一位腹膜癌年輕女性之照護經驗

A Nursing Experience of a Young Woman with Peritoneal Cancer

徐任萱(Jen-Hsuan Hsu)

《新臺北護理期刊》 22卷2期 (2020/09) Pp. 109-117

https://doi.org/10.6540/NTJN.202009_22(2).0010

摘要

本文探討一位因腹膜癌入院行腹膜內化學治療的36歲女性，擔心手術、預後、治療副作用之護理經驗。於2015/12/16至2016/2/5照護期間，運用Gordon十一項健康型態評估為指引，經直接照護、身體評估、觀察、會談及傾聽等方式，確立個案有:因擔心預後導致焦慮、食慾不振及心理焦慮導致營養不均衡：焦慮／與腹膜癌預後未知有關；營養不均衡：少於身體需要／與食慾不振及擔心預後有關；身體心像紊亂／與掉髮及術後身上管路及傷口存在有關。經團隊護理照護，傾聽、陪伴與支持，個別性指導疾病資訊及放鬆技巧來改善焦慮狀況；結合營養師共同照護，設計圖卡提供飲食衛教，促進營養攝取；鼓勵表達內心想法，藉由傾聽陪伴，減輕其不安，而走進人群，重建正向的身體心像。有感臨床醫護人員對心理層面之照護經驗不足，若能提供相關培訓，照護將更加完善。筆者深感在照護過程中，傾聽並陪伴完成其需求，使護理獨特性能幫助個案盡早擁有正向思考及生活之重要。期望藉由此護理經驗分享，提供日後照護此類個案之參考。

關鍵字

腹膜癌 ； 焦慮 ； 身體心像紊亂

並列摘要

This article describes a nursing experience of taking care of a 36-year-old women who underwent intraperitoneal chemotherapy for primary peritoneal cancer. She was worried about the operation, prognosis, and side effects of treatment. The duration of nursing care was from Dec 16^(th) 2015 to Feb 5^(th) 2016. The author used direct care, physical assessment, observation interview, listening, and Gordon's 11 function health patterns to assess and identify 3 major healthcare problems, including anxiety, malnutrition and body image disturbance. In addition to individualized nursing care, through collaboration with dietitians, we enhanced her nutrition condition. Clinical care often focuses on physical care, while ignoring the psychological level, suggesting the importance of nursing department arranging related training courses about psychological care. To encourage the patient and family members to think and live positively, we emphasized the ability of listening and accompanying the patient, and encouraged the patient to express the thoughts about the disease and her body image. We hope this kind of nursing experience can help such patients in the future.

並列關鍵字

peritoneal cancer ； anxiety ； body image disturbance

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