一位青少年初診斷睪丸癌之護理經驗

Nursing care experience of a teenager patient with initial diagnosis of testicular cancer

吳佩怡(Pei-Yi Wu) ； 潘錦樺(Jin-Hua Pan)

《高雄護理雜誌》 37卷3期 (2020/12) Pp. 82-95

https://doi.org/10.6692/KJN.202012_37(3).0008

摘要

本文探討一位初診斷睪丸癌青少年，因行睪丸切除術後身體外觀改變，及化學治療引起之噁心嘔吐、脫髮、長青春痘等副作用，導致青少年個案面對疾病適應衝擊，及治療過程產生的焦慮、緊張及害怕等負向情緒。對於初次罹癌之青少年個案，接受一連串的治療之身心靈照護，筆者以Gordon 11項健康功能評估工具，確立健康問題，面對個案化療所產生強烈的噁心嘔吐副作用，給予藥物及非藥物護理，幫助個案解決治療之不適，心理方面同理情緒，主動傾聽，鼓勵表達內心感受，提供各式治療資訊及衛教，照會團隊（心理師、社工師、癌症個管師）提供協助，並安排親友給予心理支持，協助病人勇敢面對治療，使其完成首次的化學治療療程，並接受自己身體外觀改變之事實，採正面積極態度面對生活及接下來的療程。

關鍵字

青少年 ； 睪丸癌 ； 身體心像紊亂 ； 焦慮 ； 噁心嘔吐

並列摘要

This article is about a teenager patient who was initially diagnosed with testicular cancer. He experienced changes in body appearance after testicular excision, and suffered from side effects caused by chemotherapy such as nausea and vomiting, alopecia, and acne. This led to maladaptation of the disease, and negative emotions such as anxiety, nervousness and fear caused between stages of the treatment process. During the care period in 2020 from August 14 to August 23, the author collected relevant information by observation, interviews, physical assessment, and medical chart review, and used Gordon's 11 health assessments to evaluate and explore the disease adaptation status of the patient. Medication and non-pharmacotherapy were both administered to relieve the discomfort of severe nausea and vomiting during a series of chemotherapy treatments for the cancer. Concerning the psychological aspects, communication skills such as empathy, listening, and encouraging the patient to express inner feelings were utilized. In providing a variety of treatment information and health education and consulting with medical teams to provide assistance and arrange relatives and friends to give psychologic support all assisted the patient to face treatment bravely. The author hopes that this nursing experience could provide a reference in caring for teenagers diagnosed with cancer to nursing colleagues.

並列關鍵字

teenager ； testicular cancer ； body image disturbance ； anxiety ； nausea ； vomiting

參考文獻

張嘉珣、韓玉蘭(2012)．照護一位膽管癌初次接受化學治療之護理經驗．安泰醫護雜誌，18(1)，59-70。

許維邦、林雅芬、林恆陽、楊文智(2003)．睪丸癌與睪丸自我檢查．基層醫學，18(10)，242-247。

黃鈴雅、李倩倩、沈青青(2011)．癌症病童接受化學治療引發噁心嘔吐之臨床處置與護理．源遠護理，5(1)，17-19。

楊婷馨、陳秀蓉、吳幸娟、黃玉苹(2011)．一名白血病青少女身體心像改變及因應之探討．長庚護理，22(4)，547-553。

葉麗娟(1999)．癌症青少年接受化學治療的症狀困擾．護理雜誌，46(4)，10-13。