運用繪畫協助一位初診斷白血病青少女適應身體心像改變過程

本文描述運用繪畫協助一位初診斷白血病青少女適應身體心像改變過程。護理期間為2021年2月2日至2月18日，護理過程中藉由觀察、身體評估、繪畫、會談及實際照護等方式收集主客觀資料，運用Gordon十一項健康功能型態評估工具，確立個案健康問題有身體心像紊亂、無效性保護能力、口腔黏膜改變。照護期間個案因化學藥物副作用導致掉髮，產生負向情緒反應，筆者運用繪畫的介入，建立良好的護病關係，引導個案表達內心的感受及需求，並安排一同參與治療計劃，幫助個案接受此階段外觀改變及學習照護技巧，以正向態度面對治療。建議針對青少年時期的健康照護，應要有跨領域合作的照護團隊介入，才能提供青少年更友善及全方位的保健服務。

關鍵字

急性骨髓性白血病；初診斷；青少年；繪畫

並列摘要

This article describes the use of art work to assist a teenage girl with newly diagnosed leukemia to cope with the changes of body image. Nursing care was provided from February 2 to February 18, 2021. During the nursing process, subjective and objective data were collected by means of observation, physical assessment, painting, interviews and actual care. The Gordon's 11 functional health patterns tool was used to identify the health problems of the patient, which included physical and body image disturbance, ineffective protection, and oral mucous membrane damage. During the nursing period, the patient suffered from treatment-related hair loss which resulted in negative emotions. The author used drawing and painting to establish a good therapeutic relationship and guide the patient to express her feelings and needs. The author also led the patient to participate in the planning of her treatment, helped the patient to accept the appearance change at this stage and learn selfcare practices with a positive attitude. It is suggested that multi-disciplinary collaboration should be included in order to provide more approachable and comprehensive health care services for the adolescent pateints.

並列關鍵字

acute myeloid leukemia ； newly diagnosis ； adolescent ； painting

參考文獻

姜亭妤、簡淑慧、徐鴻智、陳淑卿（2018）．心理調節措施在癌症患者身體心像改變及情緒困擾之成效－系統性文獻回顧．長庚護理，29（3），350-366。https://doi.org/10.6386/CGN.201809_29(3).0003

張綺紋、姜月桃、余幸宜（2017）．兒童治療性遊戲臨床運用之探討．源遠護理，11（1），44-51。https://doi.org/10.6530/YYN/2017.5.4

穆佩芬、尹亭雲、張家慧（2014）．兒童繪畫發展與臨床應用．榮總護理，31（4），414-425。https://doi.org/10.6142/VGHN.31.4.414

Estcourt, L. J., Birchall, J., Allard, S., Bassey, S. J., Hersey, P., Kerr, J. P., Mumford, A. D., Stan- worth, S. J., & Tinegate, H. (2016). Guidelines for the use of platelet transfusions. British Journal of Haematology, 176(3), 365-394. https://doi.org/10.1111/bjh.14423

Mones, J. V., & Soff, G. (2019). Management of thrombocytopenia in cancer patients. Cancer Treatment and Research, 179, 139-150. https://doi.org/10.1007/978-3-030-20315-3_9

主題瀏覽