陪伴一位直腸癌末期病人求死之護理經驗

The Nursing Experience of a Rectal Cancer Patient Requesting Euthanasia

本文是護理一位直腸癌末期合併肺及肝臟轉移的病人，面臨因為癌症所帶來的症狀困擾及心靈問題，而引發求死之護理經驗，護理期間自民國93年1月3日至1月17日。筆者以Gordon 11項評估，藉由觀察、會談及身體評估等方式收集資料，發現病人住院期間之主要護理問題有：（一）身體方面有疼痛、排便型態改變/便秘、及睡眠紊亂。（二）心理社會方面有無望感。（三）靈性方面有靈性困擾。護理重點是在協助病人渡過求死的念頭，維持其身體的需求及身心之舒適，減低對死亡的焦慮與憂鬱。整個照護過程中，藉由與病人和家人之互動及安寧團隊的合作，讓病人得以安寧歸去。

The purpose of this case report is to share a nursing experience of a patient with rectal cancer and lung/liver metastasis. She requested euthanasia due to suffering physical, psychosocial and spiritual distress. From January 3rd to January 17th, 2004, data were collected using the Gordon 11 health nursing evaluation system and participant observation. It was found that the patient had pain, constipation, insomnia, a feeling of hopelessness and spiritual distress. The aim of the nursing care was to help reduce the patient's hopelessness and her anxiety about death as well as to maintain her physical comfort. The nursing experience from this case report should be able to aid others to help terminal patients and their families to be well prepared for death while in the hands of a palliative care team.