照護一位無望感癌末病患之護理經驗

A Nursing Experience for a Hopeless Cancer Patient with End Stage

本文敘述一位肝癌末期病患對疾病產生無望感及面臨死亡威脅的護理經驗。筆者在2007年9月2日至10月31日以羅式適應模式為評估架構，藉由觀察、傾聽、會談、身體評估等方式，收集主客觀資料，發現主要護理問題包括：無望感、疼痛及預期性哀傷等。運用生命回顧方式，引導個案透過時序重整重建自我價值了解生命正向意義，統整生命進而與家屬共同面對死亡之過程，完成遺顧。提供個別性護理措施，協助生理不適減緩，使心理及靈性層面獲得滿足，期待此照顧經驗分享能提供臨床護理人員實務之參考。

This article describes a nursing experience for a hopeless patient with end-stage hepatic cancer facing the threat of death. With Ross's adaptation model for assessment framework, the author collected data via observation, listening, conversation, and physical examination from September 22 to October 31, 2007. Identified nursing problems included hopelessness, pain and anticipated grief, etc. Through life review, the patient was guided to rebuild self value and understand the positive meaning of life. The patient could integrate life by facing the dying process and honoring individual wishes. The author provided individualized nursing care with minimizing discomfort in physiological aspect and satisfying the patient's psychological and spiritual needs. This article may serve as a reference for those caring for patients facing the end of life.