一位初次罹患急性骨髓性白血病青少年病患之護理經驗

Nursing Experience for An Adolescent Patient Initially Suffering from AML

賴沛縈(Pei-Ying Lai) ； 陳綉惠(Shiow-Huey Chen)

《馬偕護理雜誌》 7卷1期 (2013/01) Pp. 72-82

https://doi.org/10.29415/JMKN.201301_7(1).0008

摘要

本文旨在探討一位13歲罹患急性骨髓性白血病病人，初次面臨癌症診斷與治療過程中，協助其適應生理不適及心理調適過程之護理經驗。筆者運用Gordon十一項功能性健康型態為評估指引，並經由觀察、會談、身體評估及病歷收集資料，於2009年4月2日至5月25日護理期間，確立主要的健康問題有：營養狀況改變／少於身體需要、舒適情況改變／皮膚搔癢、高危險性創傷／出血、因應能力失調、照顧者角色緊張。運用症狀護理，以同理心鼓勵個案說出內心感受，提供個案及家屬持續性的關懷，改善個案口腔黏膜破損情形、協助減輕化學治療副作用之生理不適，降低其合併症的發生、減少疾病對其產生之心理衝擊，並改善家屬因照顧個案產生之焦慮。建議增加護理人員臨床實務照護訓練機會，鼓勵同仁參與相關學術討論會等，藉以提升此類患者整體之照護品質。

關鍵字

急性骨髓性白血病 ； 青少年 ； 護理經驗

並列摘要

This article aims to discuss the nursing experience for a 13-year-old patient suffering from Acute Myeloid Leukemia (AML) who initially faces the cancer diagnosis and medical treatments. Gordon's functional health patterns were implemented as the guideline to evaluate health care requirements. The data was collected by means of the observation, interview, physical assessment, and information survey of medical records during the nursing period from April 2 to May 25 in 2009. The main health problems included under-nutrition, skin itching, high-risk hemorrhage, ability disorders in response, anxieties and strains of caregivers. The symptom care could then be applied to mitigate the cases of oral mucosal damage, to reduce the incidence of complications and physical discomfort caused by chemotherapy side-effects, and to encourage the patient expresses one's inner feeling and provide the psychological supports for patient and his/her families. In order to enhance the quality of care for young AML patients, participation in the clinical practice of nursing training and relevant symposiums are highly proposed.

並列關鍵字

Acute Myeloid Leukemia ； Adolescent ； Nursing experience