鼻咽癌患者接受門診放射線治療之護理經驗

A Nursing Experience for a Patient with Nasopharyngeal Cancer Receiving Radiation Therapy

本文為探討一位罹患鼻咽癌病患接受門診放射線治療之護理經驗。作者於2010年6月14日至2010年8月12日照護期間，藉由每日門診治療時間，以觀察、會談、陪伴傾聽、身體評估及電訪方式收集資料，運用Gordon十一項功能健康型態評估，確認有口腔潰瘍疼痛導致無法正常攝取食物，進而體重減輕；又因身為家中主要經濟來源提供者，擔心無法工作，明顯表現出心理層面的焦慮等問題。因此針對生理問題，給予個別性護理措施，改善疼痛、營養及口腔黏膜炎不適的生理問題，維持個案基本需求。處理心理層面問題則鼓勵個案表達感受、主動參與治療與處置，減輕焦慮，且尋求多項醫療團體支持系統，如營養師、社工師、宗教師等，使個案能順利的完成療程，減輕各層面護理問題，提升日常生活品質，並提供護理人員於照顧相關個案時之參考。

This article describes a nursing experience of caring for a patient undergoing radiation therapy for nasopharyngeal cancer. During the nursing period from June 14 to August 12, 2010, the author collected data through patient observation, face-to-face conversation, listening, physical assessment, and telephone interview. Data were analyzed using Gordon's 11 functional health patterns tool. The identified nursing problems included oral ulcer pain leading to poor food intake and weight loss. The patient, as the major financial provider for the family, was worried about the inability to work. To meet the patient's basic physical needs, the author provided individualized care including pain relief, nutritional support, and treatment of oral ulcers. For the patient's psychological needs, the author encouraged the patient to express internal feelings and actively participate in treatment, which would lessen the patient's anxiety. Moreover, the search for resources in medical support systems, such as dieticians, social workers, and chaplains, helps the patient successfully go through therapy courses, minimize various nursing problems, and promote quality of life. The author hopes that this report can be used as a reference for other nurses taking care of patients in similar situations.