一位急性骨髓性白血病復發病人之不確定感照護經驗

The Nursing Experience of Caring for a Relapsed Acute Myeloid Leukemia Patient with Uncertainty

陳姵涵(Pei-Han Chen)；徐莞雲(Wan-Yun Hsu)

急性骨髓性白血病 ； 復發 ； 不確定感 ； acute myeloid leukemia ； relapsed ； uncertainty

志為護理-慈濟護理雜誌

13卷1期（2014 / 02 / 01）

111 - 120

繁體中文

本文探討一位急性骨髓性白血病復發病人，面臨疾病再次復發改變治療計畫，進而引發不確定感之照護經驗。筆者於2011年11月1日至11月24日護理期間，運用Gordon十一項健康型態模式進行評估，藉由觀察、會談、身體評估及出院電訪等方式收集資料，確立個案主要健康問題為（1）不確定感；（2）無效性保護能力；（3）口腔黏膜改變；（4）疼痛等四項。透過個別性護理活動之介入，協助個案面對疾病之不適，適應疾病復發的衝擊，並運用跨團隊照護模式，心理諮商師的介入及引導，讓病人及家屬勇於面對疾病。將此護理經驗提出分享，期望提供臨床護理人員照護病人之參考。

The paper discussed the nursing experience of a patient with acute myeloid leukemia, facing a sense of uncertainty induced by relapse of the disease and the modification to the treatment plans. The nursing period lasted from 1 to 24 Nov. 2011, the patient was evaluated using Gordon's 11 functional health patterns framework. Data were collected through observation, interview, physical assessment and telephone interviews after discharge. The following major health problems were found: (1) a sense of uncertainty; (2) invalidity protection; (3) oral mucosal changes; and (4) pain. Individual nursing interventions were employed to reduce the patient's discomfort and to adapt to the impact of disease relapse. Cross-team care model, psychological counselor intervention and guidance were used to provide support for the patient and families to cope with the disease. The nursing experience can provide a reference for clinical nursing care of patients in a similar condition.