一位乳癌合併放射性皮膚炎病人之護理經驗

Nursing Experience Of A Patient With Breast Cancer Complicated With Radiation Dermatitis

曹慧如(Hui-Ru Tsao)；曾斐祺(Fei-Chi Tseng)

放射性皮膚炎 ； 急性疼痛 ； 焦慮 ； Radiation dermatitis ； Acute pain ； Anxiety

安泰醫護雜誌

30卷1期（2024 / 06 / 01）

43 - 55

繁體中文;英文

本文描述一位皮膚轉移之乳癌病人，因放射線治療後出現放射性皮膚炎之護理經驗，照護期間為2019年12月26日至2020年1月20日。筆者藉由實際照護、身體評估、會談及病歷查閱方式收集資料，依生理、心理、社會與靈性四個層面進行整體性評估，確立個案有急性疼痛、皮膚完整性受損，以及焦慮等生、心理健康問題。照護過程中，運用藥物與非藥物緩解個案急性疼痛；教導放射性皮膚炎相關照護措施、選擇適宜敷料及降低換藥頻率；並經由醫療團隊釐清傷口照護模式，協助個案建立自信及自我照護能力，引導焦慮調適並以正向態度面對疾病治療，使其能繼續接受癌症療程。期望藉此護理經驗提供護理人員日後照護此類病人之參考。

This article was inspired by a breast cancer patient with skin metastatic carcinoma, induced radiation dermatitis after receiving a series of radiation therapy course. Throughout December 26th, 2019 to January 20th, 2020, patient data was collected by physical assessment, interviews and medical records referencing, suggesting patient's concerns with acute pain, impaired skin integrity and anxiety. Advocated actions raised attention in both nursing and medical teams. The relief of acute pain was effective with medical treatment, whereas collaborative care reduced radiation dermatitis symptoms. In coordination with wound care guidance and self-care reinforcement, patient's anxiety status eventually levelled and received cancer treatment. This case shares an alternative nursing care perspective and seeks to extend the knowledge and skill for further similar cases.