照顧一位肺腺癌併腦轉移病人之護理經驗

Nursing Experience of Caring for a Patient Suffering from Lung Adenocarcinoma and Brain Metastasis

黃憶如(I-Ju Huang) ； 陳亞玲(Ia-Ling Chen) ； 司淑英(Shu-Ying Szu)

《高雄護理雜誌》 33卷2期 (2016/08) Pp. 60-70

https://doi.org/10.6692/KJN-2016-33-2-6

摘要

本文描述一位肺腺癌併腦轉移病人入院行標靶治療及全腦放射線治療的護理經驗。筆者於2012年7月25日至8月24日護理期間，藉由身體評估、會談、溝通及運用Gordon十一項健康評估工具進行個案生理、心理、靈性、社會之整體性護理評估及確立問題。照護期間發現個案因對治療不了解，加上治療副作用帶來的身心痛苦，個案有焦慮、身體心像紊亂、噁心及嘔吐、舒適情況改變等健康問題。筆者透過詳細的治療前衛教，協助個案了解標靶治療及全腦放射線治療過程，減輕個案的焦慮感及釋放負向情緒。此外，筆者也提供治療副作用的照護，緩解其症狀困擾。希望藉此經驗分享，能提供護理同仁臨床實務之參考。

關鍵字

肺腺癌 ； 腫瘤護理 ； 標靶治療 ； 全腦放射線治療

並列摘要

This paper described the nursing experience of caring for a patient who was diagnosed with lung adenocarcinoma and brain metastasis. The nursing period was from July 25th to August 24th, 2012, and the nursing assessment was developed from the framework of the Gordon 11 Health Functional Patterns, to identify the problems based on the functional evaluations and to collect related data from the patient, including health assessment, interview, and communication. As the patient had limited knowledge of understanding the medical treatment and also had some side effects caused by the treatment, including emotional anxiety, body image disturbance, nausea, and vomiting as well as altered comfort, the author offered detailed nursing instructions before the patient's treatment, for not only to help her understand the processes of targeted therapy and whole brain radiation therapy but to reduce anxiety and release negative emotion as well. We hope this nursing care experience could provide nurses with a reference for facing similar situations in the future.

並列關鍵字

lung adenocarcinoma ； cancer care ； targeted therapy ； whole brain radiation therapy