一位初診斷肺癌併腰椎轉移病人之照護經驗

Nursing Experience of a Newly Diagnosed Lung Cancer Patient with Lumbar Metastasis

林珈羽(Chia-Yu Lin)；潘慧娟(Hui-Chuan Pan)；沈桂鳳(Kuei-Feng Shen)；江彥萩(Yen-Chiu Chiang)；李月麗(Yueh-Lih Li)

肺癌 ； 腰椎轉移 ； 疼痛 ； 營養不良 ； 焦慮 ； Lung Cancer ； Lumbar Metastasis ； Pain ； Malnutrition ； Anxiety

安泰醫護雜誌

30卷1期（2024 / 06 / 01）

71 - 83

繁體中文;英文

本文為一位70歲退休女性，面臨初診斷肺癌之煎熬，曾一度表示拒絕所有治療。筆者在2020年4月28日至5月25日，運用觀察、會談及查閱病歷等方式收集資料，確立個案有疼痛、營養少於身體所需、焦慮的健康問題，提供個別性照護：教導深呼吸及穴位按摩，減緩生理上疼痛不適；擬定「食指大動」飲食計劃表並搭配彩色圖片，增加食慾；藉由啟動跨團隊會議，與病人及家屬進行雙向溝通，瞭解其所關注的重點，協助釐清疑問與決策困境，讓病人及家屬瞭解肺癌合併腰椎轉移不同治療與優缺點，最後個案選擇最適切的治療來延續生命，進而重回家庭生活。希望藉此經驗分享，提供日後臨床照護初診斷癌症末期病人之參考。

The case report described a 70-year-old retired woman who was diagnosed with metastatic lung cancer and refused all treatment.During the period of nursing care from April 28 to May 25, 2020. Through observations, interviews, and medical records to gather data, and establish that the case had health problems, which included pain, nutrition less than body requirements, and anxiety. We provided individual care that teaches deep breathing and acupressure massage to alleviate the patient's physical pain; draw up an "index finger movement" diet plan and match color pictures to increase appetite. By launching multidisciplinary team meetings, mutual communication, and understanding the concerns of the patient and her family, understanding the focus of the patient and her families, helping to clarify questions and decision-making difficulties, so that the case and his families could understood the advantages and disadvantages of different treatments for lung cancer combined with lumbar metastasis. Finally, the case chooses the most appropriate treatment to extend her life and return to domesticity. Hopefully, sharing this nursing experience to provide a reference in the future for to care patients, who are initially diagnosed with cancer.