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題名 | 運用安寧療護於一位口腔癌末病人之照護=Use Hospice Care in an Terminal Oral Cancer Patient's Care |
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作者 | 賴姿秀; 賴亭伃; 曾斐琳; 許文玲; | 書刊名 | 安寧療護 |
卷期 | 21:1 2016.03[民105.03] |
頁次 | 頁88-100 |
分類號 | 419.77 |
關鍵詞 | 口腔癌末期; 低效性呼吸型態; 慢性疼痛; 預期性哀傷; 安寧療護; Oral cancer terminal stage; Ineffective breathing patterns; Chronic pain; Anticipatory grief; Hospice care; |
語文 | 中文(Chinese) |
中文摘要 | 本文為運用安寧療護於一位口腔癌末期病人之照護,照護期間自2014年3月3日至18日,以安寧療護理念評估生理、心理、社會及靈性等層面,運用身體評估、觀察、陪伴、傾聽、同理心等實際互動過程,進行整體性評估,經分析歸納確立低效性呼吸型態、慢性疼痛、預期性哀傷的健康問題。個案因頭頸部腫瘤壓迫呼吸道導致呼吸困難及緊窒感,讓個案感到恐慌及害怕,也使家屬不知所措,故引發筆者撰寫此個案照護之動機,建議應適時衛教症狀及照護的相關技巧,依個別需求儘早確立照護計畫,以減輕個案及家屬的焦慮不安。護理期間護理師觀察個案的呼吸、疼痛、密切監測生命徵象及瀕死症狀,依個案狀況和主觀需求,隨時與醫師討論,促成藥物調整等常規的全程護理照護和關懷態度是讓個案安適的安寧療護核心因素。除藥物處置外,隨著個案病程,在個案意識還清楚,注意力還能被帶領被轉移,且願意合作的情況下,予教導呼吸放鬆訓練並引導想像療法、使用薰衣草精油進行芳香療法等,使個案低效性呼吸型態及慢性疼痛的症狀可暫時獲得緩解,經醫療照護團隊人員引導個案及家屬四道人生,鼓勵個案以瓶中信表達對女兒的關愛,彌補無法陪伴成長的遺憾。期待透過本文探討口腔癌末病人之照護,可供團隊人員照護知能,藉而提升生活品質,以協助個案安詳、平靜的善終,家屬能坦然面對個案死亡以達善別、善生。 |
英文摘要 | This report was about using hospice care in terminal oral cancer patient's care, the nursing care period was from 3rd March 2014 to 18th 2014, the methodology I used was hospice philosophy to evaluate patient's reaction from physiological, psychological, social and spiritual aspects, we also applied actual interactive process with physical assessment, observation, companionship, listening, and empathy to carried out overall assessment. After analysis and summary, I established ineffective breathing patterns, chronic pain, and anticipatory grief health problems. Due to compression of the respiratory tract caused dyspnea and choke, the patient with head and neck cancer always felt panic and fear, and their families were also totally lost. It was the motivation for me to write this report; I recommend that patient instructions should add timely tips related symptoms and care; according to the individual needs to establish care plan as early as possible to reduce anxiety of patient and their families. During the nursing care, nurse observed cases of respiratory, pain, vital signs and pre-dying signs, By case situation and needs, at any time to discuss with the physician, Drug adjustment routine nursing care and care of the whole attitude is to make the case comfortable hospice core, except dealing with drugs, With the condition, is consciousness clear, attention is also being led to be transferred, and the willingness to cooperate, I led patient into relaxation breathing training and imagination therapy, I also used lavender essential oil to carry out aromatherapy; those measures could temporary remission the ineffective breathing patterns and chronic pain. Medical care team members conducted patients and their families about four steps in the end of life; they encouraged patients to send a message in a bottle to her daughter to express her love; and this action could make up her regret for unable to accompany the growth of her daughter. I hoped that through the discussion in this article, it could provide medical care team members some care knowledge and ability to promote patient’s quality of life; and help patient to have a serene and calm end well, at same time, also assist the family member could be more comfortably with well good- by and well carefree when facing the death of patient. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。