- 期刊
一位食道癌個案因吞嚥障礙併發吸入性肺炎之照護經驗
Nursing an Esophageal Cancer Patient with Dysphagia related Aspiration Pneumonia
摘要
本文闡述一位食道癌吞嚥功能障礙併發肺炎之個案，由於化療後噁心嘔吐與進食嗆咳最終肺部感染住院之護理過程。筆者以Gordon十一項健康功能評估，於護理期間2020年8月6日至8月15日，確立主要健康問題為「現存性感染」、「營養少於身體所需」及「無望感」。照護期間透過主動關懷建立護病關係，運用跨團隊合作進行吞嚥復健、呼吸照護、擬定個別性飲食計畫，藉由穴位按摩減緩噁心不適，增加營養攝取；傾聽同理個案內心訴求，提供疾病照護資訊，陪伴渡過疾病帶來的生、心衝擊，另透過生命回顧，給予正向肯定，提升自我價值，使生理症狀得到改善進而達到心靈的安適。建議照護上以全程、全隊、全家為出發點，建構多元視頻的衛教內容，透過整合性護理照護，促使癌症病人可以得到全人的照護品質。
並列摘要
This article describes the nursing care for a patient of esophageal cancer complicated by pneumonia caused by swallowing dysfunction related symptoms such as nausea, vomiting and eating and choking after chemotherapy. Based on Gordon's eleven health function assessment, the author identified the main health problems as "existing STD", "imbalanced nutrition less than body requirements" and "sense of hopelessness" during the nursing period from August 6 to August 15, 2020. During the nursing period, the nurse-patient rapport was built through proactive care; cross-discipline collaboration was used for swallowing rehabilitation, respiratory care, and individual diet plans; acupoint massage was introduced to relieve nausea and discomfort and to increase nutritional intake. The patient received insight of other patients from the support groups, self-care information, and companionship to face the difficult and shocking journey of combating the disease. The life review therapy was provided to bring positive affirmation, enhance self-worth, improve physical symptoms and achieve spiritual comfort. It is suggested that the holistic approach should be employed from the very start to involve the whole team and the whole family while incorporating the use of digital social media for health education.