一位舌癌併發直腸癌末期病人之護理經驗

Nursing a Terminal Patient with Combined Tongue and Colon Cancer

本文在描述照顧一位舌癌併發直腸癌病人接受安寧療護的護理過程。護理期間自民國95年5月9日至6月4日。筆者於安寧病房中藉由觀察、傾聽、會談、非語言溝通的方式收集主、客觀資料並運用整體性評估進行健康評估，發現主要護理問題有：（1）、生理方面－疼痛，組織完整性受損；（2）、心理方面－家屬焦慮出院返家後之照護；（3）、靈性方面－心靈困擾。藉由與病人及家屬建立互信的關係與生命回顧法，協助病人找到人生的意義與價值，運用安寧療護的理念，以愛、關懷、傾聽、陪伴，並以四全照顧的工作觀念－全人、全家、全程、全隊，提供個別性的護理措施，減輕病人及家屬的焦慮感，維持生活品質與生命尊嚴，並提供符合病人需求之照護護理。

The purpose of this paper is to document how assessment of overall care was applied to hep a patient with combined tongue and colon cancer accept the process of the hospice care. The nursing period was from 2006/5/9 to 2006/6/4. The author used observation, written communication and family interviews, as well as sign language to collect subjective and objective data in the hospice sickroom, and to assist the patient with spiritual, mental and physiological changes in the terminal phase. The patient's health problems consisted of: 1) for the physiological aspect-pain and impaired tissue integrity; 2) for the mental aspect-family worry about the patient going home; 3) for the spiritual aspect-spiritual distress. For these reasons, the author provided individualized nursing care by building the patient's and family's confidence to reduce their anxiety and to help them maintain quality of life and dignity. At the same time, nursing intervention aimed to ease the physiological, mental and social pressure by adapting to the patient's particular nursing requirements.