)。從實證觀點談按摩處置對於癌痛病人之成效。護理雜誌,61(6),23-28。