一位食道癌合併反覆肺感染之壓力調適護理經驗

Nursing Experience Caring an Esophageal Cancer Patient with Repeated Lung Infections Who Requires Pressure Adjustment

癌症病人需長期與疾病共存，因而有高度壓力可能導致病人會有憂鬱及失眠之問題，本文敘述一位食道癌病人，因營養不均衡、反覆肺部感染入院的護理經驗，筆者於2017年3月10日至4月2日照護期間運用Gordon十一項功能性評估，發現個案主要有：現存性感染、營養少於身體所需及壓力調適能力失衡等健康問題。護理過程中筆者運用觀察、身體評估及會談等方式與個案建立良好護病關係|透過與醫療團隊共同討論護理計畫，並使用食物圖卡增加記憶，解決個案營養不均衡及感染問題|同時以同理心、傾聽及主動關懷等方式，陪伴病人度過因疾病所引起的身心壓力衝擊及疲乏感，增進病人正向思考、減少對於疾病不安的焦慮感，進而引導病人表達內心感受及了解壓力源，並教導運用各式放鬆技巧達到紓解壓力、鼓勵個案主動積極參與治療計劃，進一步達到最佳生活品質。期盼藉此護理經驗分享，提供日後照護此類型病人之護理人員參考。

Cancer could be a long-term chronic disease. Surviving with cancer may cause extreme stress which could lead depression and insomnia. This article described the nursing experience of caring a patient with esophageal cancer who was hospitalized repeatedly due to nutritional problems and lung infections. The Gordon 11 Function Health Patterns was used to assess the patient's health problems from March 10 to April 2 in 2017. The main health problems included existing infections, imbalanced nutrition: less than body requirements, and impaired stress adjustment capabilities. The author used observation, physical assessment, and communication skills to establish a good nurse-patient relationship and collaborated with the medical team to create the care plan. We used food cards to enhance the nutrition knowledge and increase the nutrient intake therefore to resolve the nutritional and infection problems. To reduce physical and mental stress and enhance positive thinking, we applied the skill of empathy, listening, and caring. In addition, we encouraged the patient to express his feeling toward the illness to better understand the sources of stress. Relaxation techniques were also provided to reduce the severity and impact of stress. Finally, we encouraged the patient to actively participate in the care plan. We hope this report can serve as a reference for caring esophageal cancer patients.