照護一位子宮內膜癌併卵巢癌復發婦女的護理經驗

Nursing Experience of a Female Patient with Endometrial Carcinoma and Recurrence of Ovarian Cancer

10.3966/102673012015062602011

李佳玲(Chia-Ling Li)

癌症復發 ； 疼痛 ； 無望感 ； 家庭運作過程 ； cancer recurrence ； pain ； hopelessness ； family operation process

長庚護理

26卷2期（2015 / 06 / 01）

232 - 241

繁體中文

本文乃探討一位46歲婦女，罹患子宮內膜癌合併右側卵巢癌在經歷手術及化學治療後，在二個月內癌症復發的護理經驗。筆者於護理期間自2012年3月22日至5月10日，藉由觀察、會談、直接參與照護等方式收集個案的相關資料，運用Gorden十一項功能性護理評估模式，分析出個案所產生的健康問題有急性疼痛：與術後傷口有關、無望感：與癌症復發有關與家庭運作過程改變：與家庭成員癌症復發住院有關三個護理問題。筆者在護理期間藉由傾聽、鼓勵表達內心感受，並透過臨床照護經驗的分享及提供家庭支持，減輕個案身體之不適感及肯定個案存在的價值。照顧癌症復發的病人是一個小組的工作，小組人員須同心，建議單位可舉辦婦癌相關跨領域課程或舒適會議，透過各專科人員協助癌症病人及其家人在家庭得以適應這漫長的治療過程，更期待此篇報告提醒護理同仁時時反思，聆聽病人的擔憂，對音樂療法有初步的認識及瞭解，並期望此次之照護經驗可做為日後照護類似病人之參酌。

This paper describes the nursing experience of a 46-year-old woman who suffered from endometrial carcinoma combined with right ovarian cancer, and had cancer recurrence within 2 months after surgery and chemotherapy. During the nursing period from March 22, 2012 to May 10, 2012, the researcher collected relevant data of the patient by means of observation, interview, and direct caring experience. Moreover, with the application of Gorden's 11 functional health patterns, the researcher concluded that the health problems of this patient include the following 3 caring issues: acute pain, caused by wound after surgery; hopelessness, caused by cancer recurrence; and change of family operation process, caused by cancer recurrence and hospitalization of family member. The researcher mitigated the patient's discomfort and confirmed the value of existence of the patient by means of listening, encouraging her to express her inner feelings, sharing clinical caring experience, and offering family support. It takes team efforts to care for the patients with cancer recurrence, and the team members should work together. It is suggested that the organization should set up cross-field courses or comforting meeting related to female cancers, thus experts can help cancer patients and their family members adapt to the long-period treatment process. This report is expected to remind nurses to reflect on their practices, listen to patients' concerns, and gain a basic understanding on music therapy. This nursing experience can also serve as an example for future caring of patients with similar disease.

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