照護一位乳癌患者首次接受化學治療之護理經驗

Nursing Experience of a Breast Cancer Patient Receiving Chemotherapy for the First Time

李文馨(Wen-Hsin Lee) ； 張瓊文(Chiung-Wen Chang)

《腫瘤護理雜誌》 12卷2期 (2012/12) Pp. 61-73

https://doi.org/10.6880/TJON.201212_12(2).06

摘要

本文描述一位乳癌術後患者首次住院接受化學治療之護理經驗。護理期間為2010年9月16日至2010年9月20日，筆者以個案為中心，藉由紐曼系統模式（Neuman's system model），透過訪談、觀察、傾聽等技巧收集資料，確立個案壓力源及主要健康問題有：知識增進的準備度／與首次接受化學治療有關、死亡焦慮及身體心像紊亂健康問題。於照護過程中，針對個案提供相關護理指導與正確資訊，澄清對疾病的預後與化學治療的疑慮；藉由關懷、陪伴，給予鼓勵與支持並提供相關醫療資訊增加個案對疾病的認識，減輕其死亡焦慮，另外藉由同儕病友，交換彼此心得和經驗分享，認同自我存在的價值，協助個案接受自己外觀的改變，使其能以正向的態度面對疾病與接受治療。希望藉此個案的照護經驗分享，能夠提供護理人員作為照護此類病患之參考。

關鍵字

乳癌 ； 化學治療 ； 護理經驗

並列摘要

The paper describes the nursing experience of a breast cancer patient receiving the first chemotherapy at the hospital. The period of nursing care offered was from September 16 to September 20 in 2010. This case was considered as the center of nursing care. The authors adopted Neuman's system model, and collected the patient's information via interviews, observation and listening. The patient's stress sources and health problems were identified as: lacks of knowledge and preparation for receiving chemotherapy the first time; anxiety, death; body image, disturbed. During the nursing care process, we provided the patient with the related care guidance and correct information. The authors also clarified the prognosis of the disease and the suspected parts of the chemotherapy to the patient. Through the provision of caring, accompanying, encouragement and support, we enhanced the patient's understanding of breast cancer and chemotherapy, and reduced the patient's death anxiety. Besides, through the peer support from other patients, they exchange their feelings, share their experience, and agree the value of the self existence. The authors also helped the patient accept the change of her body image, and take a positive attitude towards the disease and the treatment. By sharing this nursing experience, the authors expect that this case report could be used as a reference for nursing staff in taking care of breast cancer patients receiving the first chemotherapy.

並列關鍵字

breast cancer ； chemotherapy ； nursing experience