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題名 | 肝癌併頸椎轉移患者之安寧照護=The Hospice Caring Experience of a Hepatoma Patient with Cervical Vertebral Metastases |
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作者 | 何怡儒; 林千慧; | 書刊名 | 秀傳醫學雜誌 |
卷期 | 15:1/2 2016.06[民105.06] |
頁次 | 頁43-51 |
分類號 | 419.77 |
關鍵詞 | 肝癌; 疼痛; 身體活動功能障礙; 死亡焦慮; Hepatoma; Pain; Disability of physical activity; Death anxiety; |
語文 | 中文(Chinese) |
中文摘要 | 本文主旨描述照護一位52歲肝癌末期男士的經驗。個案本身為小兒麻痺併左側肢體癱瘓患者,因癌症頸椎轉移導致平時賴以行動的右手癱瘓。護理期間自2014年8月12日至8月31日,筆者藉由觀察、傾聽及會談方式收集主客觀資料,綜合生理、心理、社會及靈性面向做整體性評估。個案因頸椎壓迫導致「疼痛」與「身體活動功能障礙」,面臨無法自我照顧的問題;無法接受自身疾病走入末期,伴隨而來的無力感,以及擔憂即將與家人分離,而產生「死亡焦慮」。生理方面的照護主要為減輕疼痛,教導肢體活動及透過復健方式緩解右側肢體麻痺疼痛與無力之不適,協助個案適應生活型態的改變;心理靈性上透過生命回顧、肯定自我價值,引導四道人生,幫助病患與家屬透過分享內在的自我,提升心靈層面,真誠陪伴下共同面對死亡之將至。藉此護理經驗分享,建議可及早介入安寧共同照護,透過安寧團隊合作更能達到全面的照顧與生死兩相安的目標。 |
英文摘要 | This article describes the nursing experience of a 52-year-old man with late stage liver cancer. Due to poliomyelitis at a young age, the patient lost the function of his left limbs. Moreover, his right arm became paralyzed due to cervical metastases. The nursing period of this case was from August 12 to August 31, 2014. According to subjective and objective data from the author's observation and communication with the patient, we tried to assess the condition of the patient's suffering based on physiological, psychological, social and spiritual aspects. In this case, cervical metastases led to "pain" and "immobility". Therefore, he had trouble with self-care. He could not accept that his disease was in the late stage, let alone the feeling of powerlessness, and the upcoming separation from his family. As for the physiological aspect, the aim of care was to alleviate pain. Through physical exercise and massage, we tried to relieve the discomfort of his right limbs and prevented stricture, thus helping the patient adapt to changes in life. We helped the patient and family share inner feelings and promote spiritual growth, so they could keep each other company when facing the suffering process of imminent death. We encouraged the patient and his family to express their thoughts and share memories of life events. Such recollections enhance self-worth. Sincere sharing and consistent accompanying fulfill psychological demands. Communication and faith developed in relationships even strengthen spiritual growth. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。