運用Orem理論照顧一位放射線治療頭頸癌病人之護理經驗

The Nursing Experience of Applying Orem Theory for Caring a Patient with Head and Neck Cancer while Receiving Radiation Therapy

放射線治療是頭頸癌的主要治療方式，然而治療期間經常會引起不適症狀。本文主要描述一位頭頸癌病人接受放射線治療過程中合併口腔黏膜改變之護理經驗，護理期間為2010年8月7日至8月29日，筆者採觀察、訪談、直接照顧方式收集資料，並運用Orem理論之自我照顧需求模式評估，發現病人有口腔黏膜改變、疼痛、營養狀況改變：少於身體需要及個人因應能力失調等健康問題，住院期間針對放射線治療副作用引起的黏膜改變造成的衝擊，提供病人個別性之護理指導，協助面對口腔黏膜炎導致之進食困難問題，以增強病人自我照顧能力減少對生活的衝擊，進而提升其生活品質。

Radiation therapy (RT) is one of the primary treatment modalities for patients with head and neck cancer. However, RT in the head and neck area can cause symptom distress. This paper described the nursing experiences of a patient with head and neck cancer receiving RT and experiencing the change in oral mucosa. The nursing period was from August 7, 2010 to August 29, 2010 and the authors applied collected observations, interviews, direct care along with the use of Orem Theoretical models of self-care needs assessment. Results from this nursing experience found that the patient had oral mucosal changes, pain, altered nutrition: less than body requirements, personal coping health problems. During the period of hospitalization, the author provided the patient with individualized guidance for eating difficulties associated with oral mucositis, to enhance the coping capacity of self-care, and thereby increased the patient’s quality of life.