照顧一位年輕媽媽罹患乳癌合併高血壓之護理經驗

Nursing Experience of A Young Mother with Breast Cancer and Hypertension

呂雅鈴(Ya-Ling Lu) ； 陳秀蓮(Hsiu-Lien Chen) ； 李琇蓉(Hsiu-Jung Lee)

《北市醫學雜誌》 20卷2期 (2023/06) Pp. 253-263

https://doi.org/10.6200/TCMJ.202306_20(2).0009

摘要

本文為描述於2018年6月4日至6月11日照顧一位34歲年輕媽媽罹患乳癌併有高血壓之護理經驗。個案為成年早期婦女，生活重心在家庭，對於自己罹患乳癌及高血壓，擔心會成為家人負擔，對未來充滿悲觀及焦慮。筆者運用Gordon十一項健康功能型態為評估架構，確立個案之健康問題有急性疼痛、無望感及知識缺失。藉由教導個案非藥物方法如治療性按摩，減緩術後疼痛不適；運用家庭支持，安排病友與志工提供經驗分享；運用跨團隊醫病溝通，教導其治療重要性及非藥物控制血壓等方法，使個案願意配合高血壓的治療。經由上述之護理措施，有效緩解個案的疼痛，改善個案的負面情緒，增加自信心面對未來，並促使個案調整生活型態以控制血壓。建議製作乳癌化療流程的衛教影片及成功治癒病友的鼓勵影片，減低患者及其家屬對於術後的擔憂，並增加信心，期望更加提升護理品質。

關鍵字

乳癌 ； 高血壓

並列摘要

This paper describes the nursing experience from 4^(th) June to 11^(th) June 2018 in a 34-year-old mother suffering from breast cancer and hypertension. This case was an early stay-at-home-mother. She was afraid that the diseases would become a burden to her family and felt anxious and pessimistic. It's raised our motive to explore further. We used the Gordon 11 Function Health Patterns to build the assessment structure, and the established health problems were: acute pain, hopelessness, and lack of knowledge. We taught her non-pharmacological approaches like therapeutic massage to relieve her postoperative pain and discomfort; we used family support, arranged experience sharing from other patients and volunteers, and applied cross-discipline doctor-patient communications. We educated her on the importance of treatment and hypertension management using non-pharmacological approaches so that she was willing to treat hypertension. The nursing mentioned above measures resulted in effective pain relief, mood improvement, enhancement of her future confidence, and lifestyle adjustment for hypertension management. We recommend making health education videos about the chemotherapy process and inspirational movies of patients with successful treatments to relieve patients and their families from anxiety and enhance their confidence. In the end, we also wish to improve nursing quality further.

並列關鍵字

breast cancer ； hypertension

參考文獻

蔣秀容，齊美婷，王珮珩，顧艷秋。初次 罹患乳癌之求醫歷程。榮總護理2015； 32(1)：10-20。

楊宛榕，陳靜儀，曾烋焄。正念減壓是否 能改善乳癌患者的憂鬱情緒。彰化護理 2018；25(1)，26-29。

簡淑慧，廖美南，李淑慧，林永昌。從實證 觀點談「按摩處置對於癌痛病人之成效。護 理雜誌2014；61(6)：23-28。

郭瑞萍，翁靜美，陳金玫。護理人員在術 後疼痛照護中的挑戰。領導護理2015； 16(4)：11-20。

陳芬英。癌症資源中心協助一位初罹患乳癌 婦女的護理經驗。榮總護理2018；35(2)： 213-220。