一位成人急性淋巴性白血患者接受化學治療之照護經驗

The Nursing Experience of an Adult Acute Lymphoblastic Leukemia Patient Undergoing Chemotherapy

惡性腫瘤自民國71年起，居台灣十大死因之首位，其中，白血病屬於血液腫瘤之惡性疾病。本文是在敘述照顧一位急性淋巴性白血病患者接受化學治療之護理經驗，筆者護理期間自93年2月14日至3月11日，藉由會談、觀察、檢閱蒐集資料，將內容加以分析整理，運用Gordon十一項健康功能評估個案有：潛在危險性感染、潛在性合併症/出血、焦慮、社交隔離等問題，筆者藉由陪伴傾聽、建立良好關係、多次用心提醒衛教、有效的溝通、與家屬會談等措施，減少化療合併症發生、解除個案心中長期對罹患疾病的不了解與反覆入院行化學治療所產生的焦慮。在臨床上，護理人員為第一線照護病患的醫療人員，也是每天與患者互動最多、最直接的醫療人員，在面對日益增加的癌症患者需接受化學治療時，如何去給予完善照護實為重要，因此，透過文獻探討進而擬討完善的護理計畫與提供合宜適切的護理措施，讓護理人員面對此類癌症病患接受化療治療時，能給予身、心、靈各方面的完整性護理。

This study reported the nursing experience of caring an adult acute lymphoblastic leukemia patient underwent chemotherapy. During the nursing period, we collected data through interview, observation, interaction with the patient and family, and review of medical chart. The Gordon’s functional health assessment guide was used to identify health problem. The patient had four major nursing health problems, including risk for infection, risk for bleeding, anxiety, and social isolation. The author applied persistent caring, provided related information, listened to negative feelings, established good nursepatient relationship, engaged effective communication, and prevented chemotherapy complications to help patient cope with the consequence of disease, such as anxiety. This paper provided nurses with a reference for caring similar patients in the future. In addition to resolving physical discomfort, mental support should be emphasized to achieve holistic nursing.