協助一位初診斷肝癌病人首次接受經導管肝動脈化學栓塞術之護理經驗

The Experience Nursing of Assist in the Early Diagnosis of Hepatic Carcinoma Patient Who Received First Transcatheter Arterial Chemoembolization

吳柳秀(Wu-Liu Hsiu) ； 宋聖芬(Sheng-Fen Sung) ； 洪玉玲(Yu-Ling Hung)

《腫瘤護理雜誌》 18卷1期 (2018/06) Pp. 107-118

https://doi.org/10.3966/168395442018061801009

摘要

本文探討協助一位初診斷肝癌患者首次接受經導管肝動脈化學栓塞術治療，個案與案妻因缺乏肝癌知識及不瞭解治療過程，導致個案焦慮及照顧者角色緊張之護理經驗。護理期間從2014年11月18日至2014年11月25日，筆者經由觀察、直接照護，經整體評估後，發現個案的健康問題有：知識缺失、焦慮、急性疼痛及照顧者的角色緊張。經與個案及照顧者共同擬訂具個別性及整體性之護理計畫，運用關懷、同理心等技巧與個案建立互信關係，扮演傾聽、支持及諮詢者的角色，引導個案訴說擔心害怕的事，協助渡過首次罹癌及接受經導管肝動脈化學栓塞術過程的不安情緒；應用肝癌照護手冊，指導個案及家屬經導管肝動脈化學栓塞術治療前後照護之知識，以增進對經導管肝動脈化學栓塞術相關合併症之瞭解；透過深呼吸、音樂療法，協助減輕個案疼痛；評估到照顧者負荷問題後，提供照護技巧回覆示教，以降低照顧者角色緊張。筆者在護理過程中，除提供照顧知識及技能外，並給予個案及照顧者心理支持，扮演各部門間溝通橋樑，適時轉介結合相關病友協會，促使個案及主要照顧者能獲得完善及持續性照護。

關鍵字

初診斷肝癌 ； 經導管肝動脈化學栓塞術 ； 知識缺失

並列摘要

The aim for this article is to explore the nursing patient care related to the initial diagnosis of hepatic carcinoma and first time transarterial chemoembolization (TACE) therapy. The patient's anxiety and his wife's apprehension as caregiver was a result from lack of knowledge in hepatic carcinoma and the treatment process. During the period from November 18 to November 25 in 2014, the author identified the patient's problems to be: lack of knowledge, acute pain, anxiety, and caregiver role strain. Author, by using the Gordon's Eleven Functional Health Patterns Nursing Assessment, showed the patient and wife the benefits and importance of spiritual wellbeing, continuous companionship, trust between patient and his wife. In order to lower the anxiety level, author also provided essential information to assist the patient and his wife to understand hepatic carcinoma, and also to understanding the hepatic artery chemical embolization process, anxiety stages, being present and showing empathy throughout the treatment.

並列關鍵字

The First Diagnosis of Hepatocellular Carcinoma ； Transarterial Chemoembolization (TACE) ； knowledge missing

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