一位腦瘤術後併放射線治療個案之護理經驗

Nursing Experience with a Brain Tumor Patient Who Received Craniotomy and Radiotherapy

此篇個案報告為呈現照顧一位腦瘤術後併放射線治療個案之護理經驗，護理期間為93 年4月12日至93年5月15日。筆者經使用Gordon 11項功能性健康型態評估後，發現個案的主要護理問題為組織灌流改變/腦、潛在危險性感染、口腔黏膜改變及身體心像紊亂。筆者藉由神經學的監測、避免顱內壓上升的活動、口腔護理、感染的預防及傾聽與讚美等措施，再加上家庭支持系統的發揮，使得個案在照護期間能勇敢地面對自己身體心像的改變並願意與他人互動；護理人員除協助個案面對及解決健康問題，同時陪伴個案渡過疾病不適期。藉此提出此個案之護理過程，於專業領域中做經驗分享。

This report described the nursing experience when caring for a brain tumor patient who had received craniotomy and radiotherapy. The nursing period was from April 12th to May 15th, 2004. The Gordon 11-item health assessment was used to identify problems in the nursing process. The main nursing problems included cerebral tissue damage, the risk of infection, an impaired oral mucous membrane and a disturbed body image. Thus, the nurses not only monitored the patient's neurological condition in order to prevent increased intracranial pressure but also provided oral care, infection prevention and mental support. In addition to nursing care, family members provided continuous support by listening to the patient and giving the patient encouragement. Finally, the patient adapted to the experience in a positive manner. The nurses helped the patient to face and solve the health problems and this allowed the patient to accommodate to the impacts of the disease. This nursing experience is presented as a reference for nurses who are taking care of patients with brain tumors and similar therapies.