照顧一位十二指腸癌末期病人之安寧居家護理經驗

Nursing Experience of Hospice Home Care to a Terminally Ill Patient with Duodenal Cancer

10.6537/TJHPC.2015.20(2).6

梁惠茹(Hui-Ju Liang)

安寧居家護理 ； 癌症末期病人 ； 靈性照護 ； hospice home care ； terminally ill cancer patient ； spiritual care

安寧療護雜誌

20卷2期（2015 / 07 / 01）

166 - 176

繁體中文

安寧居家療護旨在提供末期病人出院後能持續接受高品質照顧，身心靈症狀獲得緩解。本文敘述一位十二指腸癌末期病人接受安寧居家療護之護理經驗，照護期間為2012年11月12日至12月3日，以身體評估、會談等方式收集資料，確認病人及家屬之主要護理問題：「腹部悶痛」、「雙下肢淋巴水腫」、「不知為何而活致生命無意義感」以及「案女因獨力照顧病人致壓力負荷重」。筆者藉由疼痛處置、徒手淋巴按摩、生命回顧、製作生命光碟以及抒發案女情緒等護理措施，提供病人身、心、靈的照護，緩解案女的照顧壓力負荷。雖然居家訪視時間有限，然而家是病人生活大半輩子的空間，充滿俯拾即是的回憶，可作為安寧居家護理師引導病人生命回顧的重要線索，提供病人靈性照護同時也可藉此提供家屬預期性哀傷撫慰。希望此照顧經驗分享，作為護理人員提供安寧居家照護、預期性哀傷撫慰以及靈性照護之參考。

The goal of hospice home care is to provide terminally ill patients at home with high quality of care. This article describes the nursing experience of a patient with end stage duodenal cancer receiving hospice home care. During the nursing period between 12th November and 3rd December 2012, we collected data by the way of physical assessment, interview and so on. Four issues related to nursing care were included: ＂abdominal pain led by infiltrating carcinoma cells＂, ＂lymphedema of both lower limbs＂, ＂to find the meaning of life＂ and ＂the care of burden on daughter＂. During the nursing period, we provided physical, psychological and spiritual care by pain management, lymph massage, life review, make a movie for the patient and guide daughter to express emotion. Although the home visiting hours are so limited, we still could provide patient with spiritual care at home full of memories. In the same time, we can offer family care of anticipatory grief. We would like this report to offer a clinical care reference of hospice home care and spiritual care for nursing staff.

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