Practical Nursing Model for Holistic Care for Enable Intractable Cancer Patients

本研究的目的是建立一个实用的整体护理模式，使那些难以指望完全康复的顽固性癌症患者能够主动选择治疗并度过难关。具体来说，本研究的目的在于建构护理支持理论，并将护理支持的特点与疾病的病程及性质相结合，摘要本研究以1）厘清病患经验与需求，2）分析护理人员经验个案结果为基础，探讨难治性癌症病患经验与因应护理需求。访谈进行了参与6例患者和5名护士。对访谈资料进行逐字记录，运用本纳倡导的哲学人类学现象学方法，对病人体验和护士支持体验的特点进行分析和阐释。六个人的故事 关于我们 难治性癌症患者被描述为那些具有难治性或罕见癌症经历的人：“当我的死亡迫在眉睫时，寻找一种生活方式"，“为复发做好准备，通过寻求治疗而生活"，“在过去的疾病经历中建立我的生活，而不是被严重性所吸引”，“别无他法，只能找到我自己生活的意义”，“获得知识是度过难关的策略”，以及“在不确定的情况下坚持生活”。五名护士的叙述包括“支持患者度过难关，无论预后如何”，“支持患者决定接受或停止治疗以延长生命”，“促进向姑息治疗的无缝过渡”，“确定可能使患者痛苦复杂化的背景”，以及“支持患者对复发和死亡高发生率的焦虑”。“因此，有人建议，在为难治性癌症患者提供支持时，应该给予支持，使患者能够找到剩余生命的意义，并保持或恢复他们与生命的精神联系。为了实现这一点，也有人建议，在创建支持理论的努力应该围绕'棘手'的社会含义，关闭了病人的未来的方向，并已纳入他们的头脑，以及医生和病人不同的时间性感知。少

The objective of this study is to develop a practical nursing model for holistic care that would enable intractable cancer patients, who can hardly expect treatment with a view to complete recovery, to choose a treatment on their own initiative and to live through.More specifically, the study aims at creating nursing support theory taking into consideration characteristics of support associated with the course and nature of disease by structuralizing intractable cancer patients' experience and nursing required in response, based on 1) clarification of patients' experience and needs, and 2) analysis results of cases experienced by nurses. Interviews were carried out with participating six patients and five nurses. A verbatim record was made from the interview data, of which characteristics of patient 'experience and nurses' support experience were analyzed and interpreted based on phenomenological approaches in philosophical anthropology advocated by P. Benner. The narratives of the six … More intractable cancer patients were described as those characterizing the experience of intractable or rare cancer :"to look for a way to live through when my death comes in sight,""to be prepared for reoccurrence and live through seeking for treatments,""to build my life on past experience of disease, without being caught up by the seriousness,""no other way but to find the meaning of my own life,""to acquire knowledge is the tactic to livethrough," and "to live with perseverance despite uncertainty." The five nurses' narratives included" to support the patient to live through regardless of the prognosis,""to support the patient's decision to accept or stop treatment for prolonging life,""to promote seamless transition to palliative care,""to identify the background that may complicate the patient's anguish," and "to support the patient with regard to their anxiety about high incidence of reoccurrence and death."As a result, it was suggested that, when providing support for intractable cancer patients, the support should be given so that the patients can find meaning in their remaining life and maintain or recover their mental link to life. To achieve this, it was also suggested that the efforts in creating support theory should be centered around the social implication of'intractable' that closes up the patients' orientation to the future and has been incorporated in their mind as well as temporality perceived differently by medical practitioners and patients. Less