摘要
癌症一直高居國人十大死因之首位，癌末病患約有6.7-62.5%因病情變化或治療因素，而產生淋巴水腫問題，且此問題爲安寧癌症病患的住院照護需求，因此本專案旨在改善安寧癌症病患淋巴水腫的舒適程度。由於單位內缺乏淋巴水腫相關的在職教育、淋巴水腫的護理工作規範內容缺乏完整性，及無定期監測護理人員淋巴水腫的護理技術，造成護理人員對淋巴水腫的認知不足，護理技術的完成率偏低，及病患的舒適程度降低。經由專案建立標準化安寧癌末病患淋巴水腫護理的工作規範、安寧癌末病患淋巴水腫的衛教光碟與單張、及安寧護理人員淋巴水腫護理技術的監控制度，並進行淋巴水腫的相關在職教育。透過實施多項專案的解決策略後，護理人員對淋巴水腫的認知正確率由52%提升至96%，執行淋巴水腫護理技術的完成率由53%提升至92%，而病患的舒適程度也由改善前的1.10分提升至3.15分，程度介於普通及舒適間，已經達到專案的目標，且超越之前所設立的閾值。有鑒於目前國內淋巴水腫照護之相關文獻甚少，期盼本專案改善安寧癌症病患淋巴水腫的舒適程度可做爲安寧臨床照護的方針，藉以提昇安寧癌末病患的照護品質。
並列摘要
Cancer is the top one killer of ten cause death in Taiwan. Appropriately 6.7-62.5% of cancer patients in the terminal stage would have lymphedema problem due to the illness or treatment, which is the care needs of the hospice cancer patients during hospitalization. Therefore, the purpose of this project is to alter the comfort level of lymphedema for the hospice cancer patients. The hospice unit lack of continue education about lymphedema, incomplete nursing care regulations of lymphedema, and irregularly supervised nurses’ skills of lymphedema, which has made nurses’ knowledge deficit about lymphedema, lower rates of executing lymphedema skills, and comfort level of patients reduced. Through the project, a standardized lymphedema nursing care regulation, teaching DVD and brochures, and supervised systems for lymphedema nursing skills were built for the hospice cancer patients, and conducted a lymphedema continue education. Through the multiple strategies of a project, the knowledge of lymphedema has promoted from 52% to 96% correctly, the comfort level of patients has altered from the scores of 1.10 to 3.15, which means the level as general to comfort, that has approached the goals of this project, and even more than the criteria set up. Due to the rare literature of lymphedema in Taiwan, it is expected that this project of alteration of comfort level about lymphedema for the hospice cancer patients in the terminal stage can be the references for the clinical hospice care that can promote the quality of care.
延伸閱讀
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