化學治療病童噁心嘔吐之改善方案

The Project of Improving Chemotherapy-Related Nausea and Vomiting in Children

謝枝華(Chih-Hwa Hsieh) ； 柯識鴻(Shih-Huhg Ke) ； 龔怡萍(Yi-Ping Kung) ； 吳沾(Zhan Wu)

《腫瘤護理雜誌》 9卷1期 (2009/06) Pp. 23-35

https://doi.org/10.6880/TJON.200906_9(1).03

摘要

噁心嘔吐是化學治療最常出現的副作用。因此，在腫瘤護理中，改善化學治療產生的噁心嘔吐症狀是很重要的一環。近年來，已有學者研究並提出了許多預防化學治療病童噁心嘔吐的方法。本專案目的是為改善兒童血液腫瘤病房病童化學治療產生的噁心嘔吐症狀。專案計畫始於2006年7月1日並止於2007年4月30日，利用臨床觀察法及半結構式問卷方式，確認病童及家屬的問題如下：1.害怕化學治療產生的噁心嘔吐副作用；2.以前不愉快的嘔吐經驗；3.注意力集中在化學藥物的點滴瓶。因此，本專案的執行方法是配合止吐劑或鎮靜劑使用，技巧性遮蓋化學藥物並分散、轉移病童注意力，而改善噁心嘔吐症狀。經過2006年10月至2007年4月實施後，有效地改善噁心嘔吐症狀至39%；同時有16%病童達到嘔吐量減少且進食量增加成效。本專案藉著阻斷病童壓力源與分散、轉移注意力，增加舒適感及對化學治療的順從性，具體提升病童住院醫療品質，值得臨床廣泛推行與應用。

關鍵字

化學治療 ； 噁心 ； 嘔吐 ； 止吐劑

並列摘要

Nausea and vomiting are the most common side effects of chemotherapy. Thus, in cancer care, the improvement of nausea and vomiting produced in chemotherapy is a very important part. In recent years, scholars had studied and put forward a number of prevention approach for children with chemotherapy. The purpose of this project is to improve caring children of blood cancer chemotherapy with nausea and vomiting side effects in the children's wards. The project plan started from July 1, 2006 and ended at April 30, 2007. The use of clinical observation and semi-structured questionnaires, confirmed that sick children and their families the following issues: 1. Fear of nausea and vomiting as resulting from the chemotherapy side effects; 2. previous vomiting experience; 3. focus on the Chemotherapeutic Agents dripping bottle. Therefore, the method of implementation of this project was in line with the use of antiemetic agents, or sedatives, and skillfully scattered the dripping bottle and distracted children in order to improve the symptoms of nausea and vomiting. After the implementation started from October 2006 to April 2007, the effect of improvement in symptoms of nausea and vomiting had been down to 39%; while 16% of children with vomiting reduced, and food intake increased effectively. Through blocking the sick children's stressor, scattering and distracting, to increase comfort and compliance of chemotherapy, specifically to enhance the quality of child-patient medical care, this project is worth clinical wide implementation and applications.

並列關鍵字

chemotherapy ； nausea ； vomiting ； antiemetic agents