照護一位肝癌併發頸椎轉移病患之照護經驗

Caring for a Hepatic Cancer Patient with Cervical Vertebral Metastasis

10.6880/TJON.201903/SP_19.06

謝佳珉(Chia-Min Hsieh)；林靖芸(Jing-Yun Lin)

肝癌轉移 ； 無望感 ； 照顧者角色緊張 ； Hepatic carcinoma metastasis ； hopelessness ； caregiver anxiety

腫瘤護理雜誌

19卷增訂刊（2019 / 03 / 01）

65 - 76

繁體中文

肝癌位居癌症死亡率第二，佔男性死亡率67.9%。本文探討一位肝癌併發頸椎轉移病患之護理經驗，因肝癌併發頸椎轉移產生疼痛，而出現哭泣、無望等情緒，又因案妻對照護感到徬徨、不知如何抒發哀傷情緒及照護病患，故引發筆者書寫動機。照護期間自2016年3月5日至3月19日，運用Gordon（高登）十一項健康功能模式評估，藉由會談、觀察及身體評估收集資料發現病患有疼痛／與癌症脊椎轉移有關、無望感／與罹癌後身體狀況惡化及照顧者角色緊張有關／與缺乏相關照護技能有關，藉由精油及按摩等方式，可幫助緩解疼痛，增加對於自我身體不適因應能力，鼓勵家屬參與日常照護活動，如：擦澡及美手美足，同時藉由宗教支持，使個案體會生命意義及價值，勇於面對疾病，以個案及家屬為中心，提供全人、全家、全隊、全程之照護。

Hepatic carcinoma has the second highest mortality rate, accounting for 67.9% of male mortality. This paper discusses the care provided for a hepatic cancer patient with cervical vertebral metastasis. The pain from the metastasis to the C3 vertebra caused crying and hopelessness. The patient's wife was uncertain about how to provide care and alleviate distress, which led to the motivation for this paper. Care was provided from March 5 to March 9, 2016. Gordon's functional health patterns were used to assess the patient through conversation, observation, and physical evaluation. Data collected found that the patient suffered from metastasis-related pain, hopelessness due to deteriorating physical condition, and caregiver anxiety due to lack of skills. Essential oils and massage were used to relieve pain and improve emotions which further helped the patient cope with his situation. Family was encouraged to participate in daily activities, including bathing and maintaining personal hygiene. Religion was introduced to help the patient realize the meaning and value of life and have the courage to face the disease course. The comprehensive care was centered on the patient and family.

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