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篇名 照顧一位肝癌末期病人之護理經驗
卷期 26:2=90
並列篇名 The Nursing Experience of a Patient with Terminal Hepatoma
作者 林雅萍羅樺鈴巫怡翎曾斐琳
頁次 203-213
關鍵字 疼痛無望感預期性哀傷painhopelessnessanticipatory grieving
出刊日期 201506
DOI 10.3966/102673012015062602008

中文摘要

本文探討一位肝癌末期個案,面對疾病無法治癒所導致身心靈困擾等護理過程。護理期間自2012年4月2日至5月2日,筆者藉由治療性會談、身體評估、觀察及直接照護等方式收集資料,經由分析及歸納,運用Gordon十一項健康功能型態評估進行整體性評估及資料整合分析後,確立個案有疼痛、無望感、預期性哀傷等三項健康問題。筆者在護理過程中藉由完整的疼痛評估、除止痛藥物控制外,提供非藥物止痛方法,如精油按摩、舒適臥位擺放等,減緩因疼痛引起等不適。因隨病情進展,面對疾病急速惡化,個案對生命感到無望,意志消沉,藉由希望的建立、生命回顧法及靈性的寄託,讓病人體會生命的存在價值,協助個案面對死亡並降低恐懼。經由真誠的關懷、傾聽、陪伴、溝通等,建立信任的治療性關係,引導家屬及個案走出死亡的陰霾,讓個案身心靈獲得滿足及心願的完成,無遺憾走完人生最後一段路,達到生死兩相安,期望此報告分享,提升護理人員對臨終病人的需求敏感性,適時提供靈性照顧,讓病人得以善終。

英文摘要

This article described the nursing experience for a terminal hepatoma patient from April 2 to May 2, 2012. The patient was interviewed by therapeutic talks, physical assessment, observation, and nursing care. By using Gordon’s functional health assessment, three major health problems were identified, including pain, hopelessness, and anticipatory grieving are found. Cancer pain was assessed during nursing process and controlled by medications, non-medication pain relief methods, such as essential oils massage and comfortable position. However, with the rapid deterioration of the disease, hopelessness and depression were found in the case. By the establishment of hope and life, spiritual sustenance, the patient experienced the value of life in the face of the fear of death. Through genuine care, listening, companionship, communication, confidence-building therapeutic relationships, we guided the family and the patient to walk out of the shadow of death. This nursing experience stresses the need for spiritual care for terminal cancer patients and their family.

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