照顧一位初診斷肺癌病人之護理經驗

本文探討一位初診斷肺癌的病人，因咳嗽兩個月就醫後診斷肺癌。互動過程中，病人言語透露對疾病進展、治療方式及成效的不確定感，以及疾病導致的嚴重咳嗽、疼痛生理不適，產生焦慮及失眠等生、心理等行為反應。筆者於2022年3月31日至4月29日，以Gordon十一項功能性健康型態評估方式，運用查閱病歷、身體評估及實際照護等技巧，收集生理、心理及社會等相關資料。確立健康問題：疼痛、睡眠型態紊亂及焦慮。透過與病人建立良好的治療性關係，以薰衣草精油配合穴位按摩，緩解病人疼痛，同時也改善病人的睡眠障礙。病人對疾病及治療方向的陌生，醫護團隊主動提供相關資訊與關懷，增加病人對疾病的認識及降低對治療不確定性，引導病人說出初次面對疾病的感受，教導病人及家屬緩解焦慮的方法，如：聆聽輕音樂及鼓勵家人傾聽及陪伴，減輕壓力與焦慮。透過照護措施，建議護理人員及家屬能持續運用，讓病人對未來疾病的治療抱持積極的態度，同時也可提升護理照護品質。

關鍵字

肺癌；疼痛；焦慮

並列摘要

This article discusses a patient who was initially diagnosed with lung cancer after two months of coughing. During the history taking and physical exams, the patient verbally revealed his sense of uncertainty about the progression of the disease, treatment methods and effectiveness, as well as the severe coughs, pain, and physical discomfort, resulting in physical and psychological behavioral reactions such as anxiety and insomnia. The data were collected through direct nursing, physical assessments, medical record review, and the use of Gordon's functional health assessment guidelines between March 31 to April 29, 2022. The analysis identified the health problems as pain, sleep disorders, and anxiety. By establishing the patient nurse rapport and using the lavender essential oil combined with acupressure massage, we relieved the patient's pain and improved the patient's sleep quality. Patients are often unfamiliar with the disease and treatment directions. Therefore, the medical team should proactively provide relevant information and patient education to increase the patient's understanding of the disease and reduce doubts about the treatment, and to guide the patient to express how he or she feels when facing the disease for the first time and teach patients and their families ways to relieve anxiety, such as listening to light music. Encouraging family members to listen to and be present for the patient is also essential for stress and anxiety management. Through care measures, it is recommended that caregivers and family members should continue to use the above-mentioned techniques so that the patients can have a positive attitude towards future treatment of diseases, and at the same time, the quality of care can also be improved.