- 期刊
照顧一位縱膈腔腫瘤合併骨轉移疼痛患者之護理經驗
Caring for a Patient with a Mediastinal Tumor and Bone Metastases
摘要
本文是描述一位44歲原住民偏遠地區中年男性，罹患縱膈腔腫瘤合併骨轉移接受同步化學放射線治療（concurrent chemoradiotherapy，CCRT）之護理經驗。筆者於護理期間藉由觀察及會談方式，收集個案的相關資料，運用Gordon十一項功能性護理評估模式，分析出個案所產生的健康問題有：1.疼痛：骨轉移壓迫神經2.口腔黏膜受損：作CCRT治療3.營養狀況改變：少於身體需要4.焦慮：對疾病發展及預後感到不確定感。由於偏遠地區原住民弱勢族群的醫療缺乏，因此其健康照護行為認知有所缺失，容易影響原住民個案本身面對疾病進展的健康照護行為，筆者在護理期間除了協助使用藥物疼痛控制、協助個案減少口腔黏膜受損、給予營養攝取等獨特性照護，進而改善個案日後對疾病進展中所帶來的不適外；此外，個案常會出現焦慮的情緒困擾症狀，護理期間藉由個案基督教信仰寄託給予精神支持以及教導減輕焦慮等方法，證明能幫助個案減少CCRT過程中所帶來的不適感，期望分享對此個案的照護過程，以幫助病患能獲得最佳的生活品質。
並列摘要
A 44-year-old aboriginal man had a mediastinal tumor with bone mestastases and was undergoing concurrent chemoradiotherapy. The patient's condition was assessed by observations and interviews, based on Gordon's 11-function appraisal. Four patient care issues were identified: pain resulting from nerve compression by bony mestastases, oral mucous membrane injury, insufficient nutrition to meet body requirements, and anxiety due to uncertainty about the outcome of treatment. Addressing these issues was made more difficult by the fact that the patient lived in a remote aboriginal area, which limited our understanding of medical resources available to him at home. Nursing care offered included pain management, oral care, nutritional support, and spending time with the patient to offer emotional support and nursing instruction. The care provided throughout this man's uncomfortable treatment demonstrates how nursing care can improve quality of life for such patients.