一位直腸癌末期病人善終之照護經驗

A Nursing Experience of Caring for a Patient with Rectal Cancer at the End of life

本文敘述一位接受安寧緩和療護至善終的直腸癌末期個案的照護經驗，護理期自2015年9月1日至2015年9月4日止，筆者運用觀察、訪談收集資料，針對病人生理、心理、社會、靈性等各方面評估，發現個案有疼痛，身體心像改變及預期性哀傷等健康問題；與安寧共照團隊合作，提供藥物及非藥物的疼痛處方，以薰衣草精油按摩舒緩疼痛，主動真誠關懷病人，建立護病關係，接受個案及家屬面對臨終不安情緒的表達，陪伴病人及家屬面對死亡的恐懼，讓病人心靈獲得慰藉安詳離世達成善終，讓家屬欣慰無遺憾，期待此次照護經驗分享，能提供臨床實務參考，建議增加非安寧病房護理人員參與安寧相關及靈性課程，加強評估病人靈性問題的能力，提供適切的靈性照護，提升臨終照護品質。

The following report describes a nursing experience of caring for a patient with rectal cancer at the end of life. The nursing period was from Sep 1 to Sep 4, 2015, and data was gathered through observations and interviews. The case evaluation was completed through physical, psychological, social, and spiritual aspects, which identified nursing problems including pain, body image change, and anticipatory grievance. After establishing a trusting relationship with the patient and their family through direct care, listening and accompaniment during the care period, they were able to express their anxiety and fear of what was to come and avoid regrets in the future. This experience is to be shared with nursing staffs as an example for the nursing care of patients at the end of life.