一位食道癌病人在門診接受同步化學藥物合併放射線治療之護理經驗

本文敘述一位57歲男性初診斷食道癌在門診接受同步化學合併放射線治療之護理經驗。護理期間自2013年9月18日至2013年12月26日，藉由互動、觀察與會談等方式進行生理、心理、社會及靈性等層面之整體性健康評估，分析並歸納出個案有疼痛／口腔黏膜改變、營養少於身體所需／攝取不足及個人因應能力失調／家庭、經濟支持不足等健康問題。筆者為個案之腫瘤個案管理護理師，照顧期間運用關懷照護的技巧，在疾病診斷治療期間主動關懷病人，建立良好的治療性關係，且提供疾病各項檢查與疾病治療計畫的相關訊息，針對其健康問題擬定個別性之護理計畫，教導自我評估口腔、執行口腔清潔及減輕口腔疼痛照護的技巧，針對營養問題加強攝取正確飲食方法與認知；個案因家庭支持不足而造成的因應問題，則協助聯繫相關人員、調整治療時間以及給予相關的支持，使個案能及時重返治療，避免錯過最佳治療時機且順利完成治療，期望能提供日後照護之參考。

關鍵字

食道癌；同步化學合併放射線治療；家庭支持

並列摘要

This article describes the nursing experience in taking care of a 57-year-old man with esophageal cancer who received concurrent chemoradiotherapy at the clinic. An overall health status including physiological, psychological, social, and spiritual data was assessed by nursepatient interactions, observations, and interviews from September 18, 2013 to December 26, 2013. The health problems including pain related to the change of oral mucous membrane, imbalanced nutrition related to poor intake, ineffective coping related to the insufficient support from family and financial condition. The author was the oncology case manager for the patient. Caring skills were assessed during the period. The author showed sympathy for the patient to establish a favorable relationship and provided helpful information on various examinations and treatment plans. During the treatment period, a personalized caring plan was established according to the patient’s health issues. The patient was taught to perform to self-assessment, self-clearing to his own oral cavity, and self-care measures lessen oral pain. In terms of nutrition, it was reinforced to have correct diet. When the patient had coping problem from insufficient family support, the author helped contact key personnel, adjust the treatment schedule, and provide emotional support, in order to help the patient maintain timely treatment. Hopefully, this experience can be helpful for other nurses who care for similar cases in the future.

並列關鍵字

family support ； Concurrent chemoradiotherapy ； Esophageal Cancer

參考文獻

黃玫琦、張文、韓晶彥、王守玉（2013）．食道癌病人常見的健康問題及護理．護理雜誌，60（1），99-104。[Huang, M. C., Chang, W., Han, C. Y., & Wang, S. Y. (2013). Esophageal cancer: Common health problems and health management. The Journal of Nursing, 60(1), 99-104.] doi: 10.6224/JN.60.1.99

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一位食道癌病人在門診接受同步化學藥物合併放射線治療之護理經驗

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