協助一位肺腺癌病人全家達成治療決策共識之個案管理經驗

廖翊竹; 許麗玉; 施美玲; 謝秀芳

doi:10.3966/168395442016121602006

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来源数据

P59 - 72

医药卫生 > 预防保健与卫生学
医药卫生 > 内科
医药卫生 > 社会医学

DOI： 10.6880/TJON

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协助一位肺腺癌病人全家达成治疗决策共识之个案管理经验

Nursing Experience of Case Managment in Helping a Patient with Pulmonary Adenocarcinoma to Reach Family Consensus of Therapy

廖翊竹(Yi-Chu Liao) ；许丽玉(Li-Yu Hsu) ；施美玲(Mei-Ling Shih) ；谢秀芳(Hsiu-Fang Hsieh)

肿瘤护理杂志； 16 卷 2 期 (2016 / 12 / 01) ， P59 - 72

繁体中文 DOI： 10.3966/168395442016121602006

肺腺癌；药品可近性；治疗决策冲突；生活照顾需求；个案管理； Pulmonary Adenocarcinoma ； Access to Medicines ； Conflicts in Treatment Decision-Making ； Needs of Daily Care ； Case Management

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摘要 │ 参考文献 (21) │ 被引用文献 (1) │ 国际计量

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This case report describes the nursing experience in case mangement of a middle-age female patient who suffered from adenocarcinoma of the lung with brain metastases. The nursing period was from July 4th, 2013 to September 20th, 2014. The case management nurse facilitated in conflicts resolution of treatment decision in order to reach family consensus for the patient to receive expensive target therapy in time. Data were collected through direct interactions with the patient and her family, physical examination, family meetings, and medical records. A total of 6 health problems were identified through physical, psychological, social, and spiritual assessments during the nursing process. Playing the role of resource and service coordinator, case manager, patient/family educator, and clinical care provider, the case management nurse discussed patient‘s declining selfcare functioning and confliting positions of family members in treatment decision. Using patient-centered care, conflicts in treatment decisions among the patient and her family members were resolved via decision guidance and coaching. With the power of teamwork, the costly targeted therapy was made affordable after the integration of financial resources from both inside and outside the family. In the process, family consensus on the treatment was reached and family cohesiveness strengthened. As a result, the family could provide care and support what the patient needed at different stages of disease including the final days. In today’s healthcare community with advanced medicine, case management nurses need to have not only expertise in caring for cancer patients from lifelong learning for evidencebased practice, but also the capability to overcome barriers to access treatments. We hope this case report provides practical suggestions that nurses can apply in their daily practice to improve their care quality and to ensure timely treatment.

参考文献 ( 21 ) 〈TOP〉

Baykara, M.,Kurt, G.,Buyukberber, S.,Demirci, U.,Ceviker, N.,Algin, E.,Benekli, M.(2014).Management of brain metastases from nonsmall cell lung cancer.Journal of Cancer Research and Therapeutics,10(4),915-921.
Chen, Y. C.,Chang, Y. J.,Tsou, Y. C.,Chen, M. C.,Pai, Y. C.(2013).Effectiveness of nurse case management compared with usual care in cancer patients at a single medical center in Taiwan: A quasi-experimental study.BMC Health Services Research,13,202.
Goodwin, J. S.,Satish, S.,Anderson, E. T.,Nattinger, A. B.,Freeman, J. L.(2003).Effect of nurse case management on the treatment of older women with breast cancer.Journal of the American Geriatrics Society,51(9),1252-1259.
Grant, M.,Sun, V.,Fujinami, R.,Sidhu, R.,OtisGreen, S,Juarez, G.,Ferrell, B.(2013).Family caregiver burden, skills preparedness, and quality of life in non-small cell lung cancer.Oncology Nursing Forum,40(4),337-346.
Guerin, A.,Sasane, M.,Zhang, J.,Culver, K. W.,Dea, K.,Nitulescu, R.,Wu, E. Q.(2015).Brain metastases in patients with ALK+ nonsmall cell lung cancer: Clinical symptoms, treatment patterns and economic burden.Journal of Medical Economics,18(4),312-322.

被引用文献 ( 1 ) 〈TOP〉

谢纹婷,谢佩伦,林巧惠,李佩轩(2022)。运用生命回顾协助一位肺癌末期并脑部转移病患及家属之护理经验。领导护理，23(4)，68-84。

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