一位中年乳癌病人併多處轉移之臨終照護經驗

Hospice care experience of a middle-aged breast cancer patient with multiple metastases

10.6537/TJHPC.202211_26(3).05

林詩涵(Shih-Han Lin)；陳思妤(Ssu-Yu Chen)；沈惠珊(Hui-Shan Shen)

乳癌 ； 多處轉移 ； 臨終護理 ； Breast cancer ； multiple metastases ； hospice care

安寧療護雜誌

26卷3期（2022 / 11 / 01）

266 - 276

繁體中文

本文描述照護一位未婚中年乳癌合併多處轉移的女性病人，由於在家有疼痛及呼吸喘情形，而住院接受症狀控制，照護期間為2019年1月5日至1月14日，運用傾聽、觀察、會談、身體評估及病歷查閱方式進行蒐集生理、心理、社會及靈性資料，確立個案有「慢性疼痛」、「低效性呼吸型態」、「死亡焦慮」等主要健康問題。照護期間提供個案藥物和運用香氛精油、推撫按摩、姿勢擺位技巧來緩解疼痛及呼吸困難，來促進舒適；另一方面也以傾聽、同理、陪伴、主動關懷，與個案建立良好的護病關係，透過安寧共照團隊，協調病人及家人之間的情感連結，完成四道人生，使個案能夠安心、不再牽掛，讓個案善終。建議在護理教育中，讓臨床護理人員能夠了解臨終病人的照護需求，同理心的運用以協助個案減輕臨終前的痛苦及完成遺願，提升末期照護品質。

This article described nursing experience of caring a middle-age unmarried woman with breast cancer and multiple metastases. She suffered from pain and dyspnea. Data were collected through listening, observation, interviews, physical examination and reviewing nursing records to assess the patient's physical, psychological, social and spiritual problems from January 5 to January 14. Three main health problems were identified: (1) chronic pain, (2) inefficient breathing pattern, and (3) death anxiety. Nursing interventions, including aromatherapy, massage, postural care technique were applied to alleviate the pain and breathing problems. Through attentive listening with empathy we built a trusting nurse-patient relationship. Palliative multidisciplinary team and hospice shared care were involved to better support the patient and her family at the end of life. It is important for clinical nurses to understand the care needs of dying patients, and to provide empathy to assist patients to alleviate pain and fulfill their wishes before death, to improve the quality of end-of-life care.

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