接受放射治療之鼻咽癌病患門診治療護理經驗

Experience of Nursing Care in a Patient with Nasopharynegeal Carcinoma Treated with Radiotherapy

唐佩玲(Pei-Ling Tang)

《腫瘤護理雜誌》 3卷2期 (2004/06) Pp. 59-70

https://doi.org/10.6880/TJON.200406_3(2).05

摘要

本篇個案報告是描述一位44歲男性在接受鼻咽癌放射治療期間，門診治療之護理經驗。護理期間自91年6月24日至91年8月28日，筆者於個案接受放射治療期間，藉由觀察、會談與電話訪談等方式，以羅氏理論的生理功能、自我概念、角色功能、相互依賴等四種概念架構作資料評估與分析，發現個案之主要護理問題為：(1)疼痛／因放射治療引起(2)口腔黏膜破損／因放射治療引起(3)皮膚完整性受損／因放射治療引起(4)憂鬱／對疾病診斷後及放射線治療產生情緒反應等四個問題，針對影響個案適應程度的行為與因素，並以處理主要、相關刺激與剩餘刺激執行護理措施，主要措施的重點是減輕疼痛、口腔黏膜破損無感染發炎及皮膚無破損的情形，並使個案主動談論擔心的感受。適應是促進個體完整性的過程，筆者協助個案對放射治療的了解，提供支持性的照顧，及對疾病適應，使其能順利完成治療，並進一步改善憂鬱程度，協助建立信心，重新拾起自信的生活。

關鍵字

鼻咽癌 ； 放射線治療 ； 羅氏適應模式

並列摘要

This article addressed the outpatient nursing experience in a 44-year-old male patient with nasopharynegeal carcinoma after radiotherapy. Data were collected during the period from 24-June, 2002 to 28-August, 2002 by observation and interview, either personal or by telephone. It was then evaluated and analyzed according to Roy's theory that includes physiological function, self-concept, role function, and independence. The major nursing problems we discovered were 1) the pain 2) damage of oral mucosa 3) damage of skin integrity 4) depression and emotional reaction to radiotherapy and the disease per se. The nursing policy here was to deal with the major, the associated, and the remaining stimulus aroused by the factors influencing his adaptation and the responsive behaviors. We emphasized on the relief of pain, prevention of infection on oral mucosa, and the care of damaged skin. Meanwhile, we help the patient to talk about his worrying about the disease. In addition to offering of supportive care, we help the patient to understand the radiotherapy and to adapt himself to the disease in order to facilitate the completion of radiotherapy. Accordingly, he could improve his depression, rebuild his faith, and live in a confident life.

並列關鍵字

nasopharyngeal carcinoma ； radiotherapy ； the roy's adaptation model