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題名:一位重症生命末期病人於加護病房之全人照護經驗
書刊名:榮總護理
作者:張秀琳孫培蕾
作者(外文):Chang, Hsiu-lingSun, Pei-lei
出版日期:2019
卷期:36:1
頁次:頁72-79
主題關鍵詞:重症病人生命末期加護病房全人照護Critical patientsEnd of lifeIntensive care unitHolistic care
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:23
  • 點閱點閱:5
本文係描述一位肺癌末期病人因疾病過程急驟惡化轉入加護病房,病人本身及家屬面臨非預期急救、病況變化轉加護病房及經歷臨終壓力過程之全人照護經驗。照護期間為2014年10月22日至10月29日,藉由實際照護過程,採直接觀察、身體評估及會談技巧,運用全人照護理念,進行整體性評估,歸納出主要健康問題有:一、氣體交換功能障礙;二、疼痛;三、家屬預期性哀傷。照護期間評估病人健康問題及家屬需求,運用護理專業技能,維持生命徵象穩定及減輕疼痛,並提供相關訊息及指導,以增加個案舒適及家屬認知;運用正向情緒支持及持續陪伴,以減輕家屬心理焦慮,表達關懷;經由提供哀傷輔導與整體照護,協助病人達善終及家屬正向思考死亡議題。建議未來醫療團隊能建立以案例分享方式落實全人照護,並期望藉此護理經驗分享,提供重症單位護理人員對重症病人生命末期之全人照護之參考。
This article describes the nursing care of a patient with terminal-stage lung cancer who was admitted to the intensive care unit due to sudden deterioration of health. Moreover, we share the experiences of the patient and the family members facing the unexpected emergency, changes in health condition, and the need for intensive care as well as their experiences with holistic care. During the nursing period October 22-29, 2015, problems associated with nursing care were identified through the actual holistic care process, direct observation, physical assessment, and conversation skills. The problems included abnormal gas exchange, pain, and the patient's wife's anticipated grief. During the care period, the caregiver had to use professional skills to assess the health problems of the patient and the family needs, maintain the patient's vital signs of life and reduce pain, provide relevant information and guidance to increase patient's comfort and the family's awareness, provide positive emotional support and company, reduce the psychological anxiety of the family members, provide bereavement counseling and holistic care, and coordinate with the family members to help the patient achieve positive thinking about death. On the basis of our study findings, we suggest future medical teams to implement a holistic approach to care for terminally ill patients. We believe our findings would act as a reference for caregivers providing critical end-of-life care to such patients.
期刊論文
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2.Levin, T. T.、Moreno, B.、Silvester, W.、Kissane, D. W.(2010)。End-of-life communication in the intensive care unit。Gen Hosp Psychiatry,32(4),433-442。  new window
3.陳信如、盧映潔(20131000)。從「不施行心肺復甦術」與「撤除維生醫療」之區別論「安寧緩和醫療條例」之修正。臺灣醫界,56(10),51-54。  延伸查詢new window
4.李瑞慈、陳淑銘、周傳姜、顧雅利(20131200)。探索加護病房護理人員的靈性本質。長庚護理,24(4)=84,366-378。new window  延伸查詢new window
5.王昭雲、陳姿妃(20121000)。結合安寧共照照顧一位癌末患者之臨終加護經驗。志為護理,11(5),101-110。  延伸查詢new window
6.孫效智(20120600)。安寧緩和醫療條例中的末期病患與病人自主權。政治與社會哲學評論,41,45-91。new window  延伸查詢new window
7.Fernandes, M. D. F. P.、Komessu, J. H.(2013)。Nurses challenges in view of the pain and suffering of families of terminal patients。Revista da Escola de Enfermagem da USP,47(1),250-257。  new window
8.Hughes, P. M.、Bath, P. A.、Ahmed, N.、Noble, B.(2010)。What progress has been made towards implementing national guidance on end of life care? A national survey of UK general practices。Palliative Medicine,24(1),68-78。  new window
9.Stites, M.(2013)。Observational pain scales in critically ill adults。Critical Care Nurse,33(3),68-78。  new window
10.Thompson, D. R.、Hamilton, D. K.、Cadenhead, C. D.、Swoboda, S. M.、Schwindel, S. M.、Anderson, D. C.、Harvey, M. A.(2012)。Guidelines for intensive care unit design。Critical Care Medicine,40(5),1586-1600。  new window
11.吳春桂、林宏茂、林芳如、林亞陵、蔡紋苓、廖婉伶、鄭博文、黃勝堅(20110100)。重症生命末期照護之新趨勢。臺灣醫學,15(1),37-47。  延伸查詢new window
其他
1.World Health Organization(2014)。Palliative/definition,http://www.who.int/cancer/palliative/definition/en/。  new window
 
 
 
 
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