提升護理人員執行肺癌病人臨終護理指導完整性

The Integrity of Lung Cancer Care and Nursing Instruction for the Dying Phase Preparation

10.6880/TJON.202106_21(1).05

洪紫霙(Zi-Ying Hong)；林奉儀(Fong-Yi Lin)；陳貴香(Kuei-Ksiang Chen)；林素英(Su-Ying Lin)

肺癌 ； 生命末期 ； 緩和醫療 ； lung cancer ； end of life ； palliative care

腫瘤護理雜誌

21卷1期（2021 / 06 / 01）

51 - 62

繁體中文

肺癌病人生命末期時，多數希望於臨終前能減輕身心靈痛苦勝於延長生命，故提供完整臨終護理指導可提升病人善終品質及家屬滿意度。本專案旨提升護理人員執行肺癌病人臨終護理指導完整性，現況發現護理人員執行肺癌病人臨終護理指導完整性僅57.1%，原因為臨終護理指導內容無標準化、臨終護理指導衛教手冊內容繁多且字體小、教育訓練內容缺乏心理及靈性訓練、護理人員臨終護理指導認知及家屬對護理人員執行臨終護理指導後滿意度偏低。透過臨終護理指導內容標準化、修訂臨終護理衛教手冊、舉辦臨終護理教育訓練及設計擬真教案等介入措施，使護理人員執行肺癌病人臨終照護指導完整性由改善前57.1%提升至93%，此專案達到提升護理人員執行肺癌病人臨終護理指導完整性，進而改善肺癌臨終病人護理品質及家屬滿意度，並作為日後執行肺癌病人臨終護理指導依據。

At the end of lung cancer patients' life, most of them hope to reduce the pain of body and mind before dying rather than prolonging their life. Therefore, providing complete guidance of palliative care can deliver the quality of patients' hospice care and peace to the family. The purpose of this project is to enhance the integrity of nursing staff's guidance of palliative care for lung cancer patients. It showed that the integrity rate of guidance adherence for palliative care by the nursing staff for lung cancer patients was only 57.1%. The reasons were following: (1) There is no standard instruction of palliative care; (2) The content is complicated and with the small font size; (3) Lack of psychological and spiritual training; (4) Low awareness of hospice nursing instruction of nursing staff and the satisfaction of family members. The content of intervention measures is standardization of hospice nursing instruction, revision of the health education manual of palliative care, hospice education training and realistic lesson plans. The integrity rate of terminal care for lung cancer patients by nursing staff is improved from 57.1% to 93%. This project reached its goal of elevating the chest department nurses' ability in adhering to the palliative care guidance for the lung cancer patients, thereby improving the quality of palliative care and family satisfaction. We hope this serves as a foundation for the future guidelines of palliative care implementation.

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