完全呼吸窘迫症狀（Tota1 Respiratory Distress）的觀念引自完全疼痛（Total Pain），主要在處理癌末病患之呼吸系統障礙。當安寧療設之疼痛症狀控制有令人滿意之發 展後，呼吸窘迫成為最讓病患與家屬受苦之症狀之一。為了處理呼吸窘迫之症狀，除了了解 呼吸系統障礙之基本病理機特及給予適當用藥外，心靈問題的解決以及補助性治療更是關乎 呼吸系統障礙處理的成效。臨床上處理呼吸系統障礙之步驟為先填寫適宜之症狀評估單、找 出呼吸系統障礙之可能原因、給予適當之藥物治療、選擇可能有幫助之補助性治療、以及探 索可能的心室層面問題並給予解決，相信大多數癌末呼吸系統障礙之病患都能大幅改善活品 質。 。

　　　　　The concept of the "total respiratory distress" induced by " total pain" was proposed in management of the respiratory problem of the patients with terminal cancer. After the terminal cancer pain control has a good response in hospice care, the respiratory problem becomes a major issue in hospice care. It is necessary to realize the mechanism of the respiratory problem, proper drug prescription, and even psychosocial support and adjuvant treatments for good hospice care. The processes of managing the respiratory problem are completing evaluation, differentiated diagnosis, prescribing drugs, and resolving psychosocial fear. After above treatments, most of the terminal cancer patients with respiratory distress had much improvement. Only more studies of respiratory distress mechanism, more combined drug usage, more psychosocial support, and more practically adjuvant treatments can resolve the "total respiratory distress" in the future.