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題名:一位年輕肝癌末期病人之整體性護理經驗
書刊名:榮總護理
作者:鄭沛綾林玉菜陳芝文
作者(外文):Cheng, Pei-lingLin, Yu-tsaiChen, Chih-wen
出版日期:2017
卷期:34:2
頁次:頁207-214
主題關鍵詞:年輕女性肝癌末期預期性哀傷Young femaleTerminal stageHepatomaAnticipatory grief
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(2) 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:2
  • 共同引用共同引用:20
  • 點閱點閱:20
本篇個案報告是描述一位26歲年輕女性肝癌末期的病人,除需調適癌症帶來的生理不適外,還須面對即將走到生命盡頭與家人生死分離的不捨與幼兒之安置。個案護理期間為2015年11月14日至2015年11月30日,筆者以會談、觀察、身體評估等技巧收集資料,藉由Gordon十一項健康型態功能進行評估,確立個案有一、體液容積過量;二、身體心像紊亂;三、預期性哀傷等健康問題。在護理過程中,筆者主動關懷個案及持續性照護,與病家建立良好護病關係,運用個別性護理措施解決個案的生理問題,採低鈉限水飲食及配合利尿劑以改善腹水及周邊水腫。心理靈性方面,個案自知生命期限將至,內心十分恐懼,且家屬難以承受生死分離之痛,團隊成員自入院後協同家屬著手收集及製作影音紀念專輯,供家屬及女兒長大後思念追悼母親,運用哀傷輔導協助個案面對死亡,與家人溝通,協調破除年輕人不可在家往生的傳統文化迷失,讓個案順利返家,與家人共享餘生之天倫樂,藉由整體性、個別性之照護措施,為生死兩相安之善終留下圓滿之見證。期望藉由本文之護理經驗,提供臨床同仁日後照護此類個案之參考。
This article describes the nursing experience of caring for a 26-year-old female patient at the terminal stage of hepatoma. The patient not only had to adjust to the physiological discomfort but also had to cope with the end of life and separation from her family. The patient was nursed from November 14 to November 30, 2015. Data were collected by observation, interview, and physical assessment. Gordon's 11 Functional Health Patterns were used for evaluation, and the patient was found to have problems of fluid volume excess, body image disturbance, and anticipatory grief. While nursing the patient, the author provided initiative care and continuing nursing care to establish a good relationship with her and her family. Individualized nursing measures were used to solve the patient's physical problems. Low-sodium diets, fluid restriction, and diuretics were applied to improve ascites and edema. Regarding the psychological and spiritual aspects of care, the patient's fear of death, pain of separation from her family, and sorrow regarding her daughter were soothed in the process of making video and audio materials following hospitalization. The author also communicated with family members to overcome a cultural superstition that young people cannot die at home. The patient was then discharged and returned home. For the patient and the family, complete and continuing care was provided. This nursing experience may serve as a reference for people who care for terminally ill patients.
期刊論文
1.陳慶餘(20140100)。癌末病人死亡恐懼之臨床情境:臨床佛教宗教師參與靈性照顧。臺灣醫學,18(1),115-125。  延伸查詢new window
2.Hottensen, Dory(2010)。Anticipatory grief in patients with cancer。Clinical Journal of Oncology Nursing,14(1),106-107。  new window
3.詹淑雅、劉芹芳、金繼春(20110400)。身體心像紊亂之概念分析。新臺北護理期刊,13(1),63-72。  延伸查詢new window
4.劉鐘軒、蔡正中、陳海雄(20130400)。肝癌的診斷及治療最新發展。內科學誌,24(2),85-94。  延伸查詢new window
5.崔宛玉、林寬佳、黃惠璣(20130600)。口腔癌手術病人於住院期間身體心像改變及其因應行為探討。護理暨健康照護研究,9(2),127-138。new window  延伸查詢new window
6.鄭秦妮、謝至鎠、王英偉、范聖育(20150300)。不施行心肺復甦術與接受自然死亡:影響決策的標題與說明。安寧療護,20(1),1-12。new window  延伸查詢new window
7.蘇思憓、陳亭君、黃佩珍(20110600)。提升某加護病房護理人員執行口腔照護之正確率。護理雜誌.附冊,58(3),22-30。new window  延伸查詢new window
8.洪惠容、梁明泰、洪昭安、黃淑萍(20131200)。以安寧療護理念照護一位肝癌末期病人之經驗。長庚護理,24(4)=84,424-434。new window  延伸查詢new window
9.徐雯娟、賀倫惠、林梅香、邱綉玲(20141000)。不同臥位對肝硬化腹水病人之血氧飽和度、舒適度與呼吸困難程度之影響。護理雜誌,61(5),66-74。new window  延伸查詢new window
10.黎建球(20121200)。現代人的死亡焦慮。哲學與文化,39(12)=463,5-16。new window  延伸查詢new window
11.Brady, M.(2013)。A good death: Key conceptual elements to end of life care。Journal of Paramedic Practice,5(11),624-630。  new window
12.Runyon, B. A.(2013)。Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012。Hepatology,57(4),1651-1653。  new window
13.梁倞玲、蘇郁雯、林韋君(20130700)。照顧一位肝性腹水患者併身體心像改變之護理經驗。馬偕護理雜誌,7(2),94-104。  延伸查詢new window
14.Kumar, Manoj、Panda, Dipanjan(2014)。Role of supportive care for terminal stage hepatocellular carcinoma。Journal of Clinical and Experimental Hepatology,4(Suppl. 3),S130-S139。  new window
其他
1.衛生福利部(20150617)。103年度主要死因分析,http://www.mohw.gov.tw/news/531349778。  延伸查詢new window
 
 
 
 
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