一位初診斷肝癌末期合併脊髓壓迫患者之護理

Nursing Experiences: A Patient of hepatocellular carcinoma presenting with spinal Cord Compression

本文為探討一位初診斷肝癌併有骨轉移產生脊髓壓迫而入院治療之護理過程，於94.3.20-94.4.10護理期間，筆者運用羅氏適應理論，以生理功能、自我概念、角色功能、相互依賴等四種適應導向的護理概念為架構，經觀察、會談、身體評估等方式收集資料，確定個案住院期間主要護理問題包括：(1)無望感(2)身體活動功能障礙(3)潛在危險性感染。筆者以持續性及主動關懷的態度與個案建立信任性護病關係，除協助個案維持生理功能外，並運用希望建立之照護技巧，經由維持正向社交活動，提供相關醫療訊息，使個案重新肯定自己存在的價值與意義，接受疾病已末期的事實，並在護理人員及家屬支持下，使個案在癌症末期的歲月中能有最佳的適應情形，面對疾病及未來生活。

This article explores the nursing process on a patient diagnosed with hepatocellular carcinoma with the compression of the spinal cord during the time from March, 20 to April, 16 in 2005.Researcher used Roy's adaptation theory , which is concerned with the physical function, self cincept, and role function, independence. Data collected through observation, conversation, and physical examination. The main nursing problems during the hospitalization include the difficulties of physical function, the potential risk of infection, and a sense of hopeless. I establish the nursingpatient relationship by a positive attitude that gives care continually and actively. Aside from physical care, I use nursing skills like encouraging him to have social activities and offering him medical information to help the patient feel valuable and meaningful toward life, and to help the patient to receive the fact of the last stage of the disease. Supported by the nurse and family, the patient can adjust well to face the fact of illness and life in the future.