癌症病人於門診化療時之情緒困擾的改善專案

Improving the Emotional Distress of Patients With Cancer Outpatients Undergoing Chemotherapy

10.6692/KJN.202408_41(2).0003

鍾文珍(Wen-Jean Chung)；張捷芸(Jie-Yun Jang)；鄒榮慧(Rung-Huei Tzou)；陳孟君(Meng-Chun Chen)

化學治療 ； 癌症 ； 門診病人 ； 情緒困擾 ； chemotherapy ； cancer ； outpatients ； emotional distress

高雄護理雜誌

41卷2期（2024 / 08 / 01）

23 - 33

繁體中文;英文

癌症病人經歷長時間在門診的化學治療後，容易出現情緒困擾，此會威脅病人的生活品質。故，本專案期能藉由專案以降低癌症病人在門診化療時的情緒困擾。本專案使用訪談及問卷調查以分析造成病人情緒困擾比率高的原因，其中包括：缺乏標準化護理指導與病人因為不了解而擔心化療副作用、缺乏病友照護支持團體、無腫瘤心理師轉介流程、門診化療環境缺乏溫馨感和資訊化叫號系統。現況分析後擬定的改善措施，包含：一、建立化療照護標準和化療衛教手冊以增進病人對化療的了解並降低對副作用的擔心；二、建立腫瘤心理師照會流程；三、門診化療室環境改造和設置溫馨留言板；四、增設資訊化叫號系統；五、每二週定期舉辦藝術治療活動；六、成立病友照護行動社群網路LINE支持團體等。結果發現：癌症病人困擾溫度計及心情溫度計之中、重度情緒困擾比率分別由90.0%降低至26.7%及66.7%降低至13.3%，達專案改善目的。

Patients with cancer are often prone to emotional distress after long-term outpatient chemotherapy. The purpose of this program was to improve emotional distress of cancer outpatients undergoing chemotherapy. An interview and structured questionnaire were used to collect data regarding the problems that lead to emotional distress in such patients, and six problems were identified: patients do not understand or are worried about the side effects of chemotherapy, patient care support group are lacking, standardized nursing education is lacking, no oncology psychologist referral process has been established, and electronic call systems are lacking. We sought to identify how to reduce the emotional distress of cancer outpatients undergoing chemotherapy. A program was developed in which the following interventions were applied: 1) Further development of the standard protocols of nursing education for chemotherapy and provision of a manual, 2) establishment of a psychologist referral process to provide counseling for patients with cancer, 3) establishment of a message board on which patients could express their feelings and receive feedback from a health-care professional, 4) establishment of an electronic call system, 5) establishment of art therapy activities patients could participate in twice a week, and 6) use of the LINE messaging app as a platform for providing health-care information to patients. After the implementation of the program, the Distress Thermometer scores significantly decreased from 90.0% at pre-test to 26.7% at post-test. Their five-item Brief Symptom Rating scores also significantly decreased from 66.7% at pre-test to 13.3% at post-test.

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