- 期刊
運用個案管理模式照顧一位卵巢癌復發病人之護理經驗
A Case Manager's Nursing Experiences for A Recurrent Ovarian Cancer
摘要
本文為運用個案管理模式照顧一位卵巢癌復發病人之護理經驗。個案於育齡年齡罹患癌症在接受抗癌治療後仍然復發，面對疾病和治療產生副作用所造成的不適，與疾病復發所帶來的恐懼和無力感，故引發筆者探討個案在面對疾病復發與治療之因應過程。個案管理期間自2016年11月9日至2017年1月28日，運用觀察、會談及整體性身心評估收集資料，確定個案有體溫過高、失眠及無力感等健康問題，過程中展現腫瘤個案管理護理師多專科之整合與聯繫協調能力外，透過了解個案對疾病相關訊息的需求，加強提供持續性照護的資訊，並將發現問題回饋給醫療團隊，進而改善病人健康問題，減少片斷式醫療照護。同時藉由手機應用程式讓病友們可線上互動、分享照顧訊息及與個管師互動，滿足病人健康照護需求；此外，適時轉介關懷師、病友團體提供個案關懷與情感支持，以順利度過治療，增進癌症照護品質，發揮腫瘤個案管理師專業護理的獨特性。未來建議可連結行動應用程式（mobile application, apps）做為提供衛教諮詢輔具，提高個案對疾病的認知，讓個案在面對疾病治療上更安心，期望藉此經驗分享，以提供日後個管師照護之參考。
並列摘要
This is a case manager's nursing experiences for a recurrent ovarian cancer. The case diagnosed cancer at the age of childbearing. After receiving anti-cancer treatment, unexpectedly, the disease recurred. The case needed to face the fear and powerlessness caused by the recurrence status and the side effects of chemotherapy and radiation therapy. Therefore, it is process of discussing the case of disease recurrence and treatment. Case management period was from November 9, 2016 to January 28, 2017. Both subjective and objective data were collected through observation and interview with integrated physical and mental assess. Three significant health problems were revealed to include ＂hyperthermia/caused by neutropenia,＂ ＂insomnia/worry about cancer progression,＂ and ＂powerlessness/uncertainty about the treatment effect of disease.＂ As a case manager in the oncology unit, author continued to demonstrate multi-disciplinary integration and coordination, assessed the need for disease-related information in cases, provided the more information on continuous care, gave back the problem to the medical staff, improved health problems, reduced fragmented medical care. By using mobile application, patients and patients could interactively share disease care information online, and got the online consultation with oncology case managers to solve patient problems. Author provided continuous and uninterrupted service to meet the health needs of patients. At the same time, the patient was referred to carers and patient groups to get case care. The physiological and psychological conditions were adapted, and treatment was successfully completed. Author enhanced the quality of cancer care and gave full play to the uniqueness of professional care of case managers. In the future, it is recommended to use mobile applications (apps) to instantly understand the case dynamics, provide educational counseling aids to improve the awareness of the disease and make the case more comfortable in the face of disease treatment. It is expected that this model of care will provide a reference for the management of oncology cases in the care experience.