鼻咽癌病人放射線皮膚炎自我照護改善專案

A Comprehensive Project to Improve Self-Care for Radiation Dermatitis in Patients with Nasopharyngeal Cancer

10.6880/TJON.202212_22(2).03

胡筱慧(Hsiao-Hui Hu)；汪子平(Tzu-Ping Wang)；徐育寗(Yu-Ning Hsu)；張于慧(Yu-Hui Chang)；程繼鳳(Chi-Feng Cheng)；李淑瓊(Shu-Chiung Lee)

放射線皮膚炎 ； 鼻咽癌 ； 皮膚自我照護 ； radiation dermatitis ； nasopharyngeal cancer ； skin self-care

腫瘤護理雜誌

22卷2期（2022 / 12 / 01）

35 - 48

英文

鼻咽癌病人接受放射治療，高達95%會發生放射線皮膚炎，不僅影響生活品質，嚴重時更迫使治療中斷。臨床發現鼻咽癌病人皮膚自我照護正確率低，分析原因：護理人員指導內容不一致，使病人自我照護正確率低；因播放影片設備準備耗時，使得影片使用率低；護理人員認知正確率低，導致病人未接受到完整之護理指導。本專案目的為提升病人放療皮膚自我照護正確率提高至85%及護理人員放射線皮膚炎照護認知正確率提高至93%。透過增加團體護理指導場次、制定放射線皮膚炎護理指導查檢表、設計創意教學課程、製作影片QR code等措施，使病人皮膚自我照護正確率由53.3%提升至86.7%，進步率為62.6%、護理人員放射線皮膚炎照護認知正確率由79.2提升至96.2%，進步率為21%，達成本專案目的，護病雙方之照護品質皆有所提升。

Radiation dermatitis occurs in up to 95% of patients with nasopharyngeal cancer receiving radiotherapy, which not only affects the quality of life, but also forces treatments to be interrupted in severe cases. It is clinically found that the actual rate of skin self-care performance in patients with nasopharyngeal cancer is low. The reasons for this include discrepant guidance between nurses, low rate of usage of video due to time-consuming preparation of video equipment, and relatively low accuracy of skin self-care knowledge of nurses. The goal of this project is to increase the rate of patients' skin self-care performance to 85%, and that of nurses' skin self-care knowledge to 93%. Measures used in this project included increasing frequency of group patient education, use of nursing guidance checklists, designing creative courses and generating QR codes for videos of skin self-care. Through the above measures, the recommended rate of patients' skin self-care performance was augmented from 53.3% to 86.7% (progress rate = 62.6%), and that of nurses' skin self-care knowledge from 79.2% to 96.2% (progress rate = 21%), both reaching the project goals. The quality of care for both the patients and the nurses had been improved.

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