照顧一位初次診斷食道癌第三期個案之護理經驗

A Nursing Experience of a Patient with Stage III Esophageal Cancer

邱子瑄(Tzu-Hsuan Chiu) ； 葉惠玲(Hui-Ling Yeh) ； 黃君后(Chun-Hou Huang)

《志為護理-慈濟護理雜誌》 12卷6期 (2013/12) Pp. 118-128

摘要

本篇為照顧一位48歲因罹患食道癌第三期男性產生焦慮之護理經驗。於2010年12月10日至2011年1月24日護理期間，依生理、心理、社會及靈性進行護理評估，藉持續護理、身體評估、觀察、會談、病歷查閱等方式，確立主要健康問題：噁心、知識缺失、焦慮。於護理初期因個案無法接受灌食配方的奶味而感覺噁心，與個案共同討論後以花生、巧克力醬或粉加入配方奶，降低噁心感；並給予個別指導化學治療之知識，鼓勵個案表達內心感受及焦慮原因，進而了解個案不但要說服自己年輕即罹癌之事實，還要隱瞞雙親，造成身心衝擊及負擔，因此給予傾聽、陪伴、主動關懷，更協同案姐給予心靈撫慰，協助個案正向面對疾病及後續自我照顧。期望提供臨床護理此類似個案之參考。

關鍵字

食道癌 ； 化學治療 ； 焦慮

並列摘要

This article described the nursing experience of a patient with stage III esophageal cancer. From December 10th, 2010 to January 24th, 2011, the author performed thorough physiological, psychological, social, and spiritual assessments of the patient's conditions. Through continuous care, physical assessment, close observation, interviews, and reviewing the patient's medical records, the patient's health issues were identified as nausea, insufficient medical knowledge and emotional anxiety. In the early stages of care, the patient suffered from nausea due to the intolerance of the dairy odor from the feeding formula. After a thorough discussion with patient, peanut butter, chocolate sauce or powder were added into the formula to reduce such odor. In addition, the patient was taught individually about chemotherapy related knowledge and was encouraged to express his feelings and anxiety, and in the process, it was understood that while the patient was persuadig himself to accept his condition even at a young age, but also tried to keep this news from his parents, causing him a great physical and psychological burden. Throughout listening, we accompanied the patient and provided support, assisting the patient to face his illness positively and learn how to take care of himself. We would like to provide this nursing experience as a reference to nurses for caring similar cases.

並列關鍵字

anxiety ； chemotherapy ； esophageal cancer