照顧一位小細胞肺癌末期病人之護理經驗

Nursing Experience of Caring a Small Cell Lung Cancer Patient in the Terminal Stage

10.3966/168395442015121502008

莊鈺如(Yu-Ju Chuang)；陳幼貴(Yu-Kuei Chen)；洪敏瑛(Ming-Ying Hong)

肺癌末期 ； 小細胞肺癌 ； 護理經驗 ； Terminal stage ； Small cell lung cancer ； Nursing experience

腫瘤護理雜誌

15卷2期（2015 / 12 / 01）

95 - 105

繁體中文

肺癌是國人癌症死因中之首，影響病人生心理方面的不適，大多因為呼吸困難及疼痛而導致死亡，而本篇主要是探討一位小細胞肺癌末期病人之照護經驗，護理期間自2012年11月11 ∼ 20日，藉由直接照護、會談、觀察、傾聽及身體評估等方法收集生理、心理、社會及靈性等層面資料，確認個案有氣體交換障礙、疼痛及預期性哀傷等健康問題，在護理過程中運用主動關懷及陪伴，與個案建立良好的護病關係，協助處理生理上之症狀，並運用非藥物的輔助療法來緩解個案之呼吸困難及疼痛症狀，另外，在面對個案面臨死亡的哀傷及恐懼時，鼓勵個案表達對疾病的感受及死亡的想法，透過醫護人員清楚解釋病情的預後及照護的目標，來增強個案正向的信心，藉由宗教信仰的力量及生命回顧之方法，協助個案及家屬面臨癌末過程，使靈性有寄託而不害怕，讓個案了解生命的價值與意義，以達到生死兩無憾。故藉由此經驗分享，提供日後護理人員照護相關末期病患之參考。

Lung cancer is one of the leading causes of cancer deaths in Taiwan. It causes physical and mental distress in patient, particularly dyspnea and pain, which eventually lead to death. This case study explores nursing experience of caring for a small cell lung cancer patient in the terminal stage for the period of Nov. 11 to Nov. 20, 2012. The author collected data in the physical, mental, social and psychological aspects through direct nursing care, interview, observation, listening and health assessment. The patient’s health problems identified were impaired air exchange, pain and anticipatory grief. We used non-medicine therapy to improve the patient’s dyspnea and pain. In addition, we encouraged the patient to express her feelings toward the disease and her thought about dying to help reduce the stress and grief. Finally, we introduced life review and religion to help the patient and family to lessen the feeling of fear, so the patient may better appreciate the value of life. This article could provide clinical nursing staff with more information in caring for patients with terminal lung cancer.

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