運用重症安寧療護於T-cell淋巴瘤病人之護理經驗

Palliative Care of a Patient with T Cell Lymphoma - Nursing Experience

本篇在描述一位運用重症安寧理念於末期T-cell淋巴瘤的護理經驗。照護期間2019年6月5日至2019年6月12日，利用觀察、會談、身體評估及直接照護等方式，收集資料及進行整體性護理評估。確認病患有呼吸喘、睡眠型態紊亂、死亡焦慮等健康問題，照護期間與個案建立良好護病關係，針對呼吸喘提供氧氣支持及舒適臥位，並隨時關注病患心理狀況滿足需求降低呼吸喘引發之焦慮，另採集中護理改善夜間睡眠品質，舉辦跨團隊會議鼓勵病患及家屬能說出面對死亡歷程的想法，導入安寧療護概念以降低死亡焦慮感，以協助個案獲得心靈安適走過人生最後旅程，希望藉由此照護經驗作為往後護理人員照護之臨床參考。

This article describes the nursing experience of a patient with terminal T-cell lymphoma, where the concept of critical illness and tranquility was employed for treatment. The nursing care period extended from June 5 to 12, 2019. Data collection was conducted through observation, interviews, and physical assessments, allowing for a comprehensive evaluation of the patient's physiological, psychological, and spiritual dimensions. The patient's health problems were identified as dyspnea, sleeping disorders, and death anxiety. Throughout the care process, emphasis was placed on fostering a positive nurse-patient relationship. Various nursing interventions were applied, including providing oxygen support and ensuring a comfortable lying position to alleviate dyspnea. Additionally, continuous attention was given to the patient's psychological status to address patient's needs and reduce anxiety associated with dyspnea. Furthermore, concentrated on nursing measures were implemented to improve the quality of sleep during nighttime. Cross-team discussions were organized to guide the patient and family members in expressing their thoughts on facing the end-of-life process. Hospice care concepts were employed to reduce death anxiety in the patient. The intention of this article is to offer valuable insights to nursing staff and serve as a clinical reference for similar cases in the future.