照顧一位急性淋巴性白血病少年之護理經驗

Experiences of Caring for an Adolescent with Acute Lymphocytic Leukemia

邱俐慈(Li-Tzu Chiu) ； 王珮珩(Pei-Hern Wang)

《榮總護理》 37卷1期 (2020/03) Pp. 74-82

https://doi.org/10.6142/VGHN.202003_37(1).0008

摘要

本文探討一位17歲罹患急性淋巴性白血病少年，定期入院接受化學治療卻突發急性混亂症狀，以及無法調適生病壓力致因應能力失調之照護經驗。照護期間為2018年10月16至10月23日，筆者透過觀察、會談及身體評估等方式收集資料，經由Gordon 11項功能性健康型態進行評估，確立問題為急性混亂、潛在危險性感染及無效性因應能力之健康問題。護理過程中，予降低噪音、環境刺激及營造安全感的環境，讓病人不受傷且情緒恢復平穩，可正確說出人、時、地定向感；提供預防感染及保護性隔離措施，降低感染風險；教導寫日誌、繪畫及深呼吸、放鬆等方式，協助轉換心情及妥善因應壓力，同時，讓病人參與治療計畫，提供做決定機會，以提高自信、增進自我認同及自我價值感受，達到身心健康之狀態。建議未來各家醫院能於護理指導單張介紹兒童急性混亂發生原因與照顧方式，以減少家屬不安，同時提升護理照護品質。

關鍵字

急性淋巴性白血病 ； 少年 ； 急性混亂 ； 無效性因應能力

並列摘要

In this study, the experiences of caring for a 17-year-old adolescent with acute lymphocytic leukemia were studied. The adolescent experienced acute confusion and could not effectively cope with the situation because of the inability to adjust to the stress from illness. The caring period was from October 16 to October 23, 2018. Methods such as observation, interviews, and physical assessments were used to collect data. Gordon's 11 Functional Health Pattern Assessment indicated that the health problems were acute confusion, potentially dangerous infection, and ineffective coping skills. During the nursing period, protective isolation was used to reduce the infection risks of the patient, decrease noise and environmental stimulation, and create an environment with a sense of safety to enable the patient to regain emotional strength and sense of orientation. The patient was instructed to use methods, such as maintaining a diary, painting, and taking deep breaths, to help the patient convert emotions and properly cope with stress. The patient was allowed to participate in their own treatment plans and make decisions in order to enhance self-confidence, self-identity, and self-worth and achieve physical and mental health. In the future, each hospital should care for children with acute confusion and devise methods to reduce the anxiety of their family members. In addition, the acute confusion of children can be included in the nursing diagnosis manual for clinical nurses along with the causes and methods of alleviating acute confusion and reducing family anxiety to improve nursing care quality.

並列關鍵字

acute lymphocytic leukemia ； adolescent ； acute confusion ； ineffective coping skills

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