本文描述一位21歲年輕女性,罹患膽管癌接受治療後復發的護理經驗。於2018年8月20日到9月10日,藉由直接護理、會談、觀察及身體評估等方式收集資料,運用Gordon十一項健康型態評估,確認個案有疼痛、噁心嘔吐及預期性哀傷等健康問題。提供個別性的護理措施,正確的使用藥物,並配合非藥物之輔助療法成功緩解疼痛;與個案討論飲食偏好,協助選擇其喜歡的食物,並藉由深呼吸、穴位按摩,並提供穴位位置提示小卡,協助其有效降低噁心嘔吐的頻率;以主動關懷、鼓勵個案列出願望清單,案母家人及朋友協助完成其心願。藉此照護經驗分享,提供臨床護理人員在面對癌症病人給予個別性的護理措施,以提升生活品質。
This article describes the nursing experience of caring for a 21-year-old women with cholangioma. The duration of the nursing care was from Aug. 20 to Sept. 10 of 2018. Data were collected through direct nursing care, conversations, observation and physical evaluation; the assessment was reached by using the Gordon 11 functional health pattern for reference. The health problems identified included pain, nausea, vomiting, and anticipatory grief, which all prompted the author to investigate the issue of pain relief. Besides the analgesics, some adjuvant therapies, such as the therapeutic massage and music therapy, can decrease the intensity of pain. We also offered individualized nursing care, dietary education, breathing technique, acupoint massage, and oral hygiene care to attenuate the frequency of vomiting. To help the patient cope with the distressing mood, we evaluated the patient's physical status to see how likely she was able to fulfill her wishes, and then we helped her mother and friends to realize her wishes the best we could. We hope our presence and care had provided her with support and brought her hope and consolation. We hope the combination of nursing care, psychiatric care and disease control had helped alleviate the pain and suffering so the patient could live with dignity at the end of her life.