以善終的方式照顧一位癌末患者之護理經驗

Good Death: The Experience of Caring a Terminal Patient with Colon Cancer and Ovarian Metastasis

本文是描述一位末期結腸癌合併卵巢轉移的患者，在住院照護期間，筆者運用Gorden十一項健康功能型態進行個案的健康評估，發現個案的健康問題有：(1)身體舒適問題一疼痛、大便型態改變/便秘、下肢水腫等症狀及安全維護和自我照護能力不足；(2)心理問題一牽掛、愧疚、罪惡感、身體心像改變；(3)思想問題一找不到現在存在的意義和價值。筆者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一全人、全家、全程、全隊，使個案從住院至返家、往生，在身、心、思想三方面達到了善終境界。This article reports the nursing experience of a terminal patient who had colon cancer with ovarian metastasis in the hospice ward. Using Gordon's method we assessed the patients’, pain,nausea, vomiting,constipation,pitting edema and psychological, spiritual perspectives of health problems. Four whole care models were applied to this case-holistic person, family care, continuity of care and multidisciplinary care. To love, care, listen and accompany in assisting the patient out of suffering in her last stage of the disease, we helped the patient reach the end of her life peacefully and gracefully.