臨牀透析 Vol.25 No.10(9-1)


特集名 終末期にある透析患者への対応
題名 終末期にある患者およびその家族との接し方 (1) ホスピス医の立場から
発刊年月 2009年 09月
著者 柴田 岳三 日鋼記念病院緩和ケア科/カレス・マークホスピス
【 要旨 】 末期がん患者は,身体的苦痛ばかりではなく,精神的,社会的,さらにはスピリチュアルな痛みも抱えていて,苦しんでいることが多い.また一人ががんに罹ると,その家族も心身ともに大きな負担を強いられ,患者と同様に苦痛を感じることとなる.緩和ケア病棟においてこのような状況にある末期がん患者やその家族の世話をするとき,告知問題,コミュニケーション,倫理的問題などわれわれが心に留めておかなければならない要点について解説し,さらに,終末期(ターミナルステージ)を前期,中期,後期,死亡直前期に分け,それぞれにおける末期がん患者やその家族への接し方について,ホスピス医の立場から述べた.
Theme How to Correspond to Chronic Dialysis Patients in End-of-Life Stage
Title Approaching terminal cancer patients and their families:hospice physician's view-point
Author Takemi Shibata Department of Palliative Care, Caress Mark Hospice, Nikko Memorial Hospital
[ Summary ] Terminal cancer patients experience not only physical suffering, but must deal with suffering in many forms including mental, social as well as spiritual. If one person is afflicted with cancer, then the whole family is forced to bear the mental and physical burden as well, experiencing thesame feelings of suffering as the patient. Discussed are topics such as notification of cancer diagnosis, communication, ethics problems, and other issues, all of which must be approached with discrimination when caring for terminal cancer patients and their families in relation to conditions such as those seen in palliative care wards. Also discussed from a palliative care physician's point of view is the terminal stage, which has been divided into the early, middle and late stages, including that in close proximity to death.
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