- 期刊
- OpenAccess
照護一位異體造血幹細胞移植病人之護理經驗
Nursing Experience of Patient with Acute Lymphocytic Leukemia Undergoing Allogeneic Haemopoietic Stem Cell Transplantation
摘要
本文探討一位二十六歲罹患急性淋巴性白血病首次面對接受高劑量化學藥物治療後再行異體造血幹細胞移植過程中身心靈反應及調適行為所產生的種種壓力之護理過程。筆者於98年12月11日～98年12月26日實際參與照護，依Gordon十一項功能性健康型態進行護理評估，由直接照護、觀察、病歷記錄、會談及身體評估方式收集資料，結果發現病人主要護理問題有：焦慮、社交隔離、潛在危險性感染、口腔粘膜改變等。結合醫療團隊、社會慈善團體、社工和身心科照會等相關資源，且運用同理心及溝通技巧引導個案說出心中感受，並提供資訊及介紹移植成功病友，協助抒發病人負向情緒反應，來增強自我身體外觀的肯定，使病人逐漸接受自己的改變，且成功地面對骨髓移植期間種種壓力，並順利出院。期望本篇文章能提供護理人員在照顧此類病人時之參考。
並列摘要
This article explores the nursing course facing multiplexed stresses arising from the physical and mental reaction, and the adjustment behaviour of a 26 year-old gentleman with acute lymphocytic leukemia (ALL) undergoing high dose chemotherapy followed by allogeneic haematopoietic stem cell transplantation. The author participated in nursing care of this patient over a period between 11th and 26th December, 2009. Nursing assessment was made based on the Gordon's 11 Functional Health Patterns. Data was collected from direct caring, observation, medical record, verbal communication and physical assessment. The results indicated that the major nursing issues include anxiety, social isolation, Risk for infection, mucositis. Combining the relevant resources from the medical team, social charity association, social workers, psychiatry consultation, the application of sympathy, together with communication technique, induced the patient to volunteer the deep-down feeling and thoughts. In addition, we offered relevant information and introduced patients who successfully underwent transplant for sharing past experience to help the patient relieve from negative emotional reaction, strengthen the self-affirmation of physical appearance, gradually accept physical changes, withstand successfully the stress during period of stem cell transplant, and be uneventfully released from the hospital. It is expected that this article would offer references for nursing personnel in the caring of transplant patients.
延伸閱讀
- 鄧卉淳、李姵萱（2021）。造血幹細胞移植病人經歷慢性移植抗宿主疾病之護理經驗。台大護理雜誌，17(2)，89-100。https://doi.org/10.6740/NTUHJN.202107_17(2).0009
- 陳淑樺、邱盈珍、陳淑華（2022）。照護一位活體肝臟移植手術前行血漿置換病人之加護經驗。長庚護理，33(1)，104-113。https://doi.org/10.6386/CGN.202203_33(1).0010
- 黃盈芷、戴玉慈、李啟誠（2014）。造血幹細胞移植後嚴重植體抗宿主疾病之護理經驗。台灣醫學，18(6)，634-640。https://doi.org/10.6320/FJM.2014.18(6).03
- 彭宥慈、黃惠珠（2022）。照護一位手臂異體移植病人之護理經驗。新臺北護理期刊，24(2)，119-127。https://doi.org/10.6540/NTJN.202209_24(2).0011
- 楊蕙雯、董道興、師慧娟（2004）。Nursing Experience for a Chronic Myelogenous Leukemia Patient Underwent Allogeneic Peripheral Blood Stem Cell Transplantation。腫瘤護理雜誌，4(2)，67-78。https://doi.org/10.6880/TJON.200412_4(2).07