～音符下的情感交織～運用音樂治療於直腸癌末期臨終病人之安寧居家護理經驗

Incorporating Music Therapy in the Hospice Home Care of a Terminally-ill Cancer Patient

10.6530/YYN.2012.6(2).09

王雅慧(Ya-Hui Wang)；蘇億玲(Yi-Lin Su)

音樂治療 ； 臨終照護 ； 安寧居家護理 ； music therapy ； terminal care ； hospice home care

源遠護理

6卷2期（2012 / 11 / 01）

66 - 74

繁體中文

本文係描述一位直腸癌末期病人接受安寧居家之護理經驗，護理時間自2009年8月22日至9月27日止。於護理過程中運用Gordon十一項功能健康型態評估，以會談、傾聽、陪伴、同理心及生命回顧等技巧鼓勵個案表達內心感受。個案除面臨疾病帶來身體不適及死亡產生之恐懼外，也背負著對家人之愧疚及心願未了的遺憾，故發揮護理角色功能擔任其與家人間的溝通橋樑，引導彼此說出心情的牽絆，並促進與家人的正向互動。護理期間個案的主要問題包括慢性疼痛、死亡焦慮及心靈困擾，運用音樂治療及芳香療法，協助個案減輕疼痛與勇敢面對死亡，進而改善身、心、靈的問題，協助個案如願地在家中由家人陪伴下安詳地走完人生最後一程。

This article describes the value of music therapy in the 5 weeks hospice home care nursing experience of a patient at terminal stage of rectal cancer. The use of Gordon's 11 functional health assessment skills, including interview, listening, accompany empathy, and life reviews helped the patient express his deep feelings. Besides the physical pain and fear of death, the patient also expressed sadness to family and the regret of unfulfilled wishes. Nursing problems identified were chronic pain, death anxiety and spiritual distress. The nurse functioned as the bridge between the patient and family members to facilitate their expression of emotions and to enhance their positive interactions. Both aromatherapy and music therapy were instrumental to reduce pain, helping to face death and improving the patient's physical, psychological and spiritual state. The patient passed away peacefully at home surrounded by his family members.