一位初次確診肺癌壓迫胸椎病人之護理經驗

本文探討一位初次確診肺癌壓迫胸椎之病人，照護期間突如其來的被告知罹癌，歷經生理不適及失能，致使心理衝擊之護理過程。照護期間自2019年3月27日至4月26日，經由觀察、直接照護、會談及身體評估等方式進行收集資料，依據Gordon十一項功能性健康型態評估，確認個案的健康問題為：疼痛、身體活動功能障礙、焦慮。個案確診罹癌的同時，彈指間腫瘤增大壓迫胸椎，出現疼痛及身體活動功能障礙，除予止痛藥物外，鑒於提供個別性之照護，讓個案盡早接受罹癌和不良於行之事實。每日利用護理空檔，教導個案播放喜愛的音樂分散注意力，配合精油按摩肢體或熱敷，緩解肌肉緊張，達到身體舒暢，由復健師執行下肢關節被動運動，預防關節僵硬、攣縮。個案瞬間遭逢罹癌及失能之雙重打擊，透由整合醫療照護，接納肺癌為慢性疾病，重溫原有的生活。期望藉此提供臨床護理人員面對罹癌之個案，能用轉念化為力量，用態度轉為行動，適時予陪伴支持，減輕負向壓力感受，提升積極治療意願，以擁有安定且平靜的生活。

關鍵字

肺癌；疼痛；身體活動功能障礙

並列摘要

This article discusses a patient who was diagnosed with lung cancer and thoracic vertebrae for the first time. During the period of care, he was unexpectedly informed about getting cancer, experienced physical discomfort and disability, and caused psychological shock. During the period of care, from March 27 to April 26 in 2019, data were collected through observation, direct care, communication, and physical assessment. According to 'Gordon's Eleven Functional Health Assessments', the health problems of the cases include: Pain, physical activity dysfunction, and anxiety. At the same time when the patient was diagnosed with cancer, tumors increased instantly to pressure the thoracic spine, caused pain and physical activity dysfunction. In addition to subscribe painkillers, for the purpose of providing individual care, allow the case to accept cancer and physical activity dysfunction as a matter of fact. Daily routine in between nursing slots, teach the patients to play their favorite music as a distraction, apply essential oils to massage limbs or apply heat to relieve muscle tension and achieve physical comfort, rehabilitation practitioners perform passive exercise of lower limb joints to prevent joint stiffness and contracture. The case experienced instant impact of both cancer and disability, and through integrated medical care, he accepted lung cancer as a chronic disease and restored his original lifestyle. It is hoped that this case will provide clinical nursing staff ideas when facing cancer cases, will be able to turn their belief into strength, apply attitudes into actions, provide companionship support in a timely manner, lessen negative pressure feelings, increase active treatment willingness, and enjoy a stable and peaceful life.

並列關鍵字

lung cancer ； pain ； physical activity dysfunction

參考文獻

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一位初次確診肺癌壓迫胸椎病人之護理經驗

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