大腸直腸癌病人首次化療焦慮情形的改善專案

A Project to Reduce Anxiety in Colorectal Cancer Patients Undergoing Initial Chemotherapy

在照護大腸直腸癌病人的過程中，發現首次接受化療病人常出現表情淡漠、缺乏對事物的興趣，且有難入睡或哭泣等情形，因此我們追溯2015年4月至6月護理紀錄，發現有非常高比率的病人有「焦慮」的護理診斷，另於2015年11月至12月訪談35位病人，其中有顯著焦慮者亦高達88.6%，顯示焦慮普遍存在於首次接受化療的大腸直腸癌病人。分析焦慮原因，包括預期性擔心、護理指導時機點不對、內容缺乏適切及多樣性、欠缺減輕症狀困擾之護理介入、缺少可以陳述內心感受的管道及支持系統、轉介及會診機轉不足。

 

透過本專案之執行，確實降低病人之焦慮，應對生活品質有相當助益，建議將此專案的經驗推廣至其他醫療單位，進而提升護理照護品質。

 

While taking care of colorectal cancer patients, nurses noticed that patients undergoing initial chemotherapy often show emotionless faces, apathy, and insomnia or crying. Therefore, we reviewed colorectal cancer patients’ nursing records from April to June 2015, and found that many of them had anxiety in their nursing diagnosis. From November to December 2015, we also interviewed 35 patients and found that 88.6% of them suffered from anxiety. These findings indicate that anxiety is common among patients undergoing initial chemotherapy for colorectal cancer. We analyzed the causes of anxiety, which included anticipated worry, educating patients at an inappropriate time, lack of individualization or variation in patient education, lack of nursing interventions for relieving symptom distress, lack of ways to express feelings, lack of peer-support, and insufficient means for referral or consultation.

The project reduced anxiety and improved the quality of life in patients receiving initial chemotherapy for colorectal cancer. The project can be applied to other medical units to improve the quality of nursing care.