title: [Caring for a terminal patient with nasopharyngeal carcinoma in the ICU who refuses treatment: a nurse's experience].
abstract: 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.
authors.affiliation: Emergency Department Intensive Care Unit, Chang Gung Memorial Hospital of Kaohsiung, College of Nursing, Fooyin University, Kaohsiung, Taiwan, ROC.
authors.forename: Yu-Yin
authors.initials: YY
authors.lastname: Kao
authors.forename: Jong-Ni
authors.initials: JN
authors.lastname: Lin
authors.forename: Pi-Chi
authors.initials: PC
authors.lastname: Wu
mesh_terms: D000328:Adult; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000451:nursing* / Q000523:psychology / Q000628:therapy; D016312:Treatment Refusal