- 期刊
一位白血病患者接受骨髓移植後併發移植物抗宿主疾病之護理經驗
Nursing Experience of Caring a Leukemia Patient with Graft Versus Host Disease Developed after Bone Marrow Transplantation
摘要
本文是探討一位罹患急性骨髓性白血病接受周邊血液幹細胞移植患者併發移植物抗宿主疾病之護理經驗，護理期間自90年8月24日至10月2日，筆者以整體護理評估為指引並病歷查閱、身體評估與會談等方式收集資料，確認個案骨髓移植時期之主要護理問題在生理層面為口腔黏膜障礙、體溫過高、潛在危險性皮膚完整性受損，心理層面問題為焦慮，當個案病情急轉惡化時與家屬共同出現護理問題為預期性哀傷。在照護過程中，特別在個案出現移植後併發急性移植物抗宿主疾病時，筆者針對個案出現問題，與病患建立良好關係，為個案處理生理不適症狀，並運用醫療團隊人員合作與支持，協助個案面對疾病及移植後副作用產生之心理調適、並陪伴其走完人生旅程，達到生死兩無憾之護理經驗分享。
並列摘要
This is a case report that shares nursing experience of caring a leukemia patient with Graft Versus Host Disease induced by peripheral blood stem cell transplantation. During the caring period (2001.8.24~2001.10.2), data were collected through complete physical assessment, patient interview and chart review. The nursing problems of this case included: 1. Physiological aspect: altered oral mucous membranes integrity, hyperthermia, and potential skin integrity impairment. 2. Psychological aspect: anxiety and anticipatory grieving. During the nursing process, author applied interpersonal caring skill to establish trust relationship with client. Moreover, author mobilized multidiscipline team to support and help patient to relieve discomfort and psychological distress related to rejection reaction. Author accompanied patient and their family through the dying process.
延伸閱讀
- 張家莉、楊佰能（2013）。照顧一位白血病患者初次接受異體造血幹細胞移植之護理經驗。榮總護理，30(3)，283-288。https://doi.org/10.6142/VGHN.30.3.283
- 宋筱可、李鴻春（2018）。照護一位骨髓增生異常移植後產生慢性移植物對抗宿主疾病病人之護理經驗。台大護理雜誌，14(2)，134-146。https://doi.org/10.6740/NTUHJN.201807_14(2).0013
- 陳嬿如（2000）。一位急性前骨髓細胞性白血病患者之護理經驗。榮總護理，17(3)，270-278。https://doi.org/10.6142/VGHN.17.3.270
- 蔡寶純、楊佰能、洪麗琴（2013）。急性骨髓性白血病人接受造血幹細胞移植之護理經驗。榮總護理，30(3)，274-282。https://doi.org/10.6142/VGHN.30.3.274
- 李萱、李秀花、陳清惠（2005）。An Experience in Nursing an Acute Lymphocytic Leukemia Patient with Peripherally Inserted Central Catheter。護理雜誌，52(2)，78-86。https://doi.org/10.6224/JN.52.2.78