一位初次診斷急性骨髓性白血病青少女之護理經驗

Nursing Experience of A Teenage Girl with First Time Acute Myelogenetic

黃子芮(Tzu-Jui Huang)；許雅欣(Ya-Hsin Hsu)

急性骨髓性白血病 ； 青少女 ； 陪伴 ； Acute Myelogeneticleukemia ； Teenage Girl ； Presence

若瑟醫護雜誌

16卷1期（2022 / 03 / 01）

139 - 150

繁體中文

本文描述一位17歲初次診斷急性骨髓性白血病青少女之護理經驗，護理期間109年3月12日至4月10日，處於以化療為主銜接造血幹細胞移植階段，透過實際照護及病歷收集資料方式，確立個案健康問題有：焦慮、身體心像絮亂、無效性保護能力。焦慮方面以陪伴確認引發個案焦慮情緒的因素，主動提供疾病治療計畫，以降低不確定感，利用執行瑜珈運動、打電玩轉移注意力、父母親引領信仰力量介入、介紹骨髓移植成功之志工經驗分享，進而順利調適疾病引起的焦慮感；身體心像絮亂方面以同理傾聽鼓勵個案分享內心感受及自身優點，重建正向之身體心像，並增進其社交活動；無效性保護能力方面運用症狀護理，減輕化療副作用之生理不適，藉由執行衛教後不斷提醒個案重視自我保護的重要性，提升護理措施的實質成效，降低其合併症的發生，希望藉由本文統整，提供日後護理人員於臨床參考。建議重視罹癌青少女維持同儕互動之發展需求，避免社交隔閡，將青少女身體心像改變相關評估工具納入護理常規，重建正向身體心像為青少女銜接學校做好準備。

This article describes the nursing experience of a 17-year-old teenage girl with first timeacutemyelogeneticleukemia. During the nursing period from March 12 to April 10, 109, she was in the stage of chemotherapy-based hematopoietic stem cell transplantation, and collected data through actual care and medical records. Establish case's health problems include: anxiety, disturbed body image, and ineffective protection. In terms of anxiety, accompany to identify the factors that trigger the case's anxiety, actively provide disease treatment plans to reduce the sense of uncertainty, use yoga exercises, play video games to divert attention, parents lead the power of faith to intervene, and introduce volunteers who have succeeded in bone marrow transplantation experience sharing, so as to smoothly adjust to the anxiety caused by the disease. In terms of disturbed body image using empathetic listening to encourage the case to share inner feelings and their own strengths, rebuild the positive body image, and enhance their social activities. Use symptoms care for ineffective protection, to reduce the physical discomfort caused by the side effects of chemotherapy, by constantly reminding the case of the importance of self-protection after the implementation of health education, enhancing the actual effectiveness of nursing measures, and reducing the occurrence of comorbidities. It is hoped that this article will be integrated to provide clinical reference for future nursing staff who care teenage girls with acute myelogeneticleukemia. It is recommended that attention should be paid to the development needs of teenage girls with cancer to maintain peer interaction, avoid social barriers, incorporate assessment tools related to changes in the body and mind of teenage girls into nursing routines, and rebuild positive body and mind to prepare teenage girls for joining schools.

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