照護一位初診斷多發性骨髓瘤病患接受CCRT之護理經驗

A Nursing Experience of Newly Diagnosed Multiple Myeloma Treated with Concurrent Chemoradiotherapy

10.6692/KJN.201812_35(3).0013

蔡惠婷(Hui-Ting Tsai)；李榮真(June-Chen Lee)

多發性骨髓瘤 ； 焦慮 ； 照顧者角色緊張 ； Multiple myeloma ； anxiety ； caregiver role strain

高雄護理雜誌

35卷3期（2018 / 12 / 01）

142 - 154

繁體中文

本文敘述一位56歲初診斷為多發性骨髓瘤個案，面對化學治療及放射線治療之護理經驗。照護期間為2016年3月17日至4月1日，藉由觀察、會談、家屬訪談及Gordon十一項功能健康型態，發現個案有疼痛、焦慮、照顧者角色緊張等問題。照顧過程中提供個案舒適護理技巧，運用藥物及非傳統止痛藥物方式，減輕疼痛不適；提供相關衛教如標靶化療藥物、放射線治療居家照護衛教；與案妻建立信任關係；提供傾聽與陪伴，鼓勵與肯定案妻表現，降低其緊張不安的情緒，提升照顧者能力與信心。藉由陪伴、關懷、護病關係的建立，緩解個案在治療過程中的身心靈不適，提供完整的醫護資訊，增強個案面對疾病治療的信心，紓解家屬對於疾病照護過程中的壓力，期盼本照護經驗能提供護理人員照護類似病人的參考。

The article describes the nursing experience of a 56-year-old man with newly diagnosed multiple myeloma treated with chemotherapy and radiotherapy. Nursing care was provided from March 17th to April 1st, 2016. The author utilized clinical observation, mutual communication, and family interview to gather information and further analyzed it with the aid of Gordon's 11 Functional Health Patterns. The results revealed three major health problems: pain, anxiety, and caregiver role strain. During the caring process, we provided comforting nursing skills, applying medication and alternative therapy to relieve the patient's suffering. Moreover, we provided home healthcare education regarding chemotherapy medication and radiotherapy. Finally, we built a trust relationship with the patient's wife and tried to accompany, listen to and encourage her. Also, we gave recognition to her attempts to lower her insecurity and nervousness. It was expected that we could ease the patient of discomfort, strengthen the patient's confidence in the course of treatment, and relieve the family's stress during the caring process by providing thorough medical information and establishing the nurse-patient relationship. We hope that this nursing experience can serve as a reference for other registered nurses.