照顧一位老年淋巴瘤病人住院接受化學治療之護理經驗

Nursing Experience of a Hospitalized Elder Lymphoma Patient Receiving Chemotherapy

10.6740/NTUHJN.202101_17(1).0005

林渂嬥(Wen-Di Lin)；李姵萱(Pei-Hsuan Lee)

淋巴瘤 ； 老年病人 ； 住院 ； 化學治療 ； 自我照顧 ； lymphoma ； elderly ； hospitalization ； chemotherapy ； self-care

臺大護理雜誌

17卷1期（2021 / 01 / 01）

40 - 52

繁體中文

本文為描述照顧一位老年淋巴瘤個案於住院接受化學治療期間經歷體力下降，進而導致情緒低落且不肯配合治療之護理經驗。護理期間自2018年6月27日至8月16日，藉由直接照護、觀察、會談、病歷查閱等方式收集資料，依身體、心理、靈性、社會等面向進行護理評估，確立個案有「現存性感染」、「自我照顧能力下降」及「無望感」等健康問題。照護過程中藉由主動訪視陪伴，透過協助個案處理生理問題建立良好護病關係，再進一步瞭解個案的內心想法，提供嗜中性球低下及身體清潔相關之個別性護理指導，與心理師、復健科醫師及物理治療師提供跨團隊之共同照護，使個案順利出院返家，並可於返家後持續執行住院期間所學習之照護技巧。建議類似病人返家時可先行與個管護理師聯絡，由個管護理師協助於病人返回門診時進行後續追蹤照護，提高照護成效的持續性。

This article describes the nursing experience of a hospitalized elder lymphoma patient who developed weakness and depression and refused to cooperate with treatment after receiving chemotherapy. The nursing care occurred from June 27 to August 16, 2018. Through direct care, observation, interviews, and a medical chart review, we were able to assess physical, psychological, spiritual, and social aspects. The identified health issues included infection, reduced self-care ability, and hopelessness. We established a good relationship throughout the patient's hospitalization, resolved the patient's physical discomfort and clarified the thoughts of the patient. We also provided personalized health education for neutropenia and essential personal hygiene. Moreover, we consulted a psychologist, rehabilitation physician, and physical therapist for combined care. The patient discharged in good condition and continued to implement the self-care skills that were learned during hospitalization. To achieve continuous quality of care, we recommend referring patients to an oncology nurse manager before discharge who can provide personalized continuous nursing care in the outpatient department.