- 期刊
運用Mishel不確定感理論於一位初次罹患乳癌婦女之護理經驗
A Nursing Experience of Applying Mishel's Theory of Uncertainty in Illness to a Woman with Newly Diagnosed Breast Cancer
摘要
本文旨在描述運用Mishel不確定感理論，探討一位中年女性初次診斷罹患乳癌，即將面臨一連串癌症治療的護理照護經驗。照護期間為2016年5月23日至5月27日。個案在確診罹患乳癌時，對於即將面臨化學治療可能造成的身體心像改變及後續疾病可能的進展，產生許多不確定的感受，間接影響了自我照顧的學習意願。筆者運用Mishel不確定感理論架構進行護理評估，以直接照護及會談、門診追蹤、電訪等方式完成資料蒐集，確立個案面對疾病治療有強烈的不確定感，並發現個案不確定感的導因包括焦慮、知識缺失、及身體心像紊亂，經文獻查證後擬定相關照護措施：加強疾病治療相關知識及健康照護資訊、建立良好的病人和醫療團隊溝通管道、促進病友間正向治療經驗分享以及建立家庭及社會支持系統等，藉以提升個案自我照護的能力與疾病治療的信心，成功降低個案面對疾病治療不確定之感受，促進個案正向思考並展開積極面對疾病治療的歷程。
並列摘要
This article described the application of Mishel's theory of uncertainty in illness to a middle-aged woman with newly diagnosed breast cancer, particularly from a nursing care prospective in the circumstance of the patient on the verge of facing a series of cancer treatments. The nursing care was from May 23 to May 27, 2016. After diagnosis of breast cancer confirmed, the patient developed high levels of uncertainty towards not only the physical impacts of chemotherapy, but also possible disease progression and further prognosis. As a result, the uncertainty indirectly influenced her motivation to learn for self-care. Nursing assessment was made based on Mishel's theory of uncertainty in illness. The author found that the patient had strong uncertainty towards disease and treatment, and the causes of uncertainty were identified including anxiety, knowledge deficit, and body image changes. We provided several principles of evidence-based nursing care: Enhancing the patient's understanding of disease or treatment and emphasizing health-care awareness; Establishing good communication between the patient and multidisciplinary teams; Facilitating sharing and positive feedback of disease treatment experience among different patients, and building up family and social support system. These interventions improved patient's self-care ability and self-confidence in disease treatment, reduced patient's perceived uncertainty towards disease treatment, and encouraged patient's positive thinking and actively facing the disease prognosis.
參考文獻
延伸閱讀
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