照顧一位青春期癌症復發病患之護理經驗

Nursing Experience for a Cancer Recurrence Patient in Puberty

本文旨在探討一位白血病之青春期患者，在得知自己病情復發後所面臨的身、心衝擊與調適經過。護理期間自93年12月17日至93年12月29日，運用Gordon十一項功能性健康型態評估工具，經由會談、觀察等方式，收集主、客觀資料，確立個案的問題有：「身體心像改變」、「個人因應失調」、「危險性損傷」與「口腔黏膜潰瘍」等護理問題。在瞭解個案過去的治療經驗後，尊重個案對治療方式的選擇，並考量個案人生階段的發展任務，以溝通、同理之技巧，藉由個別性及完善的護理措施後，使得個案能接受自己身體外觀的改變，並能自行說出對疾病復發的想法及感受，及能瞭解血小板減少時的自我照顧，以及使口腔黏膜潰瘍改善且潰瘍情形變薄。並持續提供個案支持、鼓勵，提升其自我照顧及調適能力，以維持最佳之生活品質。筆者藉此個案報告的護理經驗提出與護理人員分享，以助提升日後照護此類病患的參考。

This case report discusses the impact on the mind and body of a cancer recurrence patient in puberty, as he comes to terms with, and adjusts to, a recrudescence in his illness, in our study of the nursing process, we used Gorden's assessment tools for health patterns and gathered subjective or objective information through interviews and observations to establish case problems (i.e., ”changes in body and mind”, ”personal maladjustments related to changes” ”injuries of high risk” and ”oral cavity mucosa ulcers”, etc.). After gaining an understanding of the previous medical treatments employed in this case, in a way of respecting the medical selection and considering the developmental task at the stage of life, we provided support and encouragement through appropriate communications and expressions of sympathy with the objective of enhancing patient self-caring and capacity for adjustment in order to help the patient achieve the best possible quality of life.