運用安寧療護理念於一位食道癌末期病患之護理經驗

Applying Hospice Care Concepts on a Patient With Terminal Stage Esophageal Carcinoma: A Nurse’s Experience

本文描述照護一位食道癌末期病患臨終前的護理經驗，護理期間為2007年11月8日至11月30日。以個案為中心，透過觀察和筆談，進行身體、心理、社會及靈性評估，發現個案於住院期間有疼痛、呼吸道清除功能失效、預期性哀傷及心靈困擾等健康問題。照護過程中，筆者依「安寧療護」工作理念，以主動關懷、同理心、陪伴、傾聽、支持等方式，幫助個案克服面對死亡的恐懼與哀傷；並運用舒適照顧與疼痛控制技巧，緩解個案身體上之不適，使其身、心、社會、靈性獲得安適，達到「善終」的境界。

This report describes a nursing care experience with a patient diagnosed with terminal stage esophageal carcinoma. Nursing care was administered from November 8th to 30th, 2007. Patient data was collected and evaluated using direct caring, observation, medical reports and patient interviews covering the physical, psychological, social, and spiritual realms. Patient health problems included pain, ineffective airway clearance, anticipatory grieving and spiritual distress. In line with hospice care concepts, the author employed empathy, companionship, listening, and support to assist the patient to overcome fear and face death. Comfort care and pain control skills were also used to relieve the patient’s physical suffering. As such, the author assisted patient to achieve the essence of “good death”, i.e., peace of achieved in the physical, psychological, social and spiritual realms.