一位肝癌患者初次接受週波腫瘤燒灼術的護理經驗

Project to Develop a Timesaving Technique for Preparing Outgoing Fresh Frozen Plasma Radiofrequency Ablation Treatment

本文為敘述一位肝癌患者初次接受週波腫瘤燒灼術的護理經驗。護理期間為2008年1月28日至2008年1月30 日，運用羅氏適應理論為護理架構，藉由觀察、會談及傾聽方式進行資料收集，經護理評估分析發現個案有焦慮、急性疼痛、知識缺失三項健康問題。在提供適切的護理措施及個別指導後，在焦慮方面：個案會適時表達出其內心的感受，對疾病及治療的焦慮也逐漸降低；在急性疼痛方面：可以正確執行疼痛控制技巧來緩解疼痛，疼痛分數由7分降為1-2分；知識缺失方面：經了解個案對疾病的認知程度後給予合宜的衛教，可說出治療相關注意事項及定期追蹤的重要性，於1/30順利出院。筆者發現肝癌患者接受週波腫瘤燒灼術之住院天數雖不長但肝癌復發機率高，護理過程中透過治療關係的逐步建立，並傾聽個案及其家人的感受，給予個案整體性照護，以增加個案的自信心及問題解決能力。因此期望藉由此個案報告，提供護理同仁參考，使肝癌患者在治療過程中能得到完善的照顧。

This article describes the experiences of nursing a liver cancer client who received the first radiofrequency ablation (RFA) treatment. The nursing period extended for two days in January 2008. Using Callista Roy’s Adaptation Model as a nursing framework, information was collected through observations, interviews and attentive listening. After evaluation and analysis from a nursing perspective, three health issues were identified: anxiety, acute pain and cognition deficiency. After taking proper nursing measures and consulting with the client, these issues have improved and the client’s anxiety about the disease and the treatment has reduced. Pain control has reduced the client’s acute pain from 7 to 1-2 on the pain scale. After establishing the client’s baseline knowledge about the disease, and educating the client about appropriate hygiene, cognition has improved. The client was discharged after two days in hospital but the recurrence rate for liver cancer patients receiving RFA is high. This article shows that by establishing a nurse-patient relationship and listening attentively to clients and their families, nursing care can be more integrated and client self-confidence and problem-solving capability can be enhanced for liver cancer patients.