- 期刊
造血幹細胞移植後急性移植物對抗宿主疾病之照護挑戰
The Challenges in Caring for Patients with Acute Graft-versus-Host Disease after Hematopoietic Stem Cell Transplantation
摘要
本文透過急性移植物對抗宿主疾病臨床案例與個案報告，深入探討病人生理、心理調適、舒適照護、家庭和醫病關係改變等複雜健康問題。回顧文獻及臨床照護經驗發現，當急性移植物對抗宿主疾病惡化時，病人及家屬可能因面臨長期治療的不確定性和病情變化，使他們的信心耗損產生無望感，讓醫療人員和家屬同時陷入病人照護的困境與挑戰。為克服此照顧困境，我們建議護理師提供以病人為中心的全人關懷照顧，強化急性移植物對抗宿主疾病評估與臨床照護技能，整合病人身心照護需求，並提供病人及家屬心理支持，透過跨團隊合作，成為醫病之間的溝通橋樑，以雙向透明溝通方式幫助病人調適病情的變化，進而提升病人生活品質，同時陪伴病人在困境中保持對生命的希望。
並列摘要
This in-depth exploration of the intricate challenges inherent in caring for patients experiencing acute graft-versus-host disease post-hematopoietic stem cell transplantation sheds light on the multifaceted nature of their health problem. By delving into clinical cases and patient reports, the narrative unfolds overlapping and complicated health issues that patients may grapple with simultaneously. These challenges encompass not only the physical aspects of the disease but also delve into the psychological impact on the patient and their family, the ongoing process of adjusting to the disease, and considerations related to overall comfort and well-being. The uncertainties surrounding long-term treatment outcomes and the unpredictable changes in the patient's condition compound the erosion of confidence, fostering a pervasive sense of hopelessness in both patients and their families. This predicament intricately entangles patients and family members, creating a complex landscape in patient care. In response to these challenges, the recommended approach underscores the pivotal role of nurses in adopting patient-centered holistic healthcare strategies. It involves elevating their proficiency in acute GvHD assessment and clinical practice, ensuring a comprehensive understanding of the intricate interplay between patients' and their families' physical and mental health needs. Beyond this, nurses are encouraged to provide crucial psychological support to patients and their families, serving as accompaniments in uncertainty and hopelessness. Moreover, it suggested that the nurses be the proposal advocates for facilitating interdisciplinary collaboration, positioning nurses as essential bridges connecting doctors, patients and families, as well as healthcare provider teams. This collaborative effort seeks to address the immediate clinical needs of patients and provide comprehensive support in navigating the unpredictable nature of their condition. Through transparent two-way communication, nurses play a crucial role in helping patients adapt to the fluctuations in their health, ultimately contributing to an enhanced quality of life and offering indispensable companionship that sustains a hopeful outlook amid challenging circumstances.