一位肺癌合併骨轉移年輕女性之照護經驗

A Nursing Experience of Caring a Young Woman Patient of Lung Cancer Combined with Bone Metastasis

據衛生福利部2016年統計資料顯示，肺癌總死亡人數占所有癌症死亡人數之20%，躍居全國癌症死因之首。早期肺癌沒有前驅症狀，發現時，常轉移至其它器官，病人除承受生理上不適外，心靈也遭受莫大的衝擊，醫護人員雖無法阻擋死亡的到來，但可藉由臨床照護來緩解病人身體的病痛，減輕面對死亡的焦慮，運用同理心滿足病人及家屬的身心需要及調適，讓病人在最後生命裡，創造其意義及價值。本文探討一位罹患肺癌合併骨轉移之年輕女性，此年紀應是駕馭自己人生的美好開端，卻因初次診斷已是癌症末期，積極接受治療仍無法有效緩解疾病惡化速度，本身需承受生理病痛外，心理層面因應無法掌握疾病迅速變化，即將面臨死亡的威脅，進而出現低落、哀傷等情緒，言語中充滿對生命的無奈感，衍生出身、心、靈等問題，筆者因對此方面照護經驗不足，故引發深入探討之動機。 This paper described lung cancer combined with bone metastasis nursing experience of A young woman patient. The nursing period lasted from January, 11th to 27th, 2017. With Gordon's functional health patterns as framework for assessment, we integrated bed side observation, listening, communication and interviews in order to evaluate the patient. And confirmed and documented the patient's health issues as acute pain, sleeping disorder and anticipatory grief. Through a good nursingpatient relationship, the authors and the family listened and encouraged the patient to express his feelings. We also using team management with hospice nurse, pain management nurse and psychotherapist, through the convening of family conferences, the uniqueness of nursing functions is brought into play, and favorable resources are integrated to satisfy all levels. We hope to provide the nursing staff with this experience as a reference when taking care of similar cases.

This paper described lung cancer combined with bone metastasis nursing experience of A young woman patient. The nursing period lasted from January, 11th to 27th, 2017. With Gordon's functional health patterns as framework for assessment, we integrated bed side observation, listening, communication and interviews in order to evaluate the patient. And confirmed and documented the patient's health issues as acute pain, sleeping disorder and anticipatory grief. Through a good nursingpatient relationship, the authors and the family listened and encouraged the patient to express his feelings. We also using team management with hospice nurse, pain management nurse and psychotherapist, through the convening of family conferences, the uniqueness of nursing functions is brought into play, and favorable resources are integrated to satisfy all levels. We hope to provide the nursing staff with this experience as a reference when taking care of similar cases.