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[Hospice care nursing experience related to a patient with terminal stage liver cancer]
1Department of Nursing, Tri-Service General Hospital. johnny3136@yahoo.com.tw
Abstract:
This case report describes hospice care provided to a patient suffering from terminal stage liver cancer. Care was analyzed based on the Neuman System Model. In the nursing process, the author first established a good relationship with the patient and then collected information related to patient physical, mental and spiritual needs through discussions, observations and anamnesis. Results revealed that sources of pressure affecting patient functional system harmony came from two intrinsic factors; namely, intrapersonal and interpersonal stressors. Intrapersonal stressors included changes in nutritional status, aches, and struggles with fear of death. Interpersonal stressors addressed the guilt of being unable to meet the expectations of family members. Based on the Neuman System Model, patient pressures were analyzed at three levels of prevention in order to strengthen their ability to cope. The scope of intervention included (1) alleviate problems of aches and malnutrition resulting from abdominal dropsy in the terminal stage of cancer; (2) provide psychological and spiritual care in order to ease patient fears of death and encourage positive reflection on life; (3) position the family to perform a positive role to help the patient and his family obtain the best quality of life. The patient finally passed away in the company of his family in a dignified, peaceful and painless manner.
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