尊重自主，陪伴善終：一位淋巴瘤末期病人之護理經驗

Respecting Autonomy and Supporting a Good Death: Nursing Experience in a Terminal Lymphoma Patient

本文描述一位淋巴瘤末期病人於治療期間與家屬間出現醫療決策衝突，最終能自主善終之護理經驗。護理期間為2023年9月15日至2023年9月30日，透過整體性評估確立個案主要問題為慢性疼痛、決策衝突與預期性哀傷。照護過程中藉由止痛藥物及搭配音樂、芳香療法和輕柔按摩緩減疼痛；運用關懷、傾聽與同理技巧了解病人與家屬需求，透過家庭會議澄清及引導尊重病人自主意願，協助達成治療共識，並藉由生命回顧與四道人生，留愛不留憾，圓滿善終，期此經驗之分享，提供護理人員照護類似個案時之參考。

This article presents a nursing experience involving a terminal lymphoma patient who encountered conflicts in medical decision-making with family members during the course of treatment, and ultimately achieved an autonomous good death. The nursing care period spanned from September 15 to September 30, 2023. Through a comprehensive assessment, the primary care problems identified were chronic pain, decisional conflict, and anticipatory grief. Pain was alleviated through the use of analgesic medications in combination with music therapy, aromatherapy, and gentle massage. Caring presence, empathetic listening, and communication techniques were used to understand the needs of both the patient and family. A family meeting was conducted to clarify perspectives and guide consensus-building that respected the patient's autonomy. Life review was facilitated, and the four principles of life were provided to help the patient and family express love, gratitude, forgiveness, and farewell. This experience may serve as a reference for nursing professionals in providing care for patients facing similar end-of-life situations.(J Med Health. 2025;14(3):85-94)