協助一位年輕白血病患者及其家屬接受首次化學治療之照護經驗

Nursing Experience in Helping a Young Adult with Newly Diagnosed Acute Lymphoblastic Leukemia and Her Family Cope With First-Time Chemotherapyc

李姵萱(Pei-Hsuan Lee) ； 孫秀卿(Shiow-Ching Shun)

《腫瘤護理雜誌》 8卷2期 (2008/12) Pp. 71-83

https://doi.org/10.6880/TJON.200812_8(2).07

摘要

本文敘述筆者協助一位23歲首次診斷急性淋巴性白血病女性患者及其家屬適應首次化學治療的照護經驗。護理期間（2007年11月21日至2007年12月21日）以Gordon十一項功能評估為基礎，經由觀察、查閱病歷、會談及線上即時通訊等方式收集各項資料。發現個案有高危險性感染、舒適情況改變、焦慮及主要照顧者緊張之護理問題。筆者於照護期間以關懷及同理心的態度與個案及家屬建立良好的護病關係，給予個案及家屬在生理、心理、社會方面的需求協助及支持，並且針對個案的需要適時提供衛教，以減輕個案及家屬的焦慮感，成功協助個案及家屬因應首次接受化學治療所面臨的症狀困擾，並能以正面的態度面對疾病及後續治療。期望此照護經驗可提供護理人員更加了解首次接受化學治療病患及其主要照護者之需求及照護重點。

關鍵字

急性淋巴性白血病 ； 化學治療 ； 調適過程

並列摘要

This case report describes nursing experiences about helping a 23-year-old young adult with newly diagnosed acute lymphoblastic leukemia and her family cope with the first-time chemotherapy. Gordon's eleven functional health assessments were used as a guideline to collect data through observation, chart review, interview, and MSN on-line communication during the nursing period between November 21 and December 21 in 2007. The problems identified during the nursing process included risk for infection, altered comfort, anxiety, and caregiver role strain. The authors established a good relationship with the patient and her family through caring and empathy, offered interventions to meet the physical, psychological, and societal needs of the patient and her family, and provided them with health education on chemotherapy to reduce their anxiety. During the nursing process, the authors successfully helped the patient and their family cope with symptom disturbances caused by the first-time chemotherapy, and positively face the disease during the following chemotherapy sessions. This paper describes important information to help nurses understand more about the needs of patients and their families who receive chemotherapy at the first time.

並列關鍵字

acute lymphoblastic leukemia ； chemotherapy ； coping process