初診斷急性骨髓性白血病患者之照護經驗

本文探討一位初診斷急性骨髓性白血病患者，因陌生疾病的衝擊引發焦慮之照護經驗。照護期間自2017年11月18日至12月24日，以Gordon十一項功能性健康評估模式，透過身體評估、傾聽、溝通及陪伴，確立健康問題：保護能力改變／全血球低下、營養狀況改變／少於身體所需及焦慮。照護期間加強探視、耐心回覆反覆性問題及陪伴，與個案及家屬建立治療性關係，偕同家屬參與照護；運用跨團隊合作，改善生理不適症狀、引導表達內心擔憂；將衛教指導融入個案喜好的人事物，加深個案印象，使其能遵循照護措施，如：簡易口訣、穴位人形圖及正確洗手帶動唱等技巧；藉宗教信仰、重要支持者與病友的介入，使個案覺察自我情緒變化，正向面對治療、順利完成療程。期盼將此照護經驗提供臨床護理人員，協助患者在罹癌後，能同理其所面臨之壓力，引導患者正向面對疾病治療過程。

關鍵字

急性骨髓性白血病；初診斷；焦慮

並列摘要

This article shares the nursing management for acute myeloid leukemia (AML) in a patient with anxiety because of the unfamiliarity of the newly diagnosed disease. The care period was from Nov. 18th to Dec. 24th, 2017. The Gordon function health assessment was used to assess patient's conditions through physical assessment, listening, communication and companionship. Three major health problems were identified in this patient: ineffective immune protection, decreased nutrition intake, and anxiety. The author increased the frequent visits and responded to the recurring issues with patience and companionship; author also established therapeutic relationships with the patient and family to encouraged family members to participate in patient care. The author used cross-team collaborations to alleviate physical discomfort and to guide the patient to express concerns. According to the patient's individual needs and preference, the author integrated the nursing education into daily life to enhance the learning effects so that the patient can follow interventions and skills, such as: simple mnemonic phrase, charts of acupoints and hand hygiene song. Through religious beliefs and support group, the patient learned to be cognizant of changes in emotion, face the treatment with a positive attitude, and successfully complete the course of treatment. This experience of nursing management will provide staff guidelines to help patients under the pressure and suffering from cancer to better cope with the disease treatment process.

並列關鍵字

Acute myeloid leukemia ； Newly diagnosis ； Anxiety

參考文獻

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初診斷急性骨髓性白血病患者之照護經驗

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