照護一位大腸癌末期病人行緩和鎮靜治療之護理經驗

Nursing Experience of a Patient with End-stage Colon Cancer Undergoing Palliative Sedation Therapy

本文描述一位大腸癌末期病人行緩和鎮靜治療之護理過程。護理期間自2015年11月4日至11月12日，運用Gordon十一項功能性健康型態評估，藉由觀察、會談及身體評估收集資料，確立「慢性疼痛」、「低效性呼吸型態」及「死亡焦慮」之健康問題。筆者運用佛經、水晶音樂、嗅吸檀香芳療及冥想等方法，分散病人對疼痛的注意力及導引病人放鬆；協助病人採取坐臥式、提供鼻套管氧療及呼吸技巧以改善其呼吸困難：筆者、宗教師與安寧共照護理師透過關懷、宗教信仰、生命回顧及生命對話以緩解其死亡焦慮。最終，病人在介入緩和鎮靜治療後，有效改善癌痛、呼吸困難與焦慮，成就臨終過程之靈性祥和與安適。 This article described the nursing experience of a patient with end-stage colon cancer undergoing palliative sedation therapy. The nursing period was from November 4 to November 12, 2015. Gordon's 11 Functional Health Patterns Assessment were applied to collect data through observations, interviews, and physical examinations. The nursing problems were identified as follows: chronic pain, ineffective breathing pattern, and death anxiety. The author employed Buddhist and crystal musics, inhaled sandalwood essential oil, and meditation to distract attention from pain and relaxation. The patient was placed in a Fowler's position, provided nasal cannula oxygen therapy and breathing technique to improve dyspnea. In addition, the author, religious worker, and hospice shared care nurses applied caring, religious belief, life review, and dialogue of life to alleviate death anxiety. Moreover, the cancer pain, dyspnea, and anxiety had effectively improved after palliative sedation therapy, resulted in a sense of spiritual peace and well-being during dying process.

This article described the nursing experience of a patient with end-stage colon cancer undergoing palliative sedation therapy. The nursing period was from November 4 to November 12, 2015. Gordon's 11 Functional Health Patterns Assessment were applied to collect data through observations, interviews, and physical examinations. The nursing problems were identified as follows: chronic pain, ineffective breathing pattern, and death anxiety. The author employed Buddhist and crystal musics, inhaled sandalwood essential oil, and meditation to distract attention from pain and relaxation. The patient was placed in a Fowler's position, provided nasal cannula oxygen therapy and breathing technique to improve dyspnea. In addition, the author, religious worker, and hospice shared care nurses applied caring, religious belief, life review, and dialogue of life to alleviate death anxiety. Moreover, the cancer pain, dyspnea, and anxiety had effectively improved after palliative sedation therapy, resulted in a sense of spiritual peace and well-being during dying process.