一位初次罹患急性骨髓性白血病青年之護理經驗

Nursing Experience of Caring a Young Patient with First-Time Acute Myeloid Leukemia

本文旨在探討一位23歲初次診斷急性骨髓性白血病個案的護理經驗。筆者於2016年3月11日至2016年3月31日護理期間，藉由Gordon十一項健康功能型態為評估架構，運用身體評估、會談、觀察、傾聽及溝通等方式收集資料，確立個案主要之健康問題依序為口腔黏膜改變、身體心像紊亂及知識缺失，照護過程中，筆者藉由指導者與諮商者的角色，運用口腔模型、牙刷模型、口腔漱洗及選擇合適飲食，進而促進口腔黏膜的癒合；另結合資訊及介紹成功的個案，引領病人分享心理感受、抒發負向情緒，進而增強對自我身體正向肯定與認識；利用衛教單張、心智圖，主動提供個案及家屬有關於疾病治療治療過程及預後情形，以增進自我控制感和自尊。

This report described the nursing experience of caring a 23-year-old patient with first-time acute myeloid leukemia (AML). Nursing care was provided between March 11 and 31, 2016. Gordon's 11 functional health patterns were used as the assessment framework. The data was collected via physical examination, interviews, observations, attentive listening, and communication. The main health issues of the patient included oral mucosal changes, body image disturbance, and lack of knowledge. It was discovered during the provision of care that first-time AML caused the patient and the patient's family to suffer from panic and anxiety. The lack of AML-related knowledge could cause severe complications and lead to delayed or inadequate treatment. Therefore, the author functioned as an instructor and counselor and performed demonstrations in order to alleviate the patient's physiological discomfort (caused by chemotherapy side effects) and reduce the occurrence of complications and psychological impact of the disease. It is suggested that, for their clinical practice, nursing personnel discuss successful cases with their patients in order to promote the sharing of feelings, expression of negative emotional feelings and changes, and strengthening of patients' self-approval and recognition, which will help them to rebuild their sense of self and prepare for the future. During the treatment process for the disease, nurses should actively provide patients and their families with information regarding treatment and prognosis to help them adapt to the discomfort caused by the disease and boost their self-control and self-respect.