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1
題名:腦死病人生命末期照護     (20點)
END-OF LIFE CARE IN BRAIN DEAD
著者:張麟(Lin Chang) ;黃勝堅(Sheng-Jean Huang) ;蕭勝煌(Sheng-Huang Hsiao)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:重症照護 ; 安寧照護 ; 腦死 ; 器官捐贈 ; Intensive car e ; Palliative care ; Brain death ; Organ donation
刊名:重症醫學雜誌
卷期:11卷4期(2010)
頁碼:251-260
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

重症照護領域中,面對腦死病患是一門相當特殊的課題。不同於許多其他疾病的生命末期狀態,腦死的發生往往突如其來,使家屬在碎不及防的心理狀態下必須馬上試著理解並接受這病況的嚴重程度,甚至開始思考及做出與其相關的決策,色括是否簽署拒絕心肺復甦同意書或器官捐贈。近五十年來,國內外對於生命末期照護逐漸走向更人性化且讓病人或家屬有更多自主性,不論是治療的不給予或撤除,拒絕心肺復甦乃至解除瀕死痛苦的用藥等由不同角度切入醫學倫理的探討:晚近十年,這關懷的議題更逐漸由病人照護具體化地擴展到家屬照護。 在器官捐贈被大力推廣的今天,腦死病患及其家屬將是我們愈益頻繁面對的族群:當病人因驟然的創傷或疾病住進加護病房,全身安滿管路,不言不動,安寧照護被及家屬的層面近至當下的陪伴安撫,遠至日後的關懷問訊,都有助於家屬走出喪親之慟。觀察結果中,大部分家屬對於施諸病人的醫療行?普遍感到滿意,情緒面的照顧略顯不足,而硬體資源的短缺與隱私的缺乏亦是較常被揭露的困境。對於此一情境,除了正視硬體設備改善空間,加重社工人員或心理師在整個醫療團隊中的角色俾提供更即時且全面的支持外,醫療及護理人員養成過程中的溝通技巧亦應強化教育訓練。
Brain death is a sudden and traumatic event following a severe injury to the brain. The sudden onset and short course made it different from other chronic diseases in end -of-life care. Scant of psychological preparation and unfamiliarity to medical terms hinder relatives of brain dead patients from indeed understanding when bad news is broken. For fifty years, humanity and autonomy are more and more highlighted in end-of-life care, including therapy withholding or withdrawing, do not resuscitation and medication which relieving dying rattles or shortening dying processes. In this recent decade, palliative care was further expanded to include the family, not only the patients. Most patients with brain death spend the last day s of life in an intensive care unit (ICU), where some family will be approached to ask for organ donation. What comforts the relatives and helps them recover from bereavement can be a timely considerate word or a little while staying with them. In a research in the United Kingdom, most family valued the physical care their relatives had received, but communication and breaking bad news was a cause for concern. The facility of Many ICUs such as cramped relative's room and little privacy to say fin al goodbye was also mentioned. This similar situation is also noticed in our country. To deal with the se problems, besides facility improvement, palliative care team should offer the support through the last day s and into period of bereavement; staff training on how to communicate bad news should al so be stressed.


    

本卷期目次
重症醫學雜誌 11卷4期 (2010)
改善急性腦中風病人血栓溶解治療評估效率之經驗及探討/ 顏正昌盧玉強萬樹人林清煌張運德羅崇誠陳立偉高志翔
THE ACUTE-PHASE HEART RATE VARIABILITY IN ACUTE CORONARY SYNDROME- THE IMPLICATIONS OF DIFFERENT ANALYSES/ Ho-Tsung HsinChi-Yu YangJiann-Shing ShiehPi-Chi LinLiang-Yu Chen
腦死病人生命末期照護/ 張麟黃勝堅蕭勝煌
CARDIOVASCULAR COLLAPSE AFTER GENERAL ANESTHETIC INDUCTION COMBINED WITH ESMOLOL/ Yu-Ling YehYi ChangWen-Wei LiaoHsiang -Chien TsengKuo-Ching Wang
PULMONARY ALVEOLAR PROTEINOSIS TREATED WITH WHOLE LUNG LAVAGE IN INTENSIVE CARE UNIT/ Yao-Chang WangJau-Yeong LuWein-Shung KuoMing-Teng ChungPen-Fang Yeh
NOSOCOMIAL URINARY TRACT INFECTION RELATED RETROPERITONEAL ABSCESS WITH INTERNAL COLONIC FISTULA/ Shih-Hung TsaiWei-Chou ChangChin-Wang HsuShi-Jye ChuWann-Cherng Perng
LIDOCAINE-ASSOCIATED SEVERE DYSPNEAAND PULMONARY INFILTRATES AFTER BRONCHOSCOPY: A CASE REPORT/ Kuan-Chun LinChi-Wen LaChia-An Chou
 
   
 
   

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