喪偶至痛的陪伴，讓生死兩相安－以安寧療護照護一位食道癌末期病人及家屬之經驗

Hospice Care Nursing Experience of a Patient with Terminal Stage Esophageal Cancer and his Family

本文係運用安寧療護全人、全家、全程、全隊、全社區的五全照顧理念，照護一位食道癌末期病人及家屬的護理經驗。照護期間為2009年10月3日至2009年12月4日，筆者運用Gordon十一項健康功能評估，藉由觀察、會談及身體評估等技巧，發現個案有呼吸道清除功能失效、營養狀況改變、靈性困擾等護理問題，在護理過程中，運用傾聽、陪伴、同理、生命回顧及輔助療法，協助病人及家屬互相表達情感，給予病人及家屬身體、心理、靈性全人照顧，改善癌症末期病人的生活品質，協助善終；並在病人往生後，發現家屬出現自殘行為及強烈情緒反應時，有哀傷功能失常護理問題，擬訂護理措施，持續給予喪親者哀傷追蹤與輔導，幫助家屬放下，使達往生者善終，在世者安適的狀態。

This case report described the nursing experience of applying hospice care concept, including holistic, whole family, whole procedure, and whole team care to a patient with terminal stage esophageal cancer and his family. The duration of nursing care was from October 3 to December 4 in 2009.The author assessed the patient with Gordon's 11 functional health assessment tool, and collected the relevant data through observation, conversation, and physical assessment. The patient's problems included ineffective airway clearance, imbalance nutrition, and spiritual confusion. During nursing care processes, we applied listening, accompany, empathy, life reviews, and aromatherapy, to encourage the patient to express his internal feelings with his family, provided them with holistic care, including physical, psychological, and spiritual aspects. Our techniques improved the quality of life and promoted peaceful death for the terminal cancer patient. After the patient passed away, the family member appeared suicidal behavior and expressed sad mood. Nursing assessment showed dysfunctional grieving problems. We continued to give bereavement care, helping the family move on to regular life.