一位年輕未婚乳癌病人術後接受化學治療療程之照護經驗

Nursing Experience of a Young Unmarried Breast Cancer Patient who Underwent Adjuvant Chemotherapy

陳珈諭(Chia-Yu Chen) ； 李彩緣(Chai-Yuan Lee) ； 陳宥蓁(Yu-Chen Chen)

《澄清醫護管理雜誌》 16卷1期 (2020/01) Pp. 53-61

摘要

本文探討一位年輕未婚女性罹患乳癌行腫瘤切除手術後，接受化學治療療程之護理經驗。照護期間自2017年5月10日至2017年8月21日，個案住院接受化學治療療程共6次，週期為三週施打一次，住院期間藉由會談、身體評估、直接照護、查閱病歷資料及電訪方式收集資料，以Gordon十一項功能性健康型態評估，確立個案有噁心、身體心像紊亂、社交隔離三項護理問題。護理過程中，經由擬定個別性護理措施，運用精油按摩及薰香的芳香治療及口含蜂蜜冰塊，改善個案因化學治療產生的噁心嘔吐感；引導個案說出接受化學治療的心理感受，透過藝術治療，教導個案藉由藝術創作時尚流行之假髮穿戴方法及指甲彩繪藝術，重新建立個案的自信心，建立自我心像，正向面對身體外觀的改變；提供諮商與支持、鼓勵參與表達性藝術活動、乳房重建或義乳相關資訊及社會支持力量，協助個案克服因疾病所帶來的壓力與衝擊，使個案願意走出去，面對人群，參與社交活動，重整自我新的生活方式。

關鍵字

乳癌 ； 化學治療 ； 身體心像改變 ； 輔助治療

並列摘要

The present paper described the nursing experience of a young unmarried breast cancer patient who underwent chemotherapy after breast tumor resection surgery. Nursing care was administered to the patient, who was hospitalized for six cycles of tri-weekly chemotherapy, from May 10, 2017 to August 21, 2017. During the hospitalization period, patient data were collected through face-to-face interviews, physical assessments, direct care, reviews of the patient's medical records, and telephone interviews. By assessing the patient's condition using Gordon's 11 Functional Health Patterns, it was confirmed that the patient experienced three major nursing problems, namely nausea, body image disturbance, and social isolation. During the nursing process, the patient's sensation of nausea induced by chemotherapy was alleviated through the formulation of individualized care measures, which included essential oil massages, aromatherapy, and sucking honey-infused ice cubes. In addition, the patient was guided to express her psychological feelings regarding chemotherapy, and art therapy was employed to teach the patient stylish wig-wearing techniques and nail art, which enabled the patient to rebuild her self-confidence, establish her self-image, and adopt a positive attitude towards the changes in her bodily appearance. Finally, counseling and support were provided, and the patient was encouraged to participate in expressive art activities and to seek information and social support related to breast reconstruction or breast prostheses, to help the patient overcome disease-induced stresses and shocks, and enhance her willingness to face the outside world, participate in social activities, and create a new lifestyle.

並列關鍵字

Breast cancer ； Chemotherapy ； Body image change ； Adjuvant therapy