一位中年女性胰臟癌患者面對死亡威脅的護理經驗

Nursing Experience when Treating a Middle Aged Woman Suffering from Pancreatic Cancer and Facing the Threat of Death

當一位癌症末期病人纏綿病塌，所要承受的不僅是肉體上的折磨，還有面對死亡一步步逼近的恐懼，其錯縱複雜的情緒與心理反應，是多方面的衝擊及考驗。本個案報告是描述一位中年女性胰臟癌患者面對死亡威脅的護理經驗，筆者在照護個案的護理期間，運用整體身體評估、收集資料、參與性觀察法、多次深入會談及出院後電話訪談，將協助個案面對死亡威脅之過程及所收集的六篇行為記錄，依內容分析法以Kubler-Ross提出「與死亡協議的階段過程」加以評估，確立個案護理問題為心、靈之困擾--死亡焦慮，且透過安寧療護之個別性的護理措施，使個案能坦然面對死亡是人生的過程，並於臨終時安詳、平靜的離開人世。僅以此報告提供護理人員臨床照護之參考。（志為護理, 2008;7:3, 120-128.）

When a terminal stage cancer patient lies on a sickbed, there is not merely torment of the body, but the person also faces the fear that death is approaching step by step. The result is a range of complicated moods and psychology reactions that impacts on many different aspects of the patient’s life. This case report describes nursing experience during the treatment of a middle aged female pancreatic cancer patient who is facing death. During the nursing period while caring for this case, we used body assessment, data collection, participant observation, a number of deep conversations with the patient, and a telephone interview after leaving hospital to record the treatment process. We then assessed the case in terms of facing death and identified six behaviors that were present based on “content analysis”. These were compared to the stages proposed by Kubler-Ross for the course followed by a patient facing death. From the above assessment we confi rmed that this case involved death anxiety. Through specifi c bodily, emotional and spiritual nursing measures, it was possible to help the patient face the imminent threat of death. We would like this report to offer a clinical care reference case for nursing staff in a similar situation. (Tzu Chi Nursing Journal, 2008; 7:3, 120-128.)