照護一位肺癌腦轉移個案藉由家庭復原力模式協助其家庭因應之護理經驗

Nursing Care for a Lung Cancer Patient with Brain Metastasis Using the Family Resiliency Model

本文主要探討一位肺腺癌患者腦轉移後無法自我照護，個案調適及家庭因應之護理經驗。護理期間自2012年7月26日至2012年8月7日，筆者運用家庭復原力模式，並藉由身體檢查與評估、觀察及會談收集資料，評估個案生理、心理、社會及案家的適應方式，確立個案及案家出現以下五項護理問題：「潛在危險性肺吸入」、「自我照顧能力缺失」、「調適障礙」、「照顧者角色緊張」及「家庭因應能力失調」，並依其問題擬定護理計畫及目標，協助個案增進自我照護的能力，提升主要照顧者照護技巧，協調家庭成員適時協助，減輕主要照顧者的負荷，提升個案及案家的生活品質。

This article describes the experience of the author in providing nursing care to a lung cancer patient with brain metastasis who was unable to care for herself. The period of care ran from July 26th to August 7th, 2012. The focus of the article is on the problems of disease adaptation and the coping strategies of the patient and her primary caregivers. The author used the Family Resiliency Model to collect information via physical examination, observation, and interviews. Five major nursing problems were identified in this case: risk of aspiration, self-care deficits, adjustment disorder, caregiver role strain, and family coping ineffectiveness. Based on these problems, the author constructed an individualized care plan to: 1) improve the self-care ability of the patient, 2) enhance the skills of the primary caregiver, 3) recruit the timely assistance of other family members, 4) and reduce the burden of the primary caregiver. The primary goal of this care plan was to promote the quality of life of the patient and her family.