運用Swanson關懷理論照護一位初診斷乳癌病人之護理經驗

林欣蓉; 洪敏瑛; 崔宛玉

doi:10.6880/TJON.202206_22(1).06

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P69 - 84

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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运用Swanson关怀理论照护一位初诊断乳癌病人之护理经验

The Nursing Experience of Using Swanson's Caring Theory in a Newly Diagnosed Breast Cancer Patient

林欣蓉(Hsin-Jung Lin) ；洪敏瑛(Ming-Ying Hong) ；崔宛玉(Wan-Yu Tsui)

肿瘤护理杂志； 22 卷 1 期 (2022 / 06 / 01) ， P69 - 84

繁体中文 DOI： 10.6880/TJON.202206_22(1).06

Swanson关怀理论；乳癌；个案管理； Swanson's caring theory ； breast cancer ； case management

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摘要 │ 参考文献 (17) │ 被引用文献 (1) │ 国际计量

摘要〈TOP〉

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This article describes the nursing experience in caring for a 41-year-old woman with newly diagnosed breast cancer treated with mastectomy and postoperative adjuvant chemotherapy. The nursing care was implemented from January 30th, 2019 to October 9th, 2019. The overall assessment in the physiological, psychological, sociological, and spiritual aspects was performed. Three major health problems were identified, including anxiety, body image disturbance, and ineffective protection. The patient cried during the initial visit, revealing her deep sense of helplessness in the face of the life-threatening new diagnosis of breast cancer. Patient also exhibited great anxiety about the changes in body image after the operation. The author was motivated to initiate an in-depth exploration of the patient's experience. It was expected that, with the utilization of Swanson's caring theory, the patient could gain positive coping skills, which could get her through the crisis of having cancer. In the nursing process, the author acted as the oncology case manager to povide individualized caring measures. During the diagnostic period, through proactive care, positive therapeutic relationship, encouragement in the expression of feelings, as well as provision of helpful information, the anxiety of the patient regarding the disease and treatment was reduced. During the treatment period, through listening, companionship, guidance in the expression and integration of feelings about the changes in body image, and encouragement in the participation in patient support group, the patient was able to face and accept the fact of her physical changes. The author utilized professional knowledge to provide correct information on the disease and treatment, as well as improve the patient's self-care skills during chemotherapy. During the follow-up period, the author provided continuous care through in-person and telephone interviews, which helped the patient to regain her original role functions. The importance of regular follow-up visits was also reinforced. During the whole process, communication and coordination skills of an oncology case manager were adopted. Furthermore, continuous nursing consultation was provided and fragmented care was integrated. The patient was referred to relevant resources and her status was reported to the medical team in a timely manner as well. The patient was able to cope with the impact of the cancer diagnosis. She had successfully completed the treatment. It is hoped that this nursing experience could serve as a helpful reference to other nursing staffs in caring for similar patients in the future.

参考文献 ( 17 ) 〈TOP〉

姜亭妤,简淑慧,徐鸿智,陈淑卿(2018)。心理调节措施在癌症患者身体心像改变及情绪困扰之成效－系统性文献回顾。长庚护理，29(3)，350-366。
连结：
施美玲,郭信智,许丽玉(2020)。初诊断乳癌病人术前焦虑之多媒体卫教效果初探。医务管理期刊，21(1)，13-26。
连结：
洪晓佩,曾丽华,雍允雯,林素萍,黄琼慧,明金莲(2019)。术前焦虑概念分析。荣总护理，36(2)，212-219。
连结：
Cardoso, F.,Kyriakides, S.,Ohno, S.,Penault-Llorca, F.,Poortmans, P.,Poortmans, P.,Rubio, I.T.,Zackrisson, S.,Senkus, E.(2019).Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.Annals of Oncology,30(8),1194-1220.
Dillon, D.,Guidi, A. J.,Schnitt, S. J.(2014).Pathology of invasive breast cancer.Diseases of the Breast

被引用文献 ( 1 ) 〈TOP〉

杜侑容(Yu-Jung Tu);黄文慧(Wen-Hui Huang);蔡佳吟(Chia-Yin Tsai)(2024)。运用Swanson理论於一位重郁症自杀企图患者行造瘻口之护理经验。高雄护理杂志。41(2)。106-117。

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