照顧愛滋感染合併淋巴癌末期患者之護理經驗

Terminal Care for A Human Immunodeficiency Virus (HIV) Infected Patient with Refractory Diffuse Large B-cell Lymphoma (DLBCL)

10.6537/TJHPC.202009_24(3).06

葉乙臻(Yi-Chen Yeh)；潘玫燕(Mei-Yan Pan)；劉秀雲(Hsiu-Yun Liu)

愛滋感染 ； 淋巴癌 ； 末期 ； 緩和醫療 ； HIV ； lymphoma ； terminal illness ； palliative care

安寧療護雜誌

24卷3期（2020 / 09 / 01）

262 - 276

繁體中文

本文敘述照護愛滋感染合併淋巴癌病患之臨終經歷，當患者與其家庭在面臨癌症惡化、疾病快速進展至臨終期時，心理調適時間不足與對疾病治療期望之落差，如何在保護個案隱私之前提下，協助調解其面對病危決策之兩難情境。護理期間評估及處理患者因淋巴癌及其治療副作用導致的疼痛及生理不適，且運用安寧療護概念，陪伴病家做出適宜之病危決策，調適死亡焦慮造成的負向情緒，並減輕患者因失去控制感和死亡恐懼而產生的焦慮，協助家屬面對個案臨終產生的預期性哀傷等照護需求，盡最大努力使其獲得善終。此照護經驗可印證愛滋癌症患者之緩和醫療需求，並顯示愛滋專科病房護理師接受安寧緩和訓練之重要性，讓愛滋合併癌症患者在面臨疾病末期時，能獲得更全方位照護。

Here we shared an experience of terminal care about a Human Immunodeficiency Virus (HIV)-infected patient with refractory diffuse large B-cell lymphoma (DLBCL). Base on patient-centered palliative care, and expressing proper empathy with patient and family, we suggested more concern on psychological aspect rather than physiological aspect only in end-of-life care. To achieve comprehensive care and better control of suffers from terminal malignancy, maintain better quality of life, decision making was made and shared between medical teams, family, patient and his same-sex partner. Meanwhile, on the basis of a confidential patient-physician relationship, we emphasized the importance of HIV/AIDS specialist ward nurses to receive palliative training, so that patients living with HIV or AIDS can achieve a good death as well.

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