一位肺癌復發息者面臨不確定成之護理經驗

The Nursing Experience of Uncertainty in a Patient with a Case Presentation

10.7078/TSMHMNJN.200912.0261

蘇曉郡(Hsiao-Chun Su)；李美雲(Mei-Yun Li)

肺癌復發 ； Mishel疾病不確定感理論 ； 護理經驗 ； Lung Cancer Relapse ； Mishel's Uncertainty Theory ； the nursing experience

安泰醫護雜誌

15卷4期（2009 / 12 / 01）

261 - 270

繁體中文

本文在描述一位女性個案因肺癌復發導致一連串不確定感產生之護理經驗。護理期間為2008年12月22日至2009年1月19日，筆者經由觀察及會談方式，並運用Mishel疾病不確定感理論做為護理評估架構及擬定護理措施的指引，發現個案有(1)對疾病症狀的模糊及預後感到不確定感、(2)對疾病檢查的陌生與醫師主張不同之治療過程產生不確定感及(3)疼痛等健康問題，透過建立信任感及主動提供訊息，加強個案對疾病的認知，進而提升對疾病的控制感、減少不確定感。藉由此次照護經驗，期望能提供日復運用該理論在照護類似病患之護理人員，協助病患發展出合適的因應行為之參考。

The purpose of this report was to describe a nursing experience in helping a female patient of lung cancer relapse coping with her uncertainty between 22nd of December 2008 and 19th of January 2009. Mishel's Uncertainty Theory was applied as the framework to assess patient's uncertainty level and to design care plans. Data were collected through clinical observation, chart review, and interviews. Three nursing problems were identified: (1) uncertainty caused by symptoms and the prognosis of Lung Cancer relapse; (2) uncertainty caused by unfamiliar methods of inspection and inconsistently of doctor's opinion regarding treatment; (3) pain. By means of building trust with the care givers and providing disease related information, the patient's level of uncertainty had been reduced. From this experience, it is recommended that the nursing staff can apply the Mishel's theory when helping patients with lung cancer relapse developing appropriate coping strategies.