隨著醫療科技進步,癌症病人治療後存活率逐漸上升,然而,癌症復發對病患與家庭而言仍是有形及無形的壓力,本文個案在得知乳癌復發後,難過失望之餘對疾病預後、化學治療成效與副作用產生質疑,加上經濟壓力與資訊不足而猶豫是否接受化學治療。住院期間筆者以紐曼模式評估,運用會談、傾聽、觀察等技巧收集資料,確立個案壓力源及主要健康問題有:潛在危險性傷害、家庭因應能力失調、焦慮。筆者除提供個別性護理措施以緩解其生理不適,並扮演協助者、指導者、諮詢者與支持者等角色,提供相關護理指導與正確資訊,澄清對疾病預後與化學治療的疑慮,並協助解決家庭經壓力,同時介紹化學治療成效佳的個案,使其能克服心理障礙,坦然接受治療,並對日後的治療抱持正向積極的態度。
This article discusses a nursing care process for a breast cancer patient who considered accepting chemotherapy when facing the recurrence and metastasis, financial stress and side effects of therapy. I applied the Neuman Systems Model to assess and collect information through interview and observation. Realizing her sources of stress and physical problems were a potential risk for injury, ineffective coping of family, and anxiety, I provided individual care to relieve her from physical discomfort by playing a role of consultant and supporter. Furthermore, I clarified her questions about chemotherapy, providing guidance and resolving her financial stress as well as using several successful cases of chemotherapy to encourage her.