一位心肌梗塞個案於加護病房之臨終照護經驗

A Nursing Experience for a Patient with Myocardial Infarction in the Intensive Care Unit

本文旨在探討一位80歲因心肌模塞併重症入住加護病房的個案因無法治癒而改為緩和醫療的照護經驗。護理期間為2009年10月1日至14日，藉由訪談、觀察等方式收集資料並運用Gordon十一項功能性健康型態進行評估，發現個案主要護理問題有：組織灌流改變（心肺）／心肌供氧量低、焦慮／受疾病之威脅、預期性哀傷／家屬面對個案死亡，護理目標為減輕個案痛苦、降低死亡焦慮、提供個案及家屬心理支持，減輕家屬面對死亡的哀傷，讓個案在生命末期獲得良好的醫療照顧得以善終，期望本文的經驗可以提供曰後照護此類臨終個案之參考。

This study describes an experience of caring for an 80-year-old patient with an irreversible condition secondary to severe myocardial infarction. Considering quality of life and living with dignity, the patient chose palliative care and hospice. Data were collected from October 1 to October 14, 2009 through interview and observation. Through the use of Gordon's 11 Functional Health Patterns assessment, the major identified medical problems included alteration of tissue perfusion (cardio-pulmonary) and insufficient cardiovascular oxygen supply, anxiety and threat from disease, and anticipatory grief. The goals of nursing care were to alleviate the patient's suffering, reduce the patient's anxiety from facing death, offer the patient and family emotional support, and alleviate the family's grief after the patient's death; therefore, the patient could receive high quality care during the last stage of life. This study can be used as a reference for those who take care of terminally ill patients.