照護一位加護病房肺癌末期病患之護理經驗

The Nursing Experience of a Terminal Lung Cancer Patient in the Intensive Care Unit

本篇報告主要探討一位55歲男性，於2007年3月被診斷肺癌末期，2007年6月14日因呼吸喘至急診求治，緊急放置氣管內管後轉入加護病房治療，個案罹患肺癌前健康狀況良好，未曾住過院，突然被診斷為肺癌末期且存活率只剩半年，感到極為震驚。2007年6月14日至6月28日於加護病房照護期間，藉由會談及觀察等方式，以生理、心理、社會及靈性層面進行整體護理評估，結果顯示個案有疼痛、無望感及心靈困擾等健康問題。 以安寧療護理念為基礎，提供全人、全家、全隊及全程的照護，強化以個案及家屬為中心的照護；透過醫師、營養師、社工師及宗教師之團隊成員，提供全隊的醫療照護；除了在加護病房照護外，也曾到普通病房探訪個案，經個案及家屬同意下，出院後電話訪談，以達到持續性之全程照護。最後讓個案原本對生命絕望的瞬間，在家屬的陪伴下，讓個案無憾的過完人生。期望藉此個案照護經驗分享，運用於臨床護理實務之應用，為日後臨床照護之參考。This case report was to describe the nursing care experience of a 55-year-old man with terminal lung cancer in March 2007. The case was sent to the emergency room for treatment due to the shortage of breath on June 14, 2007. After treatment, he was admitted to the intensive care unit. The case had good physical condition and had never been hospitalized before he was diagnosed terminal lung cancer. The case was extremely shocked after knowing about the incoming death within six months. Data were collected through the interview and observation methods from June 14 to June 28, 2007. The nursing holistic assessment included physical, psychological, social, and spiritual aspects. Pain, hopelessness, and spiritual distress were identified as three major health problems. The intervention based on the principles of hospice care, which included providing holistic care, family care, team care, and continuing care in this case report. The hospice care was centered on the case and his family, including through doctors, dieticians, social workers, and religionist to provide care. Under the case and his family's agreements, the author visited the case when he was transferred to the general ward. The author also conducted followed-up phone call after the case discharge. This case at first felt hopeless. Finally, through the family's company with this case, he was quite peaceful and had his life without regrets. This care experience would be expected to provide useful information in the nursing care of the clinical practice and for the future reference.