本個案報告是探討一位肺癌末期患者，因併發惡性肋(Dyspnea)及胸痛的症狀，對疾病惡化感到沮喪並焦慮未來的病情發展。筆者於2006年5月30日至2006年7月4日護理期間，藉由觀察、會談技巧及Gordon十一項功能性健康評估收集資料，確立個案護理問題：低效性呼吸型態、疼痛、疲憊、預期性哀傷等。運用護理過程，針對以上問題，提供個別性且適宜的護理處置。在護理過程中以同理心與個案建立良好治療性人際關係，透過主動關懷病患的需求、傾聽、陪伴並鼓勵家庭重要成員的探視及彼此溝通，從中獲得支持、安慰進而讓個案接受自己，增加自我控制感，使個案在住院過程中漸獲身、心、社會各方面的適應。臨床護理不僅於提供生理照護需求，更應重視疾病以外心理層面諸多問題。期待此篇文章能作為護理人員在照護癌末病患時的參考，並計畫適當的護理措施，提升癌末病患照護品質。

This article is to describe a patient with lung cancer in the terminal stage who suffered from dyspnea and chest pain duo to the complicated malignant pleural effusion, who was depressed and anxious about the disease progress and poor outcome. The data were collected and assessed through observations, interviews and Gordon’s eleven function health patterns, during nursing care period from May 30 to July 4 in 2006. The patient’s problems were recognized as the follows: (1) Ineffective breathing pattern, (2)Pain, (3)Fatigue, (4)Anticipatory grief. Used nursing process, in view of above problems. We provide patients individualized and adapted nursing care. During the course of providing nursing care, the author established a good relationship with the patient through devoted attention to the patient's needs and listening and accompanying. Increased family member visits and interaction, Eventually, the author gained the trust of the patient, who, in turn, regained
self-control as well as physical and socio-psychological adaptabilities. Clinical nursing must attend to the physical care needs of patients as well as patient mental wellness, the latter of which extends
beyond the disease itself. We expect this article could provide reference for clinical nursing and enhance the quality of terminal care.