照顧一位嗜鉻細胞瘤病患初次接受碘^(131)MIBG治療之護理經驗

Experiences of Caring for a Patient First Received ^(131)I-MIBG for Pheochromocytoma

陳姿云(Tzu-Yun Chen) ； 李麗紅(Li-Hung Lee)

《腫瘤護理雜誌》 19卷2期 (2019/12) Pp. 91-103

https://doi.org/10.6880/TJON.201912_19(2).07

摘要

本文描述一位嗜鉻細胞瘤病人經多次開刀後，初次接受碘^(131)MIBG治療的護理經驗。碘^(131)MIBG治療因具輻射性，治療期間個案需單獨留在隔離病房內，且放射線治療注意事項繁多，主責護理師在照護期間需遵循防輻射保護措施，提供適當的護理照護，並清楚衛教有關放射線治療的注意事項給個案及家屬，對於臨床護理人員而言是一大挑戰。筆者在照護期間（2016年10月19日至10月22日），透過直接照護、觀察及會談方式收集資料，運用Gordon十一項健康功能評估，確立護理問題有疼痛、焦慮及知識缺失。在照顧過程中，因疾病治療引起生理不適，經使用藥物及非藥物方式，減緩疼痛症狀；透過視訊及電話方式主動關懷個案，鼓勵家人陪伴支持，減少因隔離治療所造成的擔心害怕。在治療前後，衛教遵守隔離措施，主動瞭解個案的疑慮並澄清，提供醫療照顧相關資訊。使個案能夠安心地接受治療，出院後除了具備居家照顧知識外，能轉變心情以正向態度面對疾病進展。期望此次護理經驗，能提供臨床同仁照顧參考。

關鍵字

嗜鉻細胞瘤 ； 碘^(131)MIBG ； 放射線護理

並列摘要

The article describes the experience of caring for a female pheochromocytoma patient receiving her first ^(131)I-MIBG treatment after several surgical treatments. ^(131)I-MIBG is a radiation treatment where the patient remains in solitary quarantine in the isolation ward during treatment. There are many precaution protocols for radiotherapy; in order to provide appropriate care, the primary nurse should follow the radiation protection procedures during the care and educate the patient and her family. Implementation of such protocols may present challenges to the nurses. From October 19 to 22, 2016, both observation and interview techniques in accordance with Gordon's 11 Functional Health Patterns Assessment were applied by the first author to obtain data. Consequently, the patient's healthcare issues were identified as pain, anxiety, and inadequate knowledge. The interventions comprised of facilitating pain relief through pharmacotherapy and non-pharmacotherapy methods and reducing stress by encouraging family members to be involved and support the patient. In order to allay the patient's concerns with regard to the isolation policies, visual aids and phones were used for communication and support from the family. Prior to and after the treatment procedure, the isolation policies and related information were explained clearly by the nurse, who took the time to address the patient's concerns. After the treatment, the patient, already equipped with home care knowledge, was discharged with a more positive attitude toward her condition. This nursing care experience will serve as a reference to nurses facing similar situations.

並列關鍵字

Pheochromocytoma ； ^(131)I-MIBG ； radiation therapy nursing care

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