照顧一位神經膠母細胞瘤復發個案之護理經驗

神經膠母細胞瘤病程惡化快速，其疾病平均存活期約15-18個月，本文個案面臨神經膠母細胞瘤復發，正值青壯年期的病人面臨疾病造成身體偏癱而擔憂未來，所產生生理與心理層面問題，引發照護動機。護理期間為2019年3月31日至2019年4月29日。護理過程筆者運用Gordon十一項功能性健康型態評估後，藉由身體評估、觀察及會談方式收集料分析，確認主要的護理問題為：疼痛、身體活動功能障礙及焦慮。護理期間使用音樂療法、放鬆技巧、舒適擺位、按摩與營造舒適睡眠環境以緩解疼痛，利用融入日常生活活動的肢體訓練計畫及肌肉放鬆方式等設計一天生活運動計畫表。運用回顧生命意義療法並結合個案之專業，幫助個案找出自我價值，透過親情支持系統的發揮及藉由宗教支持，讓個案能正向面對問題，克服疾病的焦慮。期望藉由以上護理措施，能提供同仁日後在照顧此類個案之護理參考，以更完善之護理照護品質。

關鍵字

神經膠母細胞瘤；疼痛；身體活動功能障礙；焦慮

並列摘要

According to statistics, glioblastoma has the fastest course of deterioration, the average survival rate of the disease is about 15-18 months. This article describes the care experience of a patient with glioblastoma recurrence. The cases in their prime years were faced with hemiplegia caused by the disease and worries about the future. The physiological and psychological problems caused by the disease cause nursing motivation. The first author taking care of the patient from March 31, to April 29, 2019. By means of physical assessment, interviews, observation techniques and Gordon 11 function health pattern to collect data. Consequently, three nursing problems were identified: pain, impaired physical mobility, and anxiety. During the nursing period, use music therapy, relaxation techniques, comfortable positioning, massage and creating a comfortable sleeping environment to relive pain during your treatment, and design a one-day exercise schedule using physical training programs and muscle relaxation methods that incorporate everyday activities. By reviewing the meaning of life therapy and combining with the specialty of the case, it helps the case to find out self-worth. Through the exertion of family support system and religious support, the case can face the problem positively and overcome the anxiety of the disease. With the development of multi-language version, it will be more convenient to establish a multi lingual database for clinical practice. Hope this experience can as a reference for those nurses who taking care the similar patients.

並列關鍵字

Glioblastoma ； pain ； impaired physical mobility ； anxiety

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