- 期刊
照顧一位肝癌患者接受動脈化學栓塞術後不良反應之護理經驗
The Experience of Nursing Care for a Hepatic Carcinoma Patient who Received Transcatheter Arterial Chemoembolization (TACE) With Adverse Reaction
摘要
本文探討照護一位肝癌患者第一次接受動脈化學栓塞術後，因引發菌血症導致高燒不退，治療過程不如個案預期，導致個案對治療進展感到失落，造成無望感的護理經驗。護理期間從2010年1月15日至2010年2月21日，筆者經由直接照顧、觀察、會談及與家屬之互動，經整體性評估後，發現個案在生理層面有體溫過高與疼痛；心理層面有焦慮/對治療過程不熟悉及癒後的不確定感、無望感/欠缺治療信心及感受死亡的威脅等四項健康問題。筆者藉由羅氏適應模式為架構進行護理評估，採持續性及主動關懷的態度密集陪伴，與個案建立良好的信任關係，不但協助個案維持生理功能、運用資源緩解疾病引起的不適感，並以同理心陪伴個案面對疾病，緩解焦慮之過程，與個案及家屬一同渡過焦慮的階段，並運用建立希望的技巧及家人的支持，使個案重新肯定自己存在的價值與意義。希冀藉由分享此個案護理經驗，作為往後類似個案照護之參考。
並列摘要
The aim for this article was to explore nursing experiences related to the care for a patient with hepatic carcinoma who had high degree fever caused by procedure-related bacterimia after the first transcatheter arterial chemoembolization (TACE). The patient felt loss and hopeless when the treatment effectiveness was not as expected. During the period from January 15 to February 21 in 2010, the author identified the patient's problems as: hyperthermia, pain, anxiety caused by a lack of knowledge on the treatment and unexpected outcomes, hopelessness/ anticipating the threat of death through direct patient care, observation, and the interactions with the patient and family. The author performed nursing assessment based on the Roy adaptation model, and built good trust relationship with the patient through continuous and active caring, and closely accompaning. During the hospitalization, we did not only take care for the patient's physiological function, but also reduced his discomfort. In addition, we helped the patient and his family experience the terrible stage. We would like to share this case report with nursing staffs taking care of the patients with hepatic carcinoma to improve health care quality in the oncology units.