照護一位卵巢癌末期病患無力感之護理經驗

本文敘述一位58歲長期血液透析病人罹患卵巢癌末期之護理經驗。護理期間自2022年10月20日至11月16日，經由會談、身體評估、觀察、病歷查閱及直接照護等方式收集資料，運用Gordon十一項健康功能型態評估進行整體性評估及資料整合分析歸納，確立個案有體液容積過量、無力感、增進自我照顧能力的準備度等健康問題。護理期間筆者先與病人建立信任之護病關係後提供個別性護理；教導穴位及耳穴按壓，減少疲憊感與腹脹不適導致的食慾不振，偕同營養師了解個案飲食的喜好，擬定營養計畫，改善以維持身體基礎代謝需求及血液透析飲食；主動給予關懷、陪伴、傾聽心理問題，鼓勵個案表達內心想法，澄清個案對疾病的無力和不安感，同理首次進行化學治療等不安情緒，引薦病友與提供婦癌團體資訊，提供其情緒抒發之管道，以減少個案心理的焦慮與憂鬱；透過跨團隊照護服務解決病人社會經濟等問題，協助聯繫居家服務等專業服務，讓個案在疾病治療過程中獲得安全與歸屬，減輕其對於疾病的擔憂與無力感。

關鍵字

卵巢癌；末期；無力感；血液透析

並列摘要

This article describes the nursing experience of a 58-year-old long-term blood dialysis patient with end-stage ovarian cancer. Data were collected during the nursing period from October 20, 2022 to November 16, 2022 through discussions, physical assessments, observations, review of medical records, and direct care. The data were analyzed and integrated using Gordon's Functional Health Patterns to conduct an overall assessment and identify health problems, including excess fluid volume, powerlessness, readiness for enhanced self-care. During the nursing period, the author established a trusting nurse-patient relationship with the patient and provided individualized care. The patient was taught acupressure massage to reduce fatigue and abdominal discomfort that led to loss of appetite. The author worked with a nutritionist to understand the patient's dietary preferences and develop a nutrition plan to maintain basic metabolic needs and a blood dialysis diet. The author provided active care, companionship, and listened to the patient's psychological problems, encouraging the patient to express their inner thoughts, clarify their powerlessness and anxiety about the disease, and empathy with their first chemotherapy and other anxiety. The author also referred the patient to patient support groups and provided information to provide emotional outlets to reduce anxiety and depression. Cross-team care services were used to solve the patient's social and economic problems, and the patient's children were informed of the patient's condition changes, worries, and helplessness, rebuilding their family's operational capabilities, and providing professional services such as home care to improve family dysfunction problems.

並列關鍵字

Ovarian cancer ； terminal stage ； powerlessness ； hemodialysis

參考文獻

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