一位末期肺癌病人接受安寧共同照護之護理經驗

A Nursing Experience in Hospice Shared Care With a Terminal Lung Cancer Patient

「安寧共同照護」是提供末期癌症病人在身、心、靈的照顧，提高病人生命尊嚴與輔導家屬哀傷反應的轉機。本文為一位末期肺癌病人因病程逐漸惡化，面臨瀕死前接受安寧共同照護之護理經驗。筆者於2010年8月13日-26日提供安寧共同照護期間，藉由觀察、會談、身體評估、團隊討論及查閱病歷收集資料，運用Gordon十一項功能性健康型態評估病人的健康問題，確立有疼痛、癌因性疲憊、皮膚完整性受損及家屬預期性哀傷。護理過程中，協助病人得到適切的疼痛控制、肢體運動/下床及傷口照護。最後，在安寧共同照護模式及與原醫療團隊合作，傾聽家屬即將面對個案死亡的預期性哀傷，提供個別、全面且連續性的照顧，使病人得以善終。藉由此安寧共同照護經驗，提供臨床護理人員照顧類似病人時之參考。

“Hospice shared care” is a critical timing in providing end-of-life care, preserve dignity and offer family members’ bereavement supports for terminal cancer patients. The purpose of this case report is to share the nursing experience of a terminal lung cancer patient who had received hospice shared care. From 13th - 26th Aug, 2010, the patient's health problems were pain, fatigue, skin impairment, and his family had anticipatory grieving as assessed by Gordon's 11 functional health patterns assessment tool. Due to cooperation with the patient's original medical care team and communication with family members, the patient received appropriate pain control, improved skin integrity and adequate range of motion/movement training. Finally, we listened and helped family to face patient's good-death and to prepare for funeral affairs. “Hospice shared care” is a special nursing care model which when combined with original medical care team, provides holistic, individualized and continuous care. We shared this valuable experience with other similar cases.