運用安寧緩和療護照顧一位脊索瘤末期病人之護理經驗

Nursing Experiences of the Hospice and Palliative Care for a Terminal-Stage Chordoma Patient

10.3966/168395442017061701006

謝依靜(Yi-Ching Hisieh)；賴亭伃(Ting-Yu Lai)；曾斐琳(Fei-Lin Tseng)

安寧緩和療護 ； 脊索瘤 ； 末期病人 ； hospice palliative care ； chordoma ； terminal stage

腫瘤護理雜誌

17卷1期（2017 / 06 / 01）

63 - 74

繁體中文

本文描述運用安寧緩和療護照顧一位脊索瘤末期病人之護理經驗。護理期間自2014年3月6日至2014年3月30日。筆者運用整體性護理評估個案的身體、心理、社會及靈性層面資料收集，確認個案有慢性疼痛、預期性哀傷、心靈困擾之健康問題。以安寧緩和療護理念，提供個別性護理措施，針對慢性疼痛，除藥物使用外，利用舒適臥位、轉移注意力、冷熱療法、經皮電刺激療法、芳香療法及按摩等輔助措施緩解個案疼痛不適；協助個案與女友完成結婚登記之心願，並攝影、拍照留念，以度過預期性哀傷。針對心靈困擾運用生命回顧肯定個案人生歷程，藉宗教師引導個案了解死亡為自然現象，找到人生的意義與價值，使個案及家屬達到生死兩相安。期望此照護經驗可提供護理人員對日後照顧此類病人之參考。

This article is about the nursing experiences of the hospice and palliative care for a terminal stage chordoma patient; nursing care duration was from March 6, 2014 to March 30, 2014. With patient's data on his physiological, psychological, social and spiritual aspects and comprehensive nursing assessment, we confirmed that patient had health related problems such as chronic pain, anticipatory grief, and disrupted spirituality. Based on the hospice palliative care guidelines, we provided individualized nursing care to patient; for chronic pain, we used drugs and some adjuvant therapy, such as comfortable lying position, distraction away from pain, hot and cold immersion therapy, transcutaneous electrical nerve stimulation, aromatherapy, and massage to relieve pain. We also assisted patient in accomplishing his last wish to marry his girlfriend, to have the wedding album made and register their marriage which helped him get through anticipatory grief. On the spirituality side, we used life reflection to give patient the recognition of life course; and arranged visits from the religious worker who led the patient to understand that death is a natural phenomenon, and more importantly, to find the meaning and value of life. We hope all the efforts can prepare the patient and his family in facing death and help the family move on to normal life afterwards. We share this nursing experience as reference for the nursing staff in further care of similar patients.

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