論述惡性蕈狀傷口對癌症病人的生理、心理、社會與靈性衝擊

The Physical, Psychological, Social, and Spiritual Impacts of Malignant Fungating Wounds on Cancer Patients

惡性蕈狀傷口其惡臭、大量分泌物、出血及疼痛等特性，對癌症病患生理、心理、社會文化及靈性層面造成極大衝擊，甚而影響其健康生活品質感受。全人照護是緩和醫療照護目標，然國內外以全人照護觀點進行此議題探討之文獻付之闕如，導致專業人員僅能提供片斷式的傷口照護。本文的目的在增進護理人員對惡性蕈狀傷口認識，進而提供病患多面向傷口的照護。內容將涵蓋惡性蕈狀傷口病因學、病患面臨惡性蕈狀傷口可能造成生理、心理、社會與靈性層面的改變與問題，提出照護建議與策略。透過系統性說明將有助於護理人員在惡性蕈狀傷口照護之知能，進而提升病患的生活品質。

Malignant fungating wounds (MFW) are accompanied by odor, secretions, bleeding and pain. Cancer patients must not only suffer the physical, psychological, social and spiritual impacts on their disease, but also experience considerable change in health-related quality of life. Palliative health care aims to provide comprehensive services to patients and their families. To date, no study has adopted the standpoint of palliative health care to describe comprehensively the impacts of MFWs on cancer patients, with the result that health professionals are incapable of providing comprehensive care to such patients. This study illustrates the etiology of MFWs, their physical, psychological, social, and spiritual impacts on cancer patients, and wound care strategies. It aims to improve nurses' knowledge and understanding of how to assess and identify the etiology of MFWs, in the hope that such knowledge can be applied in clinical practice and as a reference for nurses organizing MFW plans, in order to provide better patient care.