協助一位癌末個案獲得善終的護理經驗

A Nursing Experience of a Terminal Cancer Patient Enabling a Good Death

10.29936/DMFCCHJN.201206.0003

侯升雍(Sheng-Yung Hou)

癌症疼痛 ； 善終 ； 哀傷 ； cancer pain ； good death ； grieving

嘉基護理

12卷1期（2012 / 06 / 01）

24 - 34

繁體中文

本文描述一位直腸癌併發多處肝轉移末期個案的照護經驗。照護期間為2009/2/02～2009/3/18，經由與個案、案妻及案子會談、觀察，進行資料收集，從生理、心理、社會與靈性四方面評估，發現個案主要的吉缸里問題有疼痛、哀傷及放不下。筆者逢周安寧療護四全照護理念，提供個案藥物及非藥物的疼痛控制、個別性的衛教指導，緩解個案的疼痛；安排機會讓案子們對個案表達愛與感謝，修復親子關係，並陪伴家屬面對個案即將死亡的哀傷及向個案道別；協助家屬尊重個案自我意志決定的身後事安排，幫助個案完成心願，使之能夠放下、不再牽掛，讓個案獲得善終，家屬獲得善別，達到生死兩相安的目的。期望藉此護理經驗，提供臨床護理人員日後照顧此類病患之參考。

The purpose of this case report was to describe the nursing experience of a terminal cancer patient who had diagnosed rectal cancer with multiple liver metastases. During the nursing period from February 2nd to March 18th 2009, communication and observation were used to collect data and to assess four dimensions including physiological, mental, societal and spiritual. Three nursing health problems were identified including pain, grief and unable to lay down. By practicing the concept of the holistic care, the author provided individual nursing care to relieve the patient's pain, to repair the parent-child relationship, and to accompany family confronting death and saying good-bye. Finally, the patient received a good death, and also the patient and family felt at peace. This experience was presented to our fellow nurses as a persuasive example.