# 一位護理師正在協助一場家庭會議，會中醫療團隊正在討論將一位患有轉移性癌症且多器官衰竭惡化的個案，轉為以舒適為導向的照護。下列哪些護理行動反映了最佳實務？請選擇所有適用選項。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374987&lang=zh-tw  
> language: zh-TW  
> subject: Basic Care and Comfort  
> category: BCC

## 題目

一位護理師正在協助一場家庭會議，會中醫療團隊正在討論將一位患有轉移性癌症且多器官衰竭惡化的個案，轉為以舒適為導向的照護。下列哪些護理行動反映了最佳實務？請選擇所有適用選項。

1

允許難消息後的沉默,避免倉促安慰

2

依家屬偏好提供牧靈或靈性照護轉介

3

使用合格醫療口譯而非家屬翻譯

4

具體記錄商定的症狀管理目標與決策人

5

向家屬聲明任何持續積極治療皆屬無益且不倫理

## 解析

討論照護目標的會議需要合格的醫療口譯員（家屬擔任口譯會引入偏見和情緒負擔），對於沉默感到自在，以便家屬能夠消化資訊，清楚記錄決策者和症狀控制目標，並提供符合文化的精神照護。告訴家屬繼續治療是無效或不道德的，是帶有批判性且會破壞共享決策——團隊應探討價值觀、預後及取捨，然後提出照護計畫。

## 深入解析

使用SPIKES或NURSE法:命名情緒、理解、尊重、支持、探索。避免倉促安慰與如「無益」之價值標籤。

## 臨床情境

病人無法參與;醫療代理人偕3名成年子女在場。主要語言西班牙文,使用認證電話口譯。

## 重要概念

- **照護目標** — 以病人為中心,將治療與價值與預後對齊之框架。
- **緩和醫療** — 專注重症症狀管理與生活品質之專科,適用於任何階段。
- **醫療代理人** — 病人喪失能力時受指定之決策者。

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