| 题名 |
運用善終理念照顧一位直腸癌末期病人之護理經驗 |
| 并列篇名 |
The Nursing Experience of Palliative Care for an End-Stage Rectal Cancer Patient |
| DOI |
10.6530/YYN.202209_16(S).0003 |
| 作者 |
李郁彣(Yu-Wen Li)；陳淑芬(Shu-Fen Chen)；方昭敏(Chao-Ming Fang)；洪淑美(Shu-Mei Hung)；蘇碧玉(Pi-Yu Su) |
| 关键词 |
安寧照護 ； 直腸癌 ； 善終 ； palliative care ； rectal cancer ； good death |
| 期刊名称 |
源遠護理 |
| 卷期/出版年月 |
16卷增訂刊（2022 / 09 / 01） |
| 页次 |
21 - 26 |
| 内容语文 |
繁體中文 |
| 中文摘要 |
本文旨在探討一名直腸癌末期43歲女性，經歷多次手術、化療等治療依然無法阻止癌細胞轉移及持續惡化，面臨久治不癒的疾病，最後放棄積極治療，選擇接受安寧照護之護理經驗。筆者自2019年6月18日至7月3日照護個案期間，運用全人照顧模式，進行生、心、智能、社會及靈性層面評估，確立個案有疼痛／癌細胞轉移及腫瘤壓迫、哀傷／感受到將面臨死亡、心靈困擾／放不下家人的牽絆和案母信仰衝突等護理問題。筆者結合醫療團隊及安寧團隊，緩解個案生理不適症狀，並同理個案的感受與對家人不捨之情，協請社工師及宗教師一同陪伴與傾聽，協助達成個案臨終心願及解決健康問題，並舉辦生前告別式，藉由照片及錄製的影片，以生命回顧及道謝、道歉、道愛、道別等四道人生的方式達成善終。筆者藉由此經驗建議臨床護理人員可參加靈性課程以提升自我心理及靈性之專業照護，進而協助病人及家屬做好善終的準備，達到生死兩相安，並分享給臨床護理人員參考，讓更多末期病人能達善終。 |
| 英文摘要 |
The following report discussed a nursing experience which demonstrates how the collaboration between medical, palliative, and other professionals helps a 43 years old female patient when she was in the final phase of her life. With end-stage rectal cancer, the patient refused active treatment and accepted hospice and palliative care after failing to stop tumor metastasis and exacerbation by many surgeries and chemotherapies. The nursing protocol was designed base on the model of holistic health care, and the evaluation on patient's physical, psychological, intellectual, social, and spiritual aspects. During the caring period from June 18 to July 23 2019, clinical staffs faced nursing problems include patient's pain from tumor tissue metastasis and oppression, sorrow from facing to end of life, anxiety from worrying about patient's family members, and religious conflicts with her mother. Medical team and palliative team cooperated to relieve patient's uncomfortable symptoms in physical. Understanding patient's feeling and reluctance to leave family members alone, we worked with social workers and clinical religious teachers to keep the patient company and listen to her needs. In an effort to fulfill patient's desire and to resolve healthy problems, we held a living farewell ceremony with life review therapy via photographs and videos and followed four principles of life (expression of love, apology, gratitude and farewell) in order to achieve a peace end. After this experience, we suggest that clinical nursing staffs improve their profession and care quality by taking part in spiritual courses which can elevate their mental status and spirit. Therefore, they are more capable to help patients and their family members to prepare for end-of-life and to achieve peace of minds, and share it with clinical nurses for reference, so that more terminal patients can reach the end of life. |
| 主题分类 |
醫藥衛生 >
預防保健與衛生學 醫藥衛生 > 社會醫學 |
| 参考文献 |
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