一位肺癌患者併發史帝芬強森症候群之照護經驗

Lung Cancer Complicated By Stevens-Johnson Syndrome: A Case Study From A Nursing Perspective

廖育萱(Yu-Hsuan Liao) ； 韓玉蘭(Yu-Lan Han)

《安泰醫護雜誌》 18卷4期 (2012/12) Pp. 25-39

https://doi.org/10.7078/TSMHMNJN.201212.0025

摘要

本篇敘述一位因肺癌服用標靶藥物得舒緩（Tarceva），引起史帝芬強森症候群患者之照護經驗。護理期間於99年11月23日至99年12月30日，運用Gordon十一項功能性健康型態評估，發現個案主要護理問題有：現存性皮膚完整性受損、疼痛、營養不均衡：少於身體需要及身體心像紊亂。筆者於照護過程中，協助個案適應外觀改變導致之身心影響，藉由主動傾聽及關懷，與個案建立良好信任關係，鼓勵家屬陪伴及參與照護活動，建構家庭支持系統，並運用專業知識，提供直接的身體照顧活動，有效控制傷口感染，促使癒合，並改善疼痛問題，使個案提升自我價值，具正向思考，勇敢面對身心帶來之衝擊，再度積極重返抗癌之路，期望藉此分享照護經驗，能提供護理同仁臨床照護之参考。

關鍵字

肺癌 ； 史帝芬強森症候群 ； 身體心像紊亂

並列摘要

This report describes the nursing experience in a case of a lung cancer patient who received the target medicine (Tarceva) and subsequently developed Stevens-Johnson Syndrome. The nursing period was from 23 November 2010 to 30 December 2010. The patient's health status was assessed using the 11 categories in Gordon's functional health pattern, and the following major health problems were identified: extant skin integrity injury, pain, malnutrition, and body image disturbance. The author assisted the patient to adapt to the change of appearance and its effects on her body and mind, established a good therapeutic relationship by actively listening and caring, and encouraged the family members to accompany the patient and participate in care activities to build a good family support system. The author provided direct physical care activities and effective control of wound infection, promoting healing and reducing pain through the application of professional knowledge. Finally, the author helped the patient enhance her self-esteem, think positively, and face the physical and psychological impacts of her disease with courage, so that she was able to return to her anticancer treatment with a more positive outlook. The author's experience caring for this patient may have value as a useful reference in clinical care.

並列關鍵字

Lung cancer ； Stevens-Johnson Syndrome ； Body image disturbance