運用紐曼系統模式於一位胰頭癌併發膽管炎病人之護理經驗

The Nursing Care of a Pancreatic Head Cancer Patient with Cholangiolitis Using the Neuman Systems Model

羅翎君(Ling-Chun Lo) ； 李梅琛(Mei-Chen Lee) ； 李惠蘭(Hui-Lan Lee)

《馬偕護理雜誌》 9卷1期 (2015/01) Pp. 54-65

https://doi.org/10.29415/JMKN.201501_9(1).0005

摘要

本文主旨為描述照顧一位胰頭癌併發膽管炎患者之經驗，護理期間為2013年10月26日至11月11日止，筆者運用紐曼系統模式進行整體性評估，包括收集人際內、人際外、人際間因素與資料分析，確立個案有體溫過高、急性疼痛、焦慮及知識缺失（返家後經皮穿肝膽道引流傷口照護及預防膽管炎再復發日常生活注意事項）等健康問題。針對個案發燒及疼痛的問題，分別提供降低體溫及緩解疼痛的護理措施，以緩解患者的生理不適；對於焦慮問題，則提供降低焦慮之護理處置及提供相關資訊，以避免心理衝擊導致其他併發症；對於返家後引流管傷口照護及預防膽管炎再復發，則提供相關衛教以增進個案的居家生活品質。希望藉由此篇護理經驗，提供給日後照護類似個案之護理人員參考與分享。

關鍵字

紐曼系統模式 ； 胰頭癌 ； 膽管炎

並列摘要

This report describes the nursing caring for a patient with pancreatic head cancer secondary to cholangitis. During the nursing caring period (2013/10/26~11/11), Neuman systems model was adopted, which included dimensions of intrapersonal, interpersonal, and extra-personal forces as well as the environmental factors affecting the patient health and analyzing the patient's condition. The nursing problems identified included hyperthermia, acute pain, anxiety, and knowledge deficit (home care methods for care to drainage tubes, wound care and prevention of recurrent cholangiolitis after discharge). Regarding fever and pain managements, nursing interventions were applied by cooling down the body temperature and reducing pain, and thus alleviating discomfort; regarding nursing interventions for anxiety, relevant information were offered to prevent the psychological distress that might lead to other complications; regarding PTC wound care and preventing recurrent cholangitis, related health education was provided to improve the patient's quality of life. Hopefully, the nursing experience mentioned in this study can be seen as a reference for nursing staffs who care for patients with similar clinical problems in the future.

並列關鍵字

Neuman system model ； pancreatic head cancer ； pancreatic head adenocarcinoma ； cholangiolitis ； nursing care