照護一位肺癌末期病患之護理經驗
Nursing Experience of Caring a Lung Cancer Patient in
the Terminal Stage
李佩蓉;周承珍;周桂如 摘要 肺癌是一種高致死率的癌症之一，在末期患者帶給病人的是一連串身體、心理、 社會及靈性四方面的衝擊。本個案報告是以安寧照護理念，於個案住院期間，在 護理臨床工作上運用 Gordon 十一項功能性健康型態評估一位肺癌末期病患出現 的護理問題，有疼痛、發燒、照顧者角色緊張、預期性哀傷，護理人員以降低病 患之疼痛及維持體溫在正常範圍、減低身體不適、改善生活品質；傾聽並鼓勵小 孫女說出照顧個案時的感受以降低其緊張感，運用會談技巧使個案與家屬能表達 面對死亡的想法；及彼此討論有關死亡的看法以減輕哀傷的反應，並鼓勵家屬一 同參與滿足個案生理、心理、靈性各層面的需要，幫助癌末病人在最後歲月中獲 得平安尊嚴。藉此個案報告之經驗，做為提供日後照顧此類病患的護理人員做參 考。 Abstract
Lung cancer is among one of the cancer with high mortality rate. In the terminal stage of lung cancer, the impact of cancer on patients could be multiple, including physical, mental, social, and spiritual. This article used Gordon's assessment tool to assess the problems of terminal stage lung cancer patient that included pain, fever, caregiver role strain, and anticipatory grieving. By reducing pain level and keeping temperature in the normal range, the nurse tried to improve the patient's quality of life. In addition, the primary nurse also carefully listened to the family caregiver's feeling and encouraged them to express their thoughts about dying in order to reduce the stress and grief. The patient and her family members copied with their grieving process. In the end, the primary nurse and caregiver worked together to help the patient live in a peaceful and respected life in the terminal stage of her life. This article could provide clinical nursing staff more information in caring patients with terminal lung cancer.
