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1 利利 1 寧療理理靈寧理寧療靈行連料立療臨亂理靈例樂療來狀理靈力量利理理念來靈參寧療 Key Words breast cancer hospice palliative care 10A (07) [email protected] 226 寧療年 5

2 行 95 年惡數 28.1 女率 12.2 (1) 女了療女療識 (2) 寧臨靈了療不理靈聯理寧理寧理念來理理靈理理理靈罹理理靈療不狀狀理冷料量兩若 (3) 療臨類 (4) 療律率樂來力 (5) 刺 TENS 療里刺刺來狀 (6) 寧療年 5 227

3 利寧 85 (7) Kyriaki et al (8) 120 寧 24 若念 (9) 理行 (10) 理理異臨 (11) 狀率數錄理不理流 (5) (12) 療刺冷力來來 Burnett Solterbeck Strapp (13) 李 (14) 樂療度理理理女離行亂理了 (15) 理勵落離 (16) 立力量勵參參 (17) 臨理理靈理力理不念 228 寧療年 5

4 靈 (18) 臨 Kubler-Ross 1 shock and denial 2 怒 anger 3 bargaining 4 depression 5acceptance 臨歷理良勵論若理切理 (19) 來臨了力 (20) 樂 (19) 女 46 女讀女讀女寧療年 5 229

5 利 88 年 8 不理狀 9 冷切惡年 10 良切淋 90 年 8 90 年 9 92 年 12 行療 93 年 7 94 年 4 10 x-ray 療陸力 94 年 10 6 療療行不行復寧療寧 94 年年寧理寧療錄理料理理靈行理料寧狀更不 10/7 3-4 來什什不了了什 10/8 不不什不數 5-6 連量 cc 10/7 NA+ 離 138Eq/dl k+ 離 4.1Eq/dl 10/ /7 150 BMI 20 略 2.5g/dl 料 13.3g/dl 異不料尿量 1500cc 2000cc 尿 2-3 便便流料 230 寧療年 5

6 兩不了 ativan 1# 數 7-8 惡來 2-3 料 2x3 狀料 Coma Scale E4V5M6 力力易力力力來力連不更說料異 10/7 裡不不更不不 10/7 量數 7 5 量 120 / 24 / 不落淚料女來 1-2 女女來離什了狀來力來來來不女什了什不不不離不料亂理不不什寧療年 5 231

7 利不零零說不裡靈不裡來不料寧錄亂理療理理 10/9 數 2-3 S1 10/7 3-4 來了 S2 10/7 什什 S3 10/7 不了了什 S4 10/8 不不什不 O1 10/7 寧 5-6 狀 O2 10/7 O3 10/8 不 10/7- 理率量不度 10/7- 茶葉異 10/7-10/8 論 10/7-10/8 論來林樂林力 10/7- TENS 刺里刺 /8 10/7 4-6 hr 淋量勵量 cc 10/7 primperan 1pc IV q8h 10/7 茶葉不 10/8 林樂聆樂 10/9 了 10/9 淋不 10/ 寧療年 5

8 理理 S1 10/7 10/7 裡不不 S2 10/7 更不不 S3 10/9 O1 10/7 量數 7 數 5 O2 10/7 落淚不 O3 10/7 120 / 24 / O4 10/9 數 6 數來 10/7 L 10/7 TENS 療參 10/7-10/8 morphine 10mg 1# po q6h 10/9 數 6 morphine 10mg 量 1 po q4h 不來 10/7 量錄率數度 10/9 樂 10/9 10/7 30 度數 4 10/9 數 6 療數 2 不寧療年 5 233

9 利亂切療理理說 10/13 S1 來了來 S2 不不! S3 來不女 O1 O2 立不論行 10/12 10/12 10/12 勵參 10/12 了 10/13 不異不了療落理理 S1 不什不零零度 -10/17 數了理說不裡說輪來不 234 寧療年 5

10 理理 10/16 S2 S3 S4 靈不裡 S5 不裡 O1 冷不 02 寧金 VCD 留念理 10/12 來女女 10/13 參 -10/17-10/17 來 10/12 樂 10/15 來來來了靈 10/16 寧療年 5 235

11 利療理療落亂寧療理念療 TENS 刺療理理療切不句勵臨靈靈臨碌寧理 1. 行 (2007) 95 年 2007 年 /95//95 年.doc 2. 劉呂北 (9) 李玲療理理 (1) Zappa SB. Cassileth BR Complementary approaches to palliative oncological care. Journal of Nursing Care Quality (1) 林狀理北類療北 (12) Kyriaki M, Efi Parpa, Emmanuela K Antonis G Lambros V Pain and desire for hastened death in terminally ill cancer patient. Journal of Cancer Nursing (4) 林北 (5) 寧療年 5

12 10. 療寧理 (1) 寧療北林劉麗寧理寧療 (1) Burnett KM Solterbeck LA Strapp CM Scent and mood state following an anxiety-provoking task. Psychological Reports (2) 李麗樂 (5) 劉靈切女理理理 (5) 狀北理 (1) 亂理理 (4) 寧療 (2) 呂呂理 (4) 臨說寧療 (4) 寧療年 5 237

13 利 Case Report Hospice Palliative Care of Terminal Breast Cancer A Case Report Chun-Ying Shih Ya-Lie Ku 1 ABSTRACT This paper is to describe a terminal breast cancer case who has accepted the hospice palliative care and the care experiences of physical, psychological, social, and spiritual problems during hospitalization. The author used the assessment sheet developed by Taiwan Hospice Care Nursing Association to assess the case s physical, psychological, social, and spiritual aspects comprehensively and continuously and collected data through conversation, observed family interaction, and physical assessment that identified nausea, pain, body image disturbances, death anxiety health problems due to the side effect of chemotherapy, cancer transferred into the bone, body appearance changed, and fear facing death. Through family meeting and medical/nursing team, a nursing plan was designed as providing the case s physical, psychological, and spiritual individualized care. For instances, aroma, music, acupoints massages therapies can release the case s physical symptoms, and caring, listening, empathy, priest mentor leading, arranged social and volunteer accompanied can solve body image and death anxiety problems. Additionally, life-review was applied into the case to affirm his life-meaning and promote his inner power to overcome the barriers of life and death, and complete the final stage of human beings successfully. It is expected that this case report can provide as a reference for nurses to care the physical, psychological, spiritual, and social aspects of the cancer terminal case in the way of whole men, whole family, whole process, and whole team. (Taiwan J Hosp Palliat Care ) 寧療 Department of Hospice Care Unit of Kaohsiung Chang Gung Memorial Hospital 1 College of Nursing, Fooyin University 238 寧療年 5