一位直腸癌末期患者之護理經驗

Nursing Care Experienc e for a Patient with End-Stage Rectal Cancer

本文描述一位直腸癌末期併骨轉移病人之護理經驗，護理期間自2014 年09 月29 日至10 月17 日，藉由實際照護、治療性會談、身體評估及查閱病歷等技巧收集資料，運用Gordon 十一項功能性健康型態進行整體性評估分析，發現個案有慢性疼痛、死亡焦慮及角色扮演改變之護理問題。筆者利用放鬆技巧及配合藥物治療等方式，緩解骨轉移所導致的疼痛；透過護理人員陪伴、支持及引導家人共同參與照護，鼓勵說出內心感受，利用生命回顧及籌辦婚禮方式重新檢視自我，增進對疾病的認知及自我照顧調適能力，減少因疾病產生的角色衝突，肯定自我存在價值，以及利用跨團隊合作協助達成心願，使其能面對死亡焦慮，維持應有的生活品質與生命尊嚴。

This article describes the nursing care experience for a patient with terminal recta1 cancer and bone metastasis between September 29, 2014 and October 17, 2014. By using Gordon’s Functional Health Patterns as a guide and through direct care, systematic interview, physical assessment and reading medical records, the problems identified were chronic pain, death anxiety and parental role conflict. To provide the best care as possible, health care workers of different fields and her family members were invited to join hands in the caring process. The care plan focused on relief of pain, symptoms and emotional stress; and the patient was encouraged to express her final wishes. A wedding ceremony was held at her bedside to make up for her regret of previous divorce. The priority in caring for an end-stage patient is to relieve discomfort and help them maintain quality of life and dignity.