照顧一位肝癌復發個案行射頻燒灼術之護理經驗

The Nursing Experience of Caring for a Hepatocellular Carcinoma Recrudescence Following Radiofrequency Ablation

本篇報告在探討一位肝癌(Hepatocellular Carcinoma, HCC)復發個案行射頻燒灼術(Radiofrequency ablation, RFA)治療期間，因欠缺對醫療團隊治療的信心及對癌症復發治療後的預後產生不確定感，進而產生的生、心理問題。護理期間為2008年7月15日至7月20日止總共5天，於照護期間運用身體評估、觀察及訪談等方式收集個案相關資料，並運用Gordon十一項功能性健康型態評估，確立個案主要有三個健康照護問題為：知識缺失、疼痛及焦慮。針對這些問題，在治療過程中透過護理專業及協同醫療團隊合作下，提供個案及家屬詳細的治療訊息，讓他們能充分了解治療的過程和預後，並澄清他們不確定的部份，同時主動傾聽及關懷，進而使個案及家屬，在治療過程中，皆能信任與配合醫護人員的指導，讓個案於出院前疼痛狀況已緩解，並能自行面對及處理焦慮之情緒。因此，此護理經驗希望提高護理人員在照護此類病患時，能適時提供明確相關醫護之訊息，藉以提升醫護病之間的信任關係，減少個案在治療中的不信任感及疑慮，以促進個案返家後自我照護的品質。

This report discussed the nursing care experience of a patient who received follow-up radio frequency ablation (RFA) treatment because of hepatocellular carcinoma recrudescence. The author used Gordon’s eleven health functional types to evaluate and collect information from July 15, 2008 to July 20, 2008. The results indicated that the patient had nursing problems including knowledge deletion, pain, and anxiety. We established therapeutic relationship with the patient and provided individualized care to the patient to relieve the anxiety level of the patient and provided psychological support. Relevant information were also provided before treatment. After the treatment, the nursing problems were adequately and appropriately taken care of to improve the patient’s wellbeing and physiological functions. The patient was able to perform self-care at home eventually.