運用Swanson關懷理論照護初診斷鼻咽癌病人接受放射線治療之護理經驗

Nursing Experience in Using Swanson's Caring Theory to Care for Patients with Newly Diagnosed Nasopharyngeal Carcinoma who Receive Radiotherapy

10.6880/TJON.202406_24(1).05

蔡宛倪(Wan-Ni Tsai)；蔡妙青(Miaw-Ching Tsai)

焦慮 ； 鼻咽癌 ； 口腔黏膜炎 ； 疼痛 ； Swanson關懷理論 ； anxiety ； nasopharyngeal carcinoma ； mucositis ； pain ； Swanson's caring theory

腫瘤護理雜誌

24卷1期（2024 / 06 / 01）

55 - 66

繁體中文;英文

本文為一位初診斷鼻咽癌中年女性於門診接受放射線治療（放療）之護理經驗，照顧期間為2022年1月30日至3月20日，筆者利用個案每日至門診治療時，以觀察及訪談等方式收集資料，運用Gordon十一項功能性健康評估模式進行護理評估，確立個案有疼痛、口腔黏膜改變及焦慮的健康問題。個案在疾病診斷初期即出現焦慮負面情緒，故筆者運用Swanson關懷理論的五大過程，首先主動建立治療性人際關係，和個案約定利用每週二次訪談，提供個別性護理措施，經由「了解」、「在旁陪伴」鼓勵個案表達對疾病擔憂及內心感受，運用「為他做某些事」、「使他能夠」的過程，治療期間加強提供對止痛藥使用、口腔護理、疾病與放療疑慮等相關訊息，提供護理指導及輔助療法解決照護疑慮及緩解緊張焦慮，藉由跨領域的團隊合作，運用癌症資源窗口及病友的介入來強化支持系統，使個案能「維持信念」，以正向的態度面對疾病且順利完成治療。本文藉此護理經驗與同仁分享，建議護理人員未來可運用主動關懷於臨床照護，提供個別性照護計畫，增加個案對疾病的認知與自我照顧技巧，進而協助個案能順利完成艱苦的療程。

This article is about the nursing experience of a middle-aged woman with newly diagnosed nasopharyngeal cancer who received radiotherapy in an outpatient clinic. The care period was from January 30, 2022 to March 20, 2022. The author used the case to observe when she went to the outpatient clinic every day. Data were collected through interviews and other methods, and the Gordon 11-item functional health assessment model was used to conduct nursing assessments to identify health problems such as pain, oral mucosal changes, and anxiety. The patient developed anxious and negative emotions at the early stage of disease diagnosis. Therefore, the author used the five processes of Swanson's caring theory to first proactively establish therapeutic interpersonal relationships, and agreed with the patient to use two interviews per week to provide individual nursing measures. Through "understanding", " "Stay by your side" encourages patients to express their worries and inner feelings about the disease, and uses the process of "doing something for him" and "enabling him to do it". During treatment, it strengthens the provision of relevant information on the use of painkillers, oral care, disease and radiotherapy concerns, etc. , providing nursing guidance and auxiliary therapy to resolve care concerns and relieve stress and anxiety. Through cross-disciplinary teamwork, the cancer resource window and the intervention of patients with the disease are used to strengthen the support system, so that patients can "maintain their faith" and maintain a positive attitude. Face the disease and successfully complete treatment. It is recommended that nursing staff use active care in clinical care, provide individualized care plans, increase patients' understanding of the disease and self-care skills, and help patients successfully complete difficult treatment courses. This nursing experience can be shared with colleagues and used as a clinical practice in the future. Care reference.