結合安寧共照照護一位乳癌末期患者面對死亡善終之護理經驗

Nursing Experience of Caring for a Patient with Terminal Breast Cancer in the Face of Death in Combination with Peace of Mind

本文敘述照護一位乳癌末期轉移個案，藉由結合安寧共照面對死亡以達善終之護理經驗。照護期間為2021年4月9日至2021年4月26日，藉由實際觀察、會談及身體評估等方式收集資料，運用生理、心理、社會及靈性四大層面，總歸個案有慢性疼痛、無望感及死亡焦慮等健康問題。個案除面臨生理上不適，也發現病情進展快速，產生害怕死亡的情緒，於照護過程中提供藥物與非藥物疼痛控制緩解疼痛；建立護病關係，增加家庭支持並藉由生命回顧，肯定自我價值；結合安寧團隊照護，澄清個案對於安寧刻板印象，讓個案在面臨死亡恐懼不安情緒中能接受完善的安寧緩和療護，完成善終。期許透過此次照護經驗分享，共同學習臨終病患的照護技巧及有效性溝通，讓病患達成善終。

This study described the experience of a nursing personnel caring for a case patient with terminal breast cancer and metastasis. Specifically, hospice share care was integrated to help the patient face death and pass away peacefully. The caring duration was from April 9, 2021 to April 26, 2021. Data were collected via methods such as actual observations, interviews, and physical examinations. From the four aspects of physiology, psychology, society, and spirituality, we concluded that the patient had health problems including chronic pain, sense of helplessness, and death anxiety. The patient faced physiological discomfort. Moreover, she endured rapid disease progression, which led to her fear of death. During the caring process, we provided her with medical and non-medical pain controls to alleviate her pain. We established a patient–nurse relationship, and we increased her family support. In addition, we guided her to look back on her life to affirm her self-worth. We integrated the care from the hospice team to rectify the patient’s stereotypical impressions about hospice care, enabling her to receive comprehensive palliative care when facing the fear of death and when experiencing anxiety, and allowing her to pass away peacefully. We hope that by sharing this care experience, people can learn about the caring skills for terminal patients and how to conduct effective communications with them to help them pass away peacefully.