照顧一位肝癌末期無力感病人之護理經驗

The Nursing Experience of Caring a Patient with Terminal Hepatoma with Feeling of Powerlessness

本文敘述一位肝癌末期個案，從初期積極接受治療到癌症轉移後之心情改變歷程，重建個案之控制感之護理經驗。筆者於2017年12月10日至12月28日間，經觀察、會談，身體評估及查閱病歷收集資料等方式，運用Gordon十一項健康功能評估，確立個案健康問題有：疼痛、體液容積過量及無力感。照護期間透過與個案、家屬及醫療團隊共同參與討論照護計畫。給予非藥物輔助疼痛控制方法，緩解個案疼痛情形；訂定個別化飲食計劃協助個案控制腹水，以緩解腹脹不適感受；運用提供主動關懷、傾聽與陪伴個案及家屬，讓個案勇於面對疾病的進展，克服情緒低落以引導個案超越人生的無力感，提昇生活品質。期望藉此護理經驗，提供照護此類個案時之參考。

The article described the nursing experience of caring a patient with terminal hepatoma with feeling of powerlessness. Based on the Gordon's 11 Function Health Patterns system, the data were collected through observation, conversations, physical examination, and chart review from December 10 to December 28, 2017. The patient's health problems were identified as the followings: pain, fluid retention, and powerlessness. During nursing care, care plans were established by patient, family members, and the medical team to include non-medication pain relief methods to promote comfort. Individual diet plan was created to control ascites. Powerlessness was resolved by listening and accompanying to patient and family members to improve patient's quality of life. This care experience can be shared as a reference in clinical practices.