一位急性骨髓性白血病學齡期兒童接受骨髓移植前之護理經驗

The Nursing Experience for an Elementary School Child with Acute Myeloid Leukemia before Bone Marrow Transplantation

李如芳(Ru-Fang Lee)

《腫瘤護理雜誌》 20卷1期 (2020/06) Pp. 77-86

https://doi.org/10.6880/TJON.202006_20(1).06

摘要

本文探討一位學齡期患有急性骨髓性白血病兒童接受骨髓移植治療前之護理經驗。筆者自2017年7月24日至2017年8月1日照護期間，藉由觀察、會談、連續性照護、病歷查閱及團隊討論等方式收集資料，並依Gordon十一項健康功能型態評估進行整體性評估，確立個案有口腔黏膜改變、營養改變少於身體所需、恐懼等健康問題。學齡期兒童面對住院期間接受化學治療所帶來的不適及住院壓力，另外案家更因面臨骨髓移植的未知而顯擔憂，故筆者於照護期間提供合宜學齡期兒童之護理措施，協助緩解其口腔黏膜改變之不適，更改善營養改變少於身體所需之問題；此外接受個案情緒表達，配合學齡期兒童身心發展的溝通技巧，減緩其恐懼，可採連續性照護，以增進個案對於醫護團隊的熟悉感，更經由跨團隊協同合作，幫助個案解決骨髓移植前發生的問題，減輕住院的不適情況，能順利的銜接進入骨髓移植的階段，發揮護理專業讓個案及案家獲得高品質生、心、靈性的滿足，達到全人的照護，展現護理獨特的存在與價值，藉此骨髓移植前個案的護理經驗與臨床護理人員分享，並作為日後臨床照顧之參考。

關鍵字

急性骨髓性白血病 ； 骨髓移植 ； 學齡期兒童

並列摘要

We report the nursing experience for an elementary school child diagnosed with acute myeloid leukemia receiving bone marrow transplantation. The nursing care period was between July 24th and August 1st of 2017. Data was collected during the nursing care through observation, interviews, continuous care, medical record review, and team discussions. The authors evaluated the patient's condition using Gordon 11-item Functional Health Patterns and confirmed that the patient had several health issues including mucositis, decreased nutrition intake, and fear. This young child experienced discomfort and pressure from the in-patient chemotherapy treatment. In addition, the patient was getting worried about the unknown aspect of the bone marrow transplant. The author provided age appropriate care for the child to help alleviate the discomfort from mucositis. She also improved the nutrition intake. This experience will hopefully provide a useful reference for clinical nursing personnel in their future care efforts for similar patients.

並列關鍵字

Acute myeloid leukemia ； Bone marrow transplantation ； Elementary school child

參考文獻

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