照護一位初次診斷胰臟癌末期病患之護理經驗

Experience of Hospice Caring for a Newly Diagnosis of End Stage Pancreatic Cancer Patient

本文描述照護一位初次診斷胰臟癌末期病患之護理經驗，照顧期間為2020年2月24日至3月10日，筆者運用Gordon十一項功能性健康評估工具，藉由會談、傾聽、觀察直接照護等方式收集資料，分析歸納確認護理問題有疼痛、無望感、預期性哀傷。個案初次診斷即為癌症末期，除了承受疾病進展快速帶來的身體病痛，面對與家人分離，對未來無望，充滿負面念頭，因充滿哀傷情緒，身心靈皆無法安寧。照護期間透過傾聽與陪伴了解需求建立良好護病關係，引導個案在家人相互支持下，勇敢面對疾病進展，尋求自我內在安適，個案轉念接受疾病變化，最後的旅程在身心靈獲得善終。建議臨床醫護人員應多參與靈性評估及照護相關課程，加強哀傷輔導技巧，幫助病人及家屬渡過癌末階段，以此照顧經驗提出分享。

This report describes the nursing experience of caring for a terminally ill patient diagnosed with pancreatic cancer for the first time. The caring period was from February 24, 2020, to March 10, 2020. Gordon's 11-functional health patterns assessment tools were used to converse with and listen to the patient and observe nursing tasks directly; other methods were also used to collect, analyze, and conclude data. Nursing problems included pain, hopelessness, and expecting grief. The first diagnosis of the patient indicated terminal cancer. Apart from physical pain caused by rapid disease progression and separation from his family, he had lost hope and had negative thoughts. Because of sadness, his body and mind were exhausted. During the caring period, the nurse listened and provided company to understand the needs of the patient and therefore, established a good nursing relationship with the patient, guiding him to courageously face the disease's progression with the mutual support of the family, seek inner comfort of the self, and accept changes brought about by the disease; the final journey is to experience a peaceful death in the body and mind. It is suggested that clinical medical staff should participate more in spiritual assessment and care-related courses, strengthen their grief-counseling skills, and help patients and family members get through the terminal stages of cancer by sharing their caring experiences.