運用輔助療法於照護一位血液透析合併結腸癌患者無望感之護理經驗

Using Complementary Therapy with a Hemodialysis Patient with Colon Cancer and a Sense of Hopelessness

血液透析患者經常發生無望感，長期出現無望感會影響病患身、心、靈健康，甚至對生命造成威脅。本文探討照護一位洗腎患者合併癌症之雙重重大疾病打擊所產生無望感之護理經驗。筆者於照護期間以羅氏適應理論為評估架構，藉由身體評估、會談、觀察家庭互動及查閱病歷等方式收集資料，發現個案出現悲觀、情緒低落、嘆氣、皺眉、閉目、呈負向思考等無望感之特徵。針對個案無望感之護理問題，運用希望建立及使用安全、簡單、非侵入性的輔助療法，包括音樂療法、芳香療法及精油按摩等方式改善個案的身、心問題，讓個案學習自我釋放壓力，並鼓勵表達感受，且適應因疾病所造成的生活改變，使個案能以正向的態度面對疾病的衝擊，希望藉此篇個案報告以提供護理人員照顧類似病患之參考，以提升護理品質。

Hemodialysis patients usually have a sense of hopelessness. This can affect their physical, mental and spiritual health, and can even be life- threatening. This article discusses a nursing experience involving a dialysis patient who also suffered from cancer had and a sense of hopelessness due to the distress caused by the two severe illnesses. The author assessed the patient by means of Roy's theory during the nursing period (5/7/2005-6/18/2005). Data were collected through physical assessments, interviews, observation of interaction with family members and a medical history review. The patient had characteristics of hopelessness, such as pessimism, moodiness, frequent sighing, frowning, eye-closing and negative thinking. The author applied a safe, easy, and non-invasive complementary therapy program including music therapy, aromatherapy and massage with essential oil to improve the patient's physical and mental states. Through these approaches, the patient learned to release stress, and to express his feelings, so that he could adapt to his current life, changed as it was by the illnesses, and face the impact of those illnesses with a positive attitude. The author would like to share this case report to provide nursing professionals with a source of reference for healthcare quality improvement.