Care Experience of a Terminal Lung Cancer Patient Who Developed Lower Limb Paralysis After Surgery for Aortic Dissection

Authors: Pei-Shan

Abstract:

Objective: This article explores the care experience of a terminal lung cancer patient who developed lower limb paralysis after surgery for aortic dissection. During chemotherapy for lung cancer, the patient was diagnosed with aortic dissection, which led to lower limb paralysis following surgery. The patient, facing impending death and reduced mobility, felt helpless and experienced a sense of hopelessness. Methods: The nursing period was from July 19 to July 27, 2024. Together with the intensive care team and palliative care specialists, we conducted a comprehensive assessment, collecting data through observation, direct care, conversations, physical assessments, and medical record review. Gordon's eleven functional health patterns were used to perform a holistic evaluation, identifying four nursing health issues: "chronic pain," "decreased cardiac tissue perfusion," "impaired physical mobility," and "hopelessness."Results: Alongside the medical team, we first addressed the patient’s discomfort by providing pain relief medication and chemotherapy. We also engaged in open communication to understand the patient's physical, psychological, and spiritual issues. Non-pharmacological approaches such as listening, caring, companionship, opioid medication, and distraction were used to alleviate the patient’s pain and respiratory difficulties. Additionally, the palliative care team was involved, guiding the patient and family through the four paths of life, helping the patient achieve a good end-of-life experience and the family to experience a good life. This process also served to promote the concept of palliative care, enabling more patients and families to receive higher quality care. The patient was encouraged to express inner anxiety through drawing or writing, reducing the hopelessness caused by psychological distress and uncertainty about the disease’s prognosis. Conclusion: The care process was particularly impactful when the patient’s condition changed. As intensive care medical personnel, beyond routine care, we must also consider the patient's psychological needs. Family support and involvement are often the greatest source of comfort for the patient, helping to alleviate their anxiety and helplessness. It is hoped that this care experience will provide a reference for healthcare professionals in caring for similar patients and contribute to improving the quality of care.

Keywords: intensive care, lung cancer, aortic dissection., lower limb paralysis