照顧一位肺腺癌合併腹膜轉移病人因應無力感之護理經驗

Nursing Experience of Helping a Patient with Lung Adenocarcinoma and Peritoneal Seeding to Manage Feelings of Powerlessness

陳瑋筑(Wei-Chu Chen) ； 戴秀好(Shiu-Hao Tai)

《榮總護理》 39卷2期 (2022/06) Pp. 153-159

https://doi.org/10.6142/VGHN.202206_39(2).0004

摘要

本文探討一位38歲肺腺癌女性多次入院接受化療，因疾病未能有效控制，腹膜轉移後有營養不良、疼痛且對治療產生無力感及家庭面臨病人癌症復發後產生衝擊之照護經驗。2020年2月3日至3月3日運用Gordon十一項健康功能型態進行評估，確立主要健康問題有營養需求少於身體需要、無力感及照顧者角色緊張。透過治療性人際關係與病人及主要照顧者建立信任，瞭解其個別需求，提供非侵入性支持療法，如冥想、放鬆呼吸技巧，偕同營養師及腫瘤個管師運用跨團隊合作照護，引導訴說對復發治療成效不確定所產生的無力感，並鼓勵主要照顧者陪伴復發治療歷程，使病人重獲自信，願意再次面對疾病，幫助家庭獲得良好調適。期望藉此護理經驗能提供臨床人員照護類似病人之參考，進而提升照護品質。

關鍵字

肺腺癌 ； 腹膜轉移 ； 無力感 ； 營養不良 ； 照顧者角色緊張

並列摘要

This case study describes a nurse's experience caring for a 38-year-old woman with lung adenocarcinoma who regularly received chemotherapy; however, the treatment was not sufficient to manage the disease. Because of recurrence, she experienced malnutrition, pain, and feelings of powerlessness, which affect the functions of the family. On the basis of Gordon's 11 Functional Health Patterns, data were collected from February 3 to March 3, 2020. Malnutrition and feelings of powerless in the patient and strain on the caregiver were observed. The nurse established trust with the patient and her family and used collaborative care skills to help the family manage these feelings of powerlessness during the recurrence. This case study can serve as a reference for healthcare providers in similar situations.

並列關鍵字

lung adenocarcinoma ； peritoneal seeding ； powerlessness ； malnutrition ； caregiver strain

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