照顧一位重覆罹癌病人無望感之照護經驗

Caring Experience from Looking after a Repeated Cancer Patient with Hopelessness Emotion

10.29494/LN.202109_22(3).0006

賴彥和(Yen-Ho Lai)；馮淑惠(Shu-Hui Feng)；段奇維(Chi-Wei Tuan)；李婉瑜(Wan-Yu Lee)

無望感 ； 意義治療 ； 焦慮 ； 急性疼痛 ； 重覆罹癌 ； hopelessness ； meaning treatment ； anxiety ； acute pain ； repeated cancer

領導護理

22卷3期（2021 / 09 / 01）

70 - 85

繁體中文

本篇報告是描述一位51歲男性罹患膀胱腫瘤五年，此次因罹患右側腎細胞癌住院接受達文西部分腎切除手術，經歷生理、心理衝擊之照護經驗。筆者於2018年2月6日至2月15日護理過程，應用溝通、觀察、身體檢查及羅氏適應模式進行資料收集，確立健康問題有無望感、急性疼痛、焦慮共三個護理問題，剛開始病人無法卸下心防，筆者運用心理支持、背部及肢體按摩，降低病人焦慮情緒，並建立治療性關係；在主動關懷、傾聽，鼓勵表達感受，並藉助跨團隊合作力量使力，最後讓病人重新檢視生命的價值，重新找到希望和勇氣，面對疾病所帶來的衝擊。透過每個月跨團隊討論，提升團隊成員及時溝通之時效性，彼此分享照護經驗，共同協助改善心理困境，以增加多元照護之功能。希望藉此護理經驗提供護理同仁，於面對病人重覆罹癌之身體疾病照護時，更應重視情緒反應及心理調適過程。

This report describes a caring experience of a 51-year-old man who suffers from bladder tumor for five years. The patient experienced physical and psychological shocks as this time he was hospitalized for right kidney cell carcinoma and received Robotic partial nephrectomy surgery. The author used communication, observation, physical examination and Roche Adaptation Model to collect data during the nursing period from February 6th to 15th, 2018, and established three nursing issues: health problems such as hopelessness, acute pain, and anxiety. At first the patient could not stop being resistance, the author applies psychological support, back and limb massage to reduce the patient's anxiety and establish a therapeutic relationship. With active care, listening, encourages expressing feelings, and using cross-team cooperation to support, finally leads the patient to re-examine the value of life, rediscover hope and courage, as well as facing the impact of disease. Through monthly cross-team discussions, improve the timeliness of team members' prompt communication, share care experience with each other, and help improve mental distress to increase the function of multiple care. Hopefully this nursing experience will assist nursing colleagues, when facing patients with repeated physical illnesses from cancer, to pay more attention to the emotional response and psychological adjustment process.

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