放射線治療病人皮膚自我照護之改善專案

A Project to Improve Skin Self-Care for Patients Receiving Radiation Therapy

曾雅雪(Ya-Hsueh Tseng)；許美玉(Mei-Yu Hsu)；林雅萍(Ya-Ping Lin)；徐小惠(Hsiao-Hui Hsu)；楊佩雯(Pei-WenYang)；王淑貞(Shu-Chen Wang)；鍾惠君(Hui-chun Chung)

放射線皮膚炎 ； 實證 ； 皮膚自我照護 ； 專案 ； evidence-based ； project ； radiation dermatitis ； skin self-care

志為護理-慈濟護理雜誌

17卷5期（2018 / 10 / 01）

77 - 88

繁體中文

背景：放射線皮膚炎是放射線治療中不可避免症狀，但可藉由預防避免嚴重損傷。單位因連續發生嚴重放射線皮膚炎，造成病人生理不適與延長住院天數，引發執行專案動機。經分析發現，病人皮膚自我照護行為錯誤率達63.6%，放射線皮膚炎發生率25%。目的：降低病人皮膚自我照護行為錯誤率至20%以及嚴重放射線皮膚炎發生率至15%。方法：透過建立以實證為基礎的皮膚自我照護組合措施，提供病人完整與正確衛教訊息；發展緩解皮膚不適症狀方法。結果：病人皮膚自我照護行為錯誤率由63.6%降低為16.7%；嚴重放射線皮膚炎發生率由25%下降至6.3%，持續追蹤呈現改善成效。結論：透過跨團隊溝通並提供以實證為基礎的皮膚自我照護組合衛教指導，能提高病人自我照護行為，有效降低嚴重放射線皮膚炎發生。

Background: Radiation dermatitis is an inevitable side effect of radiation therapy. However, severe damage can be avoided through preventive interventions. Several severe radiation dermatitis events were reported in our otolaryngological unit that caused physical discomfort in patients and prolong their length of hospital stay. This served as the motivation of this improvement project. According to analysis, the rate of improper skin self-care among patients receiving radiation therapy was 63.6%, and the incidence of severe radiation dermatitis was 25%. Purpose: This project aimed to reduce the rate of improper skin self-care to 20%, and the incidence of severe radiation dermatitis to 15%. Methods: Through a structured evidence-based review process, a skin-care bundle was designed to provide patients with integrated and correct health care information. Additionally, methods for alleviating the symptoms of skin discomfort were developed. Results: The rate of improper skin self-care decreased from 63.6% to 16.7%; the incidence of severe radiation dermatitis significantly decreased from 25% to 6.3%. Long-term patient prognoses have continued to improve. Conclusion: Cross-team communication, coupled with the evidence-based skin bundle care, can improve self-care behaviors in patients and effectively reduce the incidence of severe radiation dermatitis.

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