照顧一位肝癌復發病人合併焦慮之護理經驗

本文探討一位肝癌再次復發病人合併焦慮之護理經驗，護理期間自2019年05月08日至05月25日，運用Gordon十一項型態評估，藉由觀察、參與照護、身體評估、團隊討論等方式，護理問題為低效性呼吸型態、體液容積過量、睡眠型態紊亂與焦慮。教導呼吸技巧、小風扇、精油噴霧嗅吸等以緩解呼吸困難，且執行穴位指壓、低鈉飲食，以改善腹水及水腫。癌症病人身心獲得寧靜，是極為重要的，故建議可設定資訊系統針對癌症病人進行篩選，輔助醫護團隊能在第一時間評估病人，且藉由資訊輔助，主動提供病人服務及追蹤治療；另院內可成立肝癌病友會、希望小站等團體，提供多元化的資訊。希冀此照顧經驗分享能提供日後相關疾病之照顧參考。

關鍵字

肝癌；復發；焦慮

並列摘要

This article discusses the nursing experience of a Patient with recurrent liver cancer complicated by anxiety. During the nursing period from May the eighth to twenty-fifth, 2019, Gordon's Eleventh Pattern Assessment was applied, through observation, participation in caring, physical assessment, and team discussion; identified nursing problems including inefficient breathing patterns, excess fluid volume, disturbed sleep pattern and anxiety. Instruct breathing techniques, use small fans, essential oil spray sniffing and so on to relieve breathing difficulties; perform acupressure and low sodium diet to improve ascites and edema. It is extremely important for cancer patients to obtain relaxation and peace of mind. Therefore, it is recommended to set up an information system for screen cancer patients, so the auxiliary medical care team can evaluate patients from the very beginning, and with the aid of information, they can proactively provide patient services and follow-up treatment. Additionally, groups such as Liver Cancer Friendship Association and Hope Station can be established to provide diversified information. It is hoped that this care experience sharing can provide as a reference to the future care of relevant diseases.

並列關鍵字

liver cancer ； relapse ； anxiety

參考文獻

Lekka, D., Pachi, A., Tselebis, A., Zafeiropoulos, G., Bratis, D., Evmolpidi, A., Ilias, I., Karkanias, A., Moussas, G., Tzanakis, N., &Syrigos, K. N. (2014). Pain and anxiety versus sense of family support in lung cancer patients. Pain Research and Treatment, 2014, 1-7.https://doi.org/10.1155/2014/312941

宋婕（2018）．一位肝性腹水反覆入院病患面對無力感之照護經驗．馬偕護理雜誌，12(1)，84-94。https://doi.org/10.29415/JMKN.201801_12(1).0007

李靜宜、王思涵（2018）．照護一位肝癌復發併呼吸衰竭面對疼痛之護理經驗．彰化護理，25(2)，105-118 。 https://doi.org/10.6647/CN.201806_25(2).0014

陳嘉琪（2017）．一位慢性阻塞性肺疾病患者反覆進出加護病房之護理經驗．彰化護理，24(1)，83-94。https://doi.org/10.6647/CN.24.01.18

呂宜佩、陳筱玲（2014）．應用紐曼模式於一位復發性肝癌病患接受再次手術治療之護理經驗．彰化護理，21(1)，50-59。https://doi. org/10.6647/CN.21.01.16

主題瀏覽