[Caring for a terminal patient with nasopharyngeal carcinoma in the ICU who refuses treatment: a nurse's experience]. 2009

Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
Emergency Department Intensive Care Unit, Chang Gung Memorial Hospital of Kaohsiung, College of Nursing, Fooyin University, Kaohsiung, Taiwan, ROC.

This article describes the experience of a nurse directly responsible for the care of a patient with terminal stage nasopharyngeal carcinoma who refused all medical treatment. Tumor bleeding had caused loss of consciousness, which led to the family arranging ICU admission. While in the ICU, the patient was overwhelmed by feelings of hopelessness regarding his disease and believed his family was not emotionally supportive. The patient was verbally non-responsive, angry and lethargic. He also refused to accept any medical care or treatment. The author collected data through observation, physical assessment, interviews and written communication between May 9th, 2007 and May 23rd, 2007. The author confirmed the diagnosis and found that the patient had some related mental health problems, including imbalanced nutrition (less than body requirements), chronic feelings of hopelessness and anxiety. The author established a positive relationship with the patient utilizing Watson's caring theory and case-establishment trust in the nursing process. The author provided disease-related information to the patient, worked as an intermediary to encourage greater family member support and encouragement, helped the patient interact with visitors and encouraged development of the patient's self-esteem. This experience can benefit nursing professionals by fostering a greater understanding of patient self-esteem and the benefits of a positive treatment environment.

UI MeSH Term Description Entries
D007362 Intensive Care Units Hospital units providing continuous surveillance and care to acutely ill patients. ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D008297 Male Males
D009303 Nasopharyngeal Neoplasms Tumors or cancer of the NASOPHARYNX. Cancer of Nasopharynx,Nasopharyngeal Cancer,Cancer of the Nasopharynx,Nasopharynx Cancer,Nasopharynx Neoplasms,Neoplasms, Nasopharyngeal,Cancer, Nasopharyngeal,Cancer, Nasopharynx,Cancers, Nasopharyngeal,Cancers, Nasopharynx,Nasopharyngeal Cancers,Nasopharyngeal Neoplasm,Nasopharynx Cancers,Nasopharynx Neoplasm,Neoplasm, Nasopharyngeal,Neoplasm, Nasopharynx,Neoplasms, Nasopharynx
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D016312 Treatment Refusal Patient or client refusal of or resistance to medical, psychological, or psychiatric treatment. (APA, Thesaurus of Psychological Index Terms, 8th ed.) Avoidance of Health Care,Avoidance of Healthcare,Avoided Health Care,Avoided Healthcare,Health Care Avoidance,Healthcare Avoidance,Patient Refusal of Treatment,Refusal of Treatment,Anesthesia Refusal,Patient Elopement,Anesthesia Refusals,Elopement, Patient,Refusal, Anesthesia,Refusals, Anesthesia,Treatment Refusals

Related Publications

Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
January 1996, Dimensions of critical care nursing : DCCN,
Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
January 1982, Kurinikaru sutadi = Clinical study,
Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
January 1982, The American journal of psychiatry,
Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
February 2009, Hu li za zhi The journal of nursing,
Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
June 2011, Hu li za zhi The journal of nursing,
Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
April 2010, Hu li za zhi The journal of nursing,
Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
April 2003, Minerva anestesiologica,
Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
April 2007, Disease-a-month : DM,
Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
January 1985, American journal of law & medicine,
Yu-Yin Kao, and Jong-Ni Lin, and Pi-Chi Wu
January 2006, British journal of nursing (Mark Allen Publishing),
Copied contents to your clipboard!