探討一位肺癌末期患者初次接受化學治療之護理經驗

Nursing Role in the Psychological Adjustment of a Patient with Terminal Lung Cancer

本文是探討一位罹患肺癌末期之37歲未婚女性入院治療之護理過程。筆者於95年9月15日至95年9月20日照護期間，以Gordon十一項功能性健康型態為評估工具，透過訪談、觀察、傾聽及身體評估等方式收集主、客觀資料，結果發現個案有死亡焦慮、知識缺失、無望感及噁心等護理問題，筆者以持續性主動關懷的態度與個案建立信任護病關係，運用希望建立技巧，維持正向社交關係，提供相關醫療訊息增加病患對疾病的認識，鼓勵病患表達對死亡的看法，減輕其死亡焦慮，並運用芳香療法，減輕個案接受化學治療後之不適感，在家人及醫護人員支持下，使個案面對癌症末期的衝擊時，能有最佳的適應情形，並促進身、心、靈的舒適。

This article discusses the therapeutic regimen and nursing care process for a 37-year-old unmarried woman with terminal lung cancer who was under the author ’s care from September 15 to September 20, 2006. The Gordon's 11 -point functional health assessment chart was used as a tool for evaluating the patient’s condition. Through discussion, observation, listening, physical examination, and other objective data, the author discovered the patient's inclination to end her life. The patient had a poor understanding of her medical condition, a sense of hopelessness, and various physical problems including nausea. The author, on her own initiative, used a caring attitude to provide medical information that would help the patient better understand her current condition and encouraged the patient to have a more positive outlook on life, thus decreasing her wish for death. Aromatherapy was initiated to counter-act the ill-effects of chemotherapy. With the support of her family and the medical staff, the patient was able to make a better adjustment and response to her terminal condition, which resulted in a more positive psychological, physical, and spiritual effect overall.