- 期刊
一位乳癌病人經化學治療與疼痛引起癌因性疲憊的護理經驗
Nursing Experience of a Breast Cancer Patient with Sudden Pain and Cancer-Related Fatigue during Chemotherapy Period
摘要
本文為一位乳癌病人經化學治療與疼痛引起癌因性疲憊的護理經驗，筆者於2020年5月18日至2020年6月15日參與照護。藉由觀察、會談等方式收集資料，以生理、社會與角色層面及心理靈性層面，進行整體性評估，發現病人有「疼痛」、「疲憊」及「增進復原力的準備度」等健康照護問題。筆者於照護過程中感受病人因身體持續感受到疲憊與疼痛，對未來不確定感及擔憂此為癌症惡化，加重病人心理壓力的負荷，因而引發筆者想要關注癌因性疲憊之照護，與病人討論以減少疲憊方法、增進對疲憊認知及跨團隊資源整合來協助緩解疲憊。另外，筆者嘗試以促進病人正向的思考、強化心理適應能力、締造生命的意義與價值及建立社會支持網絡等方式，來促發病人自身的恢復力。目前，台灣逐漸關注疲憊議題並發展癌因性疲憊之照護指引，但仍為臨床易忽略的症狀，建議單位應提供有關癌因性疲憊之評估重點與照護新知等教育內容，加強護理人員對此之關注，予病人提供更多自我照護的資訊，進而協助病人適應疾病過程，減少對疾病之不確定感引發的心理壓力。
並列摘要
This paper presents the nursing experience of a breast cancer patient with Cancer-Related Fatigue (CRF) caused by chemotherapy and pain. The author participated in the nursing care from May 18 to June 15 in 2020. Data were collected through observations and interviews, and the patient was evaluated from the physical, social, mental, and spiritual levels. The author identifies patients encounter health care issues such as "pain", "fatigue" and "readiness for resilience". During the health care process, the patient's psychological stress level increased due to the enduring fatigue and pain, uncertainty of the future, and worries about the exacerbation of cancer. The patient's increasing psychological stress motivated the researcher to focus care on CRF area, discusses fatigue relief methods with the patient, and enhances the patient's knowledge of fatigue. During the nursing process, the author senses that the patient continued to feel fatigue and body pain, uncertainty and anxiety about the future. The deterioration of cancer aggravated the patient's psychological pressure. In addition, the author attempts to promote the patient's resilience by promoting positive thinking, strengthening psychological adaptability, creating the meaning and value of life, and hence establishing a social support network. Currently, in Taiwan, although the problem of fatigue has attracted substantial attention and nursing care guidelines on CRF have consequently developed, it is still a symptom easily neglected in clinical practice. It is suggested that units should provide educational content such as the key points of assessment and new nursing knowledge on cancer-related fatigue, strengthen the attention of nursing staff on this issue, and provide patients with more self-care information; thereby assisting patients adapt to the disease process and reducing emotional stress level due to uncertainty of the disease.