本文為敘述一位鼻咽癌末期之年輕女性於加護病房的護理經驗。照護期間自2015 年12 月10 日至12 月29 日，筆者藉由觀察、筆談與身體評估等方式，對個案的生理、 心理、家庭社會、靈性等方面進行整體性評估，確立主要健康問題有因癌症引起之疼痛、 組織完整性受損與死亡焦慮。護理過程中筆者運用舒適護理及安寧療護理念，以藥物及 非藥物方式來減輕個案的慢性癌痛，緩解惡性蕈狀傷口所產生的異味、滲液及疼痛，以 改善皮膚完整性等相關問題；此外了解個案對死亡的感受，運用靈性照護協助個案面對 疾病進展和預期死亡，使其在最後的路程中能夠舒適及妥善面對臨終過程。經此個案報 告，建議重症單位能在病人急性照護之外，亦需需注意臨終病人的心靈需求，故藉此護 理經驗，做為重症護理人員照護類似個案之參考。

This article described a nursing experience of a young female patient with terminal nasopharyngeal carcinoma who was treated in intensive care unit. The nursing period was from December 10th to December 29th, 2015. Data were collected by observation, interview and physical assessment. Three main nursing problems were identified: chronic cancer pain, skin integrity problem and death anxiety. The concept of comfortable and hospice care were adopted in the nursing process. Pharmacologic and non- Pharmacologic pain management were used to alleviate patient’s chronic cancer pain. Clinical guideline for managing fungating wound was used to relief patient’s skin problem. Spiritual care was applied to help patient understand the disease progress, face the impending death and reach a peaceful death. With the collaborative effort of the critical team and hospice team, the patient’s skin problem was controlled well and was died peacefully without pain. We hope that this nursing experience can serve as a reference for intensive care unit nursing staff caring for patients with end-of-life situation.