老年癌症病人疲倦之評估與處置

Assessment and Management of Fatigue in Elderly Cancer Patients

林惠如(Hung-Ru Lin) ； 蔡松玲(Sung-Ling Tsai)

《腫瘤護理雜誌》 15卷2期 (2015/12) Pp. 19-27

https://doi.org/10.3966/168395442015121502002

摘要

惡性腫瘤是老年人常見的疾病，伴隨疾病進展及各種治療所產生的不適症狀中，又以疲倦最為常見，此症狀可能干擾病人身、心、靈及社會的恆定狀態。老年癌症病人需同時面對疾病與老化所帶來之疲倦，生活品質可能因而受影響，改善疾病或醫療相關的疲倦已成為現今癌症醫療照護的重點。透過識別藥物交互作用、治療及改善現存的貧血狀態、睡眠紊亂及失眠、代謝異常、疼痛、憂鬱等症狀，及透過非藥物的護理指導、運動、心理及行為治療、社會支持與關懷、靈性照顧等，可有效改善老年癌症病人的疲倦。疲倦評估工具簡單可分為單面向及多面向兩類，單面向著重於疲倦的程度或嚴重度，多面向則含括有疲倦的程度、嚴重度、生理反應、情緒感受、知覺感受、自我評價、伴隨或緩解的症狀、行為反應、對生活的影響程度及發生頻率與精神困擾等。老年人常有感覺功能缺損、認知或運動功能障礙的情形，使用工具評估老年癌症病人疲倦情形之前，應先評估其教育程度、認知功能與視力，衡量工具的特性，選擇適合老人的評估工具。醫護專業人員可透過對疲倦評估工具的適切使用，有效評估老年癌症病人的疲倦，協助老年癌症病人提高對疲倦之認知及自我照護能力，進而提升生活品質、享受更優質的餘生。

關鍵字

老年 ； 癌症 ； 疲倦 ； 評估 ； 處置

並列摘要

Cancer is prevalent in the elderly population. Among the symptoms of discomforts caused by cancer progression and cancer treatments, fatigue is the most common one. This symptom may interrupt the preferred state of patients’ physical, psychological, spiritual, and social wellbeing. Elderly cancer patients have to face the fatigue caused by disease and aging plus its possible influence on the quality of life. The management of the disease or treatment-related fatigue has become the present focus of cancer care. The detection of drug interactions, treatment and improvements of symptoms, such as existing anemia, sleep disorder, insomnia, metabolic abnormalities, pain, and depression, implementation of non-medication nursing guidance, exercise, psychological and behavioral treatments, social support, and spiritual practice are all ways to help the elderly to effectively cope with the fatigue issue. There are two types of fatigue assessment tools: single-dimensional and multi-dimensional, with the former focusing on the level or severity of fatigue while the latter on the level and severity of fatigue, physiological responses, emotional feelings, perceived feelings, self-assessment, accompanied or alleviated symptoms, behavioral responses, influence on life, incidence, and mental distress. The elderly tend to experience sensory impairment and cognitive or motor dysfunction. Therefore, before the use of any fatigue assessment tool in this patient population, it is necessary to first assess their educational background, cognitive functions, and vision, while measuring the characteristics of tool to select a suitable one for them. Medical and nursing professionals can use proper fatigue assessment tools to effectively assess fatigue of elderly cancer patients in order to assist them with the fatigue perception and self-care ability to achieve better quality of life.

並列關鍵字

Elderly ； Cancer ； Fatigue ； Assessment ； Treatment

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