一位愛滋末期病患及其家庭之安寧療護經驗

Hospice Care for an AIDS Patient and His Family

本文敘述一位愛滋病末期之病患與其家庭，在面臨愛滋病診斷確定後，當疾病快速進展至臨終期時，家庭面臨是否據實告知個案病情惡化之事實及決定治療方向之兩難情境。在護理期間以會談、觀察、家庭會議及醫療團隊討論等方法收集資料，針對照顧個案因伺機性感染所導致的生理不適，協助家屬於「診斷確定期」產生之憤怒及害怕被感染的情緒反應，在「臨終期」減輕個案因疾病惡化而產生焦慮並陪伴其面對死亡的恐懼，及協助家屬面對個案死亡產生預期性哀傷等照護需求；運用安寧療護理念以全人、全程、全家、全隊方式，提供身心靈之照護，幫助病人降低死亡恐懼、有意義的生命回顧、獲得案妻寬恕與子女的關愛及最後心願的妥善安排等，最後能獲得善終。此個案報告印證安寧療護對末期愛滋病患是十分重要的照顧。

This article describes the emotional reactions, fear of contamination, and pressure to disclose HIV status of a patient who was recently diagnosed with AIDS, and his family. When the patient's condition deteriorated, his family and medical team faced ethical dilemmas about whether to disclose his condition to others, and the direction of his treatment. The authors and medical team applied the principles of hospice care. During each stage, the first author collected data by means of physical assessment, interview, participant observation, family meetings and team meetings, and provided a clear evaluation of the patient's clinical situation and disease prognosis. The first author applied the principles of hospice care and family-centered nursing care to enable the patient and his family to obtain physical comfort, to reduce the patient's fear of death, to enable him to enjoy the love of his whole family, and obtain his wife's forgiveness. After the patient's death, the first author called the family members and they came back to remember him in front of his room. The article shows that hospice care is crucial to AIDS patients and their families.