一位結腸癌病人術後接受化學治療之照護經驗

本文探討照護一位27 歲第三期結腸癌年輕女性，面對術後首次行化學治療之護理經驗，護理期間為2015 年12 月1 日至2016 年1 月9 日，藉由觀察、身體評估及治療性會談等方式蒐集資料，運用Gordon 十一項功能性健康型態評估，依生理、心理及社會層面分析，確立個案有焦慮、疼痛、潛在危險性感染等護理問題，護理期間運用關懷陪伴建立良好治療性關係，醫療團隊使其瞭解診療計畫及提供化學治療相關知識及注意事項，增加對疾病的控制感，透過病友經驗分享，降低其焦慮並增強正向信念；定時與止痛藥物及提供舒適擺位、穴位指壓及芳香療法，有效控制術後疼痛不適；教導術後傷口照護預防感染之防護措施。建議醫護同仁需加強結腸癌術後個案傷口照護及化療後居家照護技能，使其身、心皆獲得適切性照護及降低感染風險，期望經此照護經驗分享，以供臨床實務參考之用。

關鍵字

結腸癌；化學治療；焦慮

並列摘要

This paper described the nursing experience for caring a 27year-old female patient with stage three colon cancer while facing the first chemotherapy. The period of care was between the 1st of December in 2015and the 9th of January in 2016. By observation, physical assessment, therapeutic counseling, and other methods, the data were collected. The Gordon 11 item functional health patterns were used for assessment. According physiological, psychological, and social aspects, the patient was identified having experienced anxiety, pain, potential dangerous infections, and other nursing problems. During the period of care, concerns and accompaniment established a favorable therapeutic relationship. The caring team communicated the treatment plan to the patient and provided relevant information to increase her sense of control of the disease. Other patients' sharing of experiences lowered her anxiety and increased her positive thoughts, while regular administration of pain relief and provision of a comfortable posture with pressure point massaging and aromatherapy effectively controlled the discomfort from post-surgical pain. Education on post-op wound care and infection prevention was also provided to the patient. We hope that this sharing of experiences can provide a reference for future practices.