一位乳癌化療掉髮病人之護理經驗

Nursing Experience for post Chemotherapy-Induced Alopecia Symptom in Women With Breast Cancer

薛羽雯(Yu-Wen Hsueh) ； 楊惠婷(Hui-Ting Yang) ； 許芳華(Fang-Hua Hsu)

《馬偕護理雜誌》 15卷1期 (2021/01) Pp. 58-67

https://doi.org/10.29415/JMKN.202101_15(1).0006

摘要

台灣女性乳癌發生率與死亡率一直居高位，且有年輕化的趨勢，本文探討一位36歲未婚罹患乳癌之女性，於化學治療期間不僅須面臨化學治療副作用造成噁心、嘔吐與掉髮之生、心理問題，且還需擔憂手術後失去乳房而產生的焦慮問題，故筆者於2017年10月21日至10月27日護理期間，藉由觀察評估及會談方式，並運用Gordon十一項健康功能指引作為評估工具，發現個案有「噁心／嘔吐」、「焦慮」及「身體心像紊亂」等護理問題。筆者針對個案需求擬定個別性護理計畫，衛教個案穴位按摩、飲食等方式緩解噁心、嘔吐所造成之生理不適，並於照護期間運用同理心傾聽個案感受，鼓勵個案說出心理焦慮，予正確的疾病認知，指導個案如何因應化療掉髮後造成的外觀改變，並適時鼓勵增加自信心，協同家屬及醫療團隊陪伴個案面對罹癌後所承受之身心問題，以正向態度接受後續抗癌治療，期望藉此護理經驗，亦能提供護理人員照顧類似病人之參考。

關鍵字

乳癌 ； 化療掉髮 ； 護理經驗

並列摘要

The incidence and mortality of breast cancer is on a constant rise in Taiwan. The age of onset of disease is younger than in the past and becomes a significant threat to women's health. In this case study, 36-year-old female patient suffered not just from nausea, vomiting, alopecia, but also the anxiety after mastectomy postoperative physiological and psychological conditions. The authors collected data through direct nursing care, physical assessments, observation, and interviews guided by the Gordon 11-functional health assessment from October 21th to 27th in 2017. The results revealed that the patient experienced three health problems, including nausea and vomiting, anxiety and body image disturbance. Individual nursing program was then designed based on the patient's needs, used massage and diet to ease the symptoms of nausea and vomiting, establishing a good nurse-patient relationship, guided how to cope with alopecia body image disturbance, helped the patient build self-confidence, assisted the patient relieving from alleviate anxiety facing the breast cancer and the change of body appearance and a positive social support system with the help from whole team work and family/social supportive group. The article hopes that this nursing experience can be of use to oncological ward staff when nursing patients with similar situation.

並列關鍵字

breast cancer ； Chemotherapy-induced Alopecia ； nusing experience

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