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題名:照顧一位胰臟癌末期病人接受安寧療護之護理經驗
書刊名:榮總護理
作者:曾昭玲
作者(外文):Tseng, Chao-ling
出版日期:2015
卷期:32:1
頁次:頁84-91
主題關鍵詞:胰臟癌末期安寧療護Terminal pancreatic cancerHospice care
原始連結:連回原系統網址new window
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  • 共同引用共同引用:30
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本文敘述一位胰臟癌末期病人不想放棄治療,但是又覺得治療很痛苦,想放棄治療又不捨家人,對未來產生無望感及抉擇衝突的護理經驗。於2012年6月24日至7月7日照護期間,藉由身體評估、治療性會談、觀察等技巧,收集病人及家屬的相關資料,運用Gorden 11項健康功能評估,來呈現病人之身、心、社會及靈性狀況,發現健康問題有:一、疼痛/與腹部腫瘤壓迫神經反射至背部有關;二、無望感/與病情惡化無法控制有關;三、抉擇衝突/與是否接受安寧療護有關。筆者透過藥物治療、分散注意力、按摩、芳香療法等方法,減輕病人之疼痛;運用傾聽、陪伴及支持,讓病人和家屬彼此說出感謝和內心期望,以重建病人自我價值,了解生命正向意義;並藉由說明安寧醫療與治癒性醫療之不同處、安寧療護之意義及參觀安寧病房,使病人和家屬了解安寧療護之正確觀念,團隊和環境,進而接受安寧療護,以期病人和家屬在其生命最後一程能無遺憾又無痛苦的走完。藉此照護經驗能和其他護理同仁分享。
This article describes the care experience of a patient with pancreatic cancer at the terminal stage. He did not want to give up and leave his family, but the treatment was extremely painful. The future was filled with hopelessness and there were conflicts in decision making. Nursing care was provided from June 24 to July 7, 2012. Data were collected through physical assessment, interview, and observation. Gordon's 11 Functional Health Patterns Assessment guide was used to identify three health problems: pain and abdominal-tumor-related nerve compression with pain radiation to the back, hopelessness because disease progression could not be controlled, and decision conflicts over whether to accept hospice care. To address these problems, the author provided medication, distraction, massage, aromatherapy, and other methods to alleviate the patient's pain. Through listening, companionship, and support, the patient and his family expressed their expectations and gratitude to each other, thereby recovering the patient's self-worth, and positive attitude toward the meaning of life. By explaining the differences between hospice care and curative treatment and the meaning of hospice, and by arranging hospice ward visitation, the patient and his family clearly understood hospice care, the team, and the environment; hence, the patient was willing to receive hospice care. The patient can live the rest of his life without pain and regret. We report this valuable experience as a reference for practitioners in this field.
期刊論文
1.曾愉芳、杜明勳、陳如意(20070200)。末期病人的靈性照顧與善終。基層醫學,22(2),52-55。  延伸查詢new window
2.李美英、呂素珍、黃鳳玉(20080300)。精油按摩之疼痛療效--以某醫學中心安寧病房為例。榮總護理,25(1),53-59。new window  延伸查詢new window
3.童琴惠、彭素珍(20100400)。照護一位無望感癌末病患之護理經驗。領導護理,11(1),52-62。  延伸查詢new window
4.Chang, V. T.、Sorger, B.、Rosenfeld, K. E.、Lorenz, K. A.、Bailey, A. F.、Bui, T.、Montagnini, M.(2007)。Pain and palliative medicine。Journal of Rehabilitation Research and Development,44(2),279-294。  new window
5.黃惠美、張美幸、胡中傑、謝玉玲(20060800)。癌末病人疼痛控制指標之監測。安寧療護,11(3),229-241。new window  延伸查詢new window
6.蘇清菁、陳玉敏(20091200)。無望感之概念分析。長庚護理,20(4)=68,456-462。new window  延伸查詢new window
7.王麗慧、李淑秋、胡瑞桃(20101100)。照護一位加護病房肺癌末期病患之護理經驗。新臺北護理期刊,12(2),91-99。  延伸查詢new window
8.許文玲、許靜雯、施君穎、姚靜宜、王培銘(20110900)。提升癌末患者及家屬參訪安寧療護病房之滿意度。長庚護理,22(3)=75,358-369。new window  延伸查詢new window
9.楊婉萍、賴維淑、趙可式(20081200)。協助一位末期病人面對整體苦難之全人照護經驗。護理雜誌,55(6),101-106。new window  延伸查詢new window
10.簡靜慧、莊正堅、劉冠麟、劉雪娥(2008)。前列腺癌個案參與治療決策過程的決策困難及其影響因素之探討。長庚護理,19(1),1-13。new window  延伸查詢new window
11.魏嘉儀、許美玉(20120200)。一位乳房惡性蕈狀傷口個案初次接受治療之護理經驗。志為護理,11(1),109-118。  延伸查詢new window
12.Greer, S.(2008)。CBT for emotional distress of people with cancer: Some personal observations。Psycho- Oncology,17(2),170-173。  new window
13.Mystakidou, K.、Tsilika, E.、Parpa, E.、Athanasouli, P.、Galanos, A.、Anna, P.(2009)。Illness-related hopelessness in advanced cancer: Influence of anxiety, depression, and preparatory grief。Archives of Psychiatric Nursing,23(2),138-147。  new window
14.Ramsay, K.、Ramsay, J.、Main, D.(2007)。Both group peer counselling and individual counselling reduce anxiety and depression, and increase self-esteem and overall life satisfaction in palliative cancer care。Counselling Psychology Quarterly,20(2),157-167。  new window
15.Yildirim, Y. K.、Cicek, F.、Uyar, M.(2009)。Effects of pain education program on pain intensity, pain treatment satisfaction, and barriers in Turkish cancer patients。Pain Management Nursing,10(4),220-228。  new window
其他
1.World Health Organization(2008)。WHO definition of palliative cave,http://www.who.int/cancev/palliative/definition/en/。  new window
 
 
 
 
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