癌末血液透析病人的安寧療護

Hospice Care for Hemodialysis Patients

安寧療護是一種以滿足病人需求為導向的全方位照護。在臨床上所做之多項研究証實，對於提昇病人尊嚴及生活品質，有其在醫療上相輔相成之效果。安寧療護秉持全人、全程、全家、全隊的全方位人性照護理念，對於癌末血液透析臨終患者，提供身心靈照護，幫助病人減輕疼痛不適、降低死亡恐懼及有意義的生命回顧、讓病人活得有尊嚴，並獲得善終。有鑒於安寧照護在癌末血液透析病人有其不可忽視之療效，故本文藉由介紹安寧療護之概念及其在癌末血液透析病人的照護需求，企盼護理人員於執行護理措施之際，能結合安寧療護於癌末血液透析病人，相信在病人照護的品質上更能達到整體全方位人性之照護。

According to the statistics of our Executive Yuan Health Bureau, cancer is currently considered to be the foremost cause of death. The number of people who contract ailments is growing annually, including people with cancer who are facing the threat of mortality. Therefore, the special care required for patients in the last stage of cancer has drawn our attention, especially regarding those who suffer from physical, psychological, or spiritual torment. This involves the so-called Hospice which is based on an all-round humanitarian treatment to meet the needs of final phase cancer patients. It is recognized for providing excellent end-of-life care, but may be underused by dialysis patients. During such an interminable process of dialysis, coupled with occasional complications, the patients suffer from tremendous pressure and anxiety in terms of their physical, spiritual and social well being, to the point where they often simply can not endure it any longer and desire to end their lives. The findings suggests that for most of those cancer patients who died without having received hospice care, up to 73% encountered intolerable pain, severe respiratory difficulties and other negative reactions (Murray, Arko, Chen et al., 2006). Herein, hospices are strongly recommended to provide them and their families with excellent care to relieve their discomforts and to raise their life quality and dignity as much as possible. Nurses play the most important role in providing the assistance and support required by hemodialysis patients with cancer. They serve the purpose of making these patients as peaceful, comfortable, and dignified as possible for the rest of their life.