- 期刊
一位復發何杰金氏淋巴瘤青少年接受造血幹細胞移植之護理經驗
Nursing Experience of an Adolescent with Relapsed Hodgkin's Lymphoma Receiving Hematopoietic Stem Cell Transplantation
摘要
本文個案為罹患何杰金氏淋巴瘤復發之青少年女性，需接受自體造血幹細胞移植，在治療前後歷經高劑量化學藥物副作用的身體不適、面對陌生的移植治療、對疾病的不確定及對事物失去控制，而出現負向情緒的情形，因此引發筆者想深入瞭解個案的身心等問題的動機。護理期間為2021年1月20日至2月4日。筆者以身體評估、病歷查閱、觀察及訪談等方式收集資料，依據Gordon十一項健康型態評估，確認健康問題有：潛在性感染、腹瀉、焦慮、無力感等健康問題。藉由文獻探討及評估，依據發展特性提供個別性護理措施，包括：鼓勵個案參與照護活動、解釋移植過程、介紹移植期間照護的成員及移植成功病友、主動關心並引導表達心理感受、計劃未來想完成的事，並且運用線上遊戲、偶像歌曲及繪畫，分散注意力減輕焦慮及負向情緒。建議未來可增加團隊間討論及溝通，使個案獲得身、心、靈性全面的照護。此照護經驗可提供護理人員未來照顧造血幹細胞移植個案之參考。
並列摘要
This study described the physical and mental aspects of a teenage girl with recurrent Hodgkin lymphoma who required autologous hematopoietic stem cell transplantation. The patient experienced negative emotions due to several reasons such as physical discomfort resulted from high-dosage chemical therapy received before and after her transplantation treatment, the experience of the alienation to her treatments, the feeling of out of control with surroundings, and the feeling of uncertainty in the disease. The author of this study provided nursing care to the patient between January 20 and February 4, 2021 and collected data through physical assessments, medical record reviews, observations, and interviews. According to Gordon's 11 functional health patterns, the patient's health problems were as follows: a likelihood of suffering from an infection, diarrhea, and feelings of anxiety and powerlessness. Individualized nursing measures were then developed in accordance with literature review, relevant assessments, and the patient's characteristics. The measures included encouraging the patient's participation in nursing activities, explaining the transplantation process to her, introducing her to the nursing team and patients who had received successful transplantation, offering proactive caring gesture to her, guiding her to express feelings and seting goals for the future, and alleviating her feeling of anxiety and negative emotions through distractions from online games, pop music, and drawing activities. This study recommends that more team discussions and communications be conducted to ensure that patients receive comprehensive physical, mental, and spiritual care. This nursing experience can provide a basis for nurses to care for patients who receive hematopoietic stem cell transplantation.