Nursing care for metastatic lung cancer: Case study

Abstract

Purpose : To assess problems and needs, plan holistic nursing care for patients with metastatic lung cancer, and study approaches to promote ethical nursing behaviors.

Study design :  A case study

Materials and Methods: This study examined an 81-year-old Thai female diagnosed with metastatic lung cancer from October 20, 2023, to March 15, 2024, at the inpatient department of Phra Chom Klao Hospital, Phetchaburi Province. Data were collected through medical records, patient interviews, and assessments using pain and quality of life evaluation tools. Data analysis was conducted using the nursing process.

Main findings: The patient presented with six major problems: 1) dyspnea, 2) tissue hypoxia, 3) malnutrition, 4) risk of complications, 5) anxiety, and 6) need for continuous home care. After receiving holistic nursing care combined with palliative care, the pain score decreased from 8/10 to 4/10, O2 saturation increased from 92% to 95%, food intake improved from less than 1/4 to 1/2 of normal portions, anxiety levels decreased, and the family demonstrated readiness for continuing care at home. The nurse's role exhibited ethical behaviors in various situations, including pain management, respecting the patient's decision to refuse NG tube insertion, and breaking bad news, which enhanced the quality of care and patient and family satisfaction.

Conclusion and recommendations: Integrating holistic care with appropriate ethical nursing roles leads to quality nursing care. Support systems for ethical nursing behavior should be promoted at individual, departmental, and organizational levels through training programs, practice guideline development, and the establishment of ethics consultation systems.