照護一位原發部位不明之癌末病人之護理經驗

Nursing Experience of Caring a Terminal Cancer Patient with Malignant Unknown Origin

10.6530/YYN.202407_18(2).0011

洪于雯(Yu-Wen Hung)；潘雪幸(Hsueh-Hsing Pan)

原發部位不明癌 ； 癌末病人 ； 護理經驗 ； Malignant unknown origin (MUO) ； terminal patient ； cancer patient ； nursing experience

源遠護理

18卷2期（2024 / 07 / 01）

85 - 91

繁體中文;英文

本文為照護一位原發位不明癌，合併結腸、眼眶、硬腦膜及腹膜轉移病人之照護經驗，筆者照護期間為2020年12月1日至2020年12月23日，運用觀察、會談、身體評估及查閱病歷等方式收集資料，以Gordon 11項健康型態進行評估，確認個案有低效型呼吸型態、慢性疼痛、焦慮之主要健康問題。護理期間藉由手持式風扇配合氧氣治療及舒適坐姿以改善呼吸困難之感受，使呼吸困難指數由5分降至1分；使用病人喜愛種類之音樂療法及按摩療法以改善頭部及腹部之疼痛情形，疼痛指數由7分降至1分；運用呼吸放鬆技巧、芳香療法、音樂療法、舒適之環境燈光及溫度、使病人參與照顧的決策等方法，配合會談以鼓勵病人說出內心憂慮之處，焦慮指數由6分降為1分。照護期間因疫情緣故，以致於無法與家屬蒐集更完整的資料，未來建議可採用視訊或通訊軟體，增加資料蒐集的完整性。

This article describes a nursing experience of a terminal cancer patient with unknown origin combined with multiple organs, such as colonic, orbital, dural, and peritoneal metastases. The collected data were based on Gordon's 11 functional health pattern assessment with observation, interviewing, physical assessment and chart review between December 1 to 23, 2020. Nursing problems were identified as ineffective breathing pattern, chronic pain and anxiety. A hand-held fan with oxygen and comfortable sitting was used to improve the perception of dyspnea. Patient reduced her dyspnea severity from 5 to 1 point. We used music therapy and massage therapy to improve her head and abdominal pain by 7 to 1 point. We also used breathing relaxation, aromatherapy, music therapy, comfortable lighting and temperature, and patient involving with the decision making, as well as to encourage the patient to talk about her worries. The anxiety severity of patient reduced from 6 to 1 point. Due to the pandemic of COVID-19, it was a little difficult to collect more comprehensive information from the family members. Therefore, it is recommended to use video or communication software to increase the comprehensive data collection in the future.