接受放射線治療病人皮膚臨床照護指引

Clinical Guidelines of Radiation Skin Reactions

李雅惠(Ya-Hui Lee) ； 梁穎(Ying Liang) ； 楊易宏(Yi-Hung Yang) ； 簡于芬(Yu-Fen Chien) ； 翁新惠(Shin-Huey Wung)

《榮總護理》 29卷4期 (2012/12) Pp. 395-404

https://doi.org/10.6142/VGHN.29.4.395

摘要

放射治療引起之急性皮膚反應是癌症病人常見的症狀困擾，目前國內各醫院雖有護理指導常規，但尚無具實證基礎的臨床照護指引。本研究之目的乃藉由實證模式，建立癌症病人接受放射線治療皮膚照護指引。研究第一階段進行系統性文獻查證，於9個資料庫、6個網站，搜尋2000~2010年的文章，經評析後共納入5篇系統性回顧及3篇指引類型文獻，建立臨床照護指引草案。第二階段進行2次焦點團體座談，邀請20位具放射線治療照護經驗專家，藉由其專業觀點，修正及討論指引草案。第三階段以問卷調查213位臨床醫護人員及20位專家臨床照護指引之可行性。最後確認31項指引，包含：評估4項、預防皮膚反應照護策略18項、及處置性照護策略9項。研究結果建議，藉由臨床照護指引增強護理人員實證照護概念及臨床應用能力，能於實務中運用多種預防及處置策略，提供病人更有效益之照護品質。

關鍵字

放射線治療皮膚反應 ； 皮膚照護 ； 臨床照護指引

並列摘要

The study aimed at establishing evidence-based clinical practice guidelines to prevent and manage radiation-induced skin reactions among adult cancer patients. Method: This study was completed through three stages: (1)A systematic review of the literature was conducted on studies published between 2000 and 2010; (2)Twenty Taiwan regional cancer care experts were invited to attend the focus group meeting to verify the protocol; and (3)A questionnaire was used for the feasible investigation of 213 clinical medical care personnel in Taiwan. Result: Based on the results of the feasible questionnaire, we deleted the items with agreement lower than 70% and finally obtained 31 items. These items were divided into three dimensions: (1)Assessment 4 items; (2)Prophylactic management of acute skin reaction 18 items; (3)Management of acute skin reaction 9 items. Conclusion: The establishment of the guidelines may strengthen the concept and clinical practice ability of the nursing staff, provide quality care for cancer patients and reduce the discomfort of radiation-induced skin reactions.

並列關鍵字

radiation dermatitis ； skin reaction ； skin care ； clinical guidelines