運用舒適理論於一位子宮內膜癌末期病人之護理經驗

Applying Kolcaba's Comfort Theory in Patient Care for Endometrial Cancer

10.6880/TJON.202212_22(2).08

陳慧萱(Hui-Hsuan Chen)；林岑薰(Tsen-Hsung Lin)；高綺吟(Chi-Yin Kao)

預期性哀傷 ； Kolcaba舒適理論 ； 末期 ； anticipatory grief ； Kolcaba's comfort theory of caring ； terminal

腫瘤護理雜誌

22卷2期（2022 / 12 / 01）

103 - 113

英文

本文描述運用Kolcaba舒適理論照顧一位子宮內膜癌症末期病人的護理經驗，照護期間為2020年3月11日至2020年4月13日，藉由觀察、身體評估、會談、病歷查閱等方式進行資料收集，並以舒適理論進行生理、心理靈性、社會文化及環境四大層面之評估。確認個案住院期間有噁心嘔吐、疼痛等生理問題，且因疾病進展至末期，延伸出預期性哀傷的護理問題。護理過程中透過緩解、自在與超越三個層面達到病人舒適，其中包括指導個案及家屬運用芳香療法、聆聽音樂、穴位按摩等技巧增加環境舒適並緩解個案的生理不適，並於舒適護理中以陪伴、同理傾聽的方式，提供個別性的護理措施與建議，並引導個案及家屬進行生命回顧、鼓勵表達內心感受、討論後事安排等，最後與個案一同製作瓶中信給家屬，以緩解個案及家屬之預期性哀傷，獲得心理靈性、社會文化層面的安適。藉由此照護經驗，期盼提供護理人員運用舒適理論於末期臨終病人的參考。

This case report describes a nursing care experience where the Kolcaba's Comfort Theory was applied in the care of a terminal patient with endometrial cancer. The associated health problems, including nausea and vomiting, pain, and anticipatory grief, were affirmed after an integrated assessment conducted via observation, physical examination, interviews, and medical record review. The Kolcaba's Comfort Theory, addressing relief, ease and transcendence, was applied during the nursing care period, which lasted between March 11 and April 13, 2020. The patient and family members were encouraged to use aromatherapy, music listening, and acupressure to increase the comfort of the environment and alleviate physical distress. In line with comfort care, the medical team provided individual care and suggestions to assist the patient and family members with life review, emotional expression, and living will discussion. Finally, the medical team assisted the patient to write messages in the bottles for her family to ameliorate anticipatory grief and achieve psychospiritual and sociocultural comfort. This case report is hoped to provide medical staffs with a reference for applying the comfort theory to terminal patient care.

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