照護一位初次罹患蘭格罕氏細胞組織球增生症個案之護理經驗

Nursing Experience of Caring for a Patient Firstly Diagnosed with Langerhans Cell Histiocytosis

10.29494/LN.202103_22(1).0006

吳素玲(Su-Ling Wu)；管珮如(Pei-Ju Kuan)

蘭格罕氏細胞組織球增生症 ； 恐懼 ； 體溫過高 ； langerhans cell histiocytosis ； fear ； hyperthermia

領導護理

22卷1期（2021 / 03 / 01）

68 - 83

繁體中文

本文主要是照護一位自治療初期懷疑膽管炎，中期懷疑胸腔惡性腫瘤至最終確診為蘭格罕氏細胞組織球增生症個案之護理經驗。照護期間為2016年6月16日至2016年7月11日，照護過程中藉由會談、觀察、身體評估技巧並運用Gordon十一項健康功能評估收集資料，分析出個案所產生的健康照護問題有：體溫過高、潛在危險性肝臟功能障礙、恐懼、照顧者角色緊張。此疾病影響各器官，在疾病初期到最終切片診斷為蘭格罕氏細胞組織球增生症的過程中，帶給病患諸多不適，病情的轉折更對案母造成莫大的衝擊。由於此疾病罕見與案母對此疾病感到陌生而引發情緒上的困擾，護理過程中提供個案個別性護理措施，透過主動關懷、傾聽，並與案母建立良好護病關係，並主動提供案母相關檢查資訊，與案母共同擬定照護計畫，進而增加案母在後續照護上的信心與能力，出院後陪同於門診持續追蹤。筆者期望以此經驗分享給其他護理人員，以提供日後照顧此類個案之參考。

This paper describes the nursing experience of caring for a patient suspected to have suffered from cholangitis at the early stage of treatment, suspected to have suffered from thoracic malignancies at the middle stage of treatment, and eventually was diagnosed with Langerhans cell histiocytosis. The patient received care from June 16, 2016 to July 11, 2016. During the care process, this study used interviews, observations, physical assessment skills, and Gordon's 11 functional health patterns to collect data. It also analyzed the healthcare problems encountered by the patient, including hyperthermia, potentially dangerous hepatic dysfunction, fear, caregiver role strain. This illness affects various organs. From the early stage of the illness to the final confirmation of diagnosis of Langerhans cell histiocytosis using biopsy, this illness caused severe discomfort in the patient, and the transition of disease condition caused a heavy impact on the patient's mother. Because this illness is rare and the patient's mother experienced emotional distress due to the unfamiliarity with this illness, the patient was provided with individualized nursing measures during the nursing process. The author developed a good nurse-patient relationship with the patient's mother by proactively expressing care and listening to her. Moreover, the author proactively provided the patient's mother with information on relevant examinations, and jointly developed a care plan with her to further strengthen her confidence and ability in providing subsequent care and accompany the patient to attend the follow-up outpatient visits after being discharged from the hospital. The sharing of this experience with other nurses may serve as reference for future care of patients with such illness.

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