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題 名 | 急診安寧:乳癌末期病人之急診護理經驗=An Emergency Nursing Experience of a Terminally Ill Patient with Breast Cancer |
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作 者 | 王怡靜; 郭嘉琪; | 書刊名 | 馬偕護理雜誌 |
卷 期 | 11:1 2017.01[民106.01] |
頁 次 | 頁55-68 |
分類號 | 419.77 |
關鍵詞 | 急診; 安寧療護; 低效性呼吸型態; 慢性疼痛; 抉擇衝突; Emergency; Hospice care; Ineffective breathing pattern; Chronic pain; Decisional conflict; |
語 文 | 中文(Chinese) |
中文摘要 | 本文旨在運用安寧療護協助一位乳癌末期病人舒適與善終的急診護理經驗。護理期間為2014年03月10日08:10至03月11日15:00,運用Gordon十一項健康功能型態為評估架構,以身體評估、觀察、會談、病歷查閱等方式收集資料,確立個案的健康問題依序為低效性呼吸型態、慢性疼痛及抉擇衝突。護理過程以安寧療護理念,首先提供緩解呼吸困難、疼痛及增進身體舒適之護理措施;藉由關懷、傾聽、溝通、討論了解個案在疾病過程所面臨之心理衝擊,並提供跨團隊資源以滿足個案對善終之期待。在急診,時常有癌症末期病人在非預期性病況惡化下,被送往急診救治,當病人或家屬尚未做好死亡準備時,常易造成選擇積極治療或安寧緩和治療的抉擇衝突困擾。建議急診團隊需秉持以病人為中心的照護理念,在生命末期時刻引導個案與家屬生命回顧、肯定自我、詮釋生命意義、克服抉擇衝突、尊重病人決策,幫助病人「舒適」與「善終」,達到病人與家屬生死兩相安的生命末期照護。 |
英文摘要 | This paper describes the emergency nursing experience of applying hospice care to a terminally ill patient with breast cancer to achieve comfort and a good death. From 08:10, March 10 to 15:00, March 11 in 2014, we used Gordon’s 11 functional health patterns as the assessment framework and collected data through physical assessment, observations, conversations, and chart review. The health problems included ineffective breathing pattern, chronic pain, and decisional conflict. During the nursing process, we conducted hospice nursing interventions to help the patient relieve pain and breathing difficulties and improve physical comfort; with giving attention, listening, communication, and discussion to understand the psychological impact on the patient, and providing inter-professional resources to satisfy the expectations of the patient for a good death. Terminally ill patients with cancer might usually need emergency care for unexpected worsening of medical conditions. Therefore, patients and family who are unprepared to accept the death may have decisional conflict on receive either aggressive treatment or hospice palliative care. We suggest that emergency teams should provide patient-centered care to help terminally ill patients and their family create a life review, promote self-affirmation, interpret the meaning of life, overcome decisional conflict, and respect patient's decision, thereby assisting end of life patients in having "comfort" and a "good death" and helping them in achieving mental well-being and having no regrets. |
本系統中英文摘要資訊取自各篇刊載內容。