一位結腸癌合併肝轉移病人之照護經驗

Caring for a Patient with Colon Carcinoma and Liver Metastasis

本文描述一位第四期結腸癌中年男性，面對腫瘤切除術後症狀及對疾病預後感到無望之照護經驗。護理期間自2016年12月22日至2017年1月6日，經由會談、觀察、身體評估及直接照護等方式收集資料，運用Gordon十一項健康功能型態評估進行整體性評估及資料整合分析歸納，確立個案有焦慮、疼痛及無望感等健康問題。護理期間醫療團隊運用關懷陪伴建立信任護病關係，透過家庭會議使其瞭解診療計畫，促進溝通並達成共，提供手術相關資訊，增強對疾病控制感，減輕其焦慮不安；提供舒適擺位、穴位指壓及芳香療法，緩解其疼痛不適；協助病人適應疾病變化及增強正向信念，肯定自我存在價值，降低對癌末預後衍生的無望感受。建議醫護同仁加強病人及照顧者重視癌末病人靈性需求，使其身、心皆獲得適切性照護，期望經此照護經驗分享，以供臨床實務參考之用。

This article reports the care of a middle-aged man with Stage IV colon carcinoma who presented post-tumor resection symptoms and feelings of hopelessness regarding disease prognosis. The care period was between December 22, 2016, and January 6, 2017. The data were collected through interviews, observations, physical assessment, and direct care. Gordon's 11 functional health patterns were adopted to assess and analyze the data. The results revealed that the patient had health problems such as anxiety, pain, and a sense of hopelessness. During the care period of caring, the relationship of nurse-patient trust was established via caring companionship of a medical team, and it enhanced treatment plants to be fully understood through family meeting to foster communication, access consensus. Learn surgeryrelated information, enhance his perceived control over the disease, and reduce anxiety. A comfortable setting was provided to the patient, who also received acupressure and aromatherapy to alleviate his pain and discomfort. The patient was taught how to adapt to disease changes, improve his mindfulness, build self-value, and prevent a sense of hopelessness regarding terminal-stage cancer prognosis. We suggest that medical staff and caregivers pay more attention to the spiritual needs of patients with terminal-stage cancer and care for the physical and mental health of the patients. We hope that this care report can serve as a reference for clinical practice.