照顧一位初罹惡性肋膜間皮瘤病人之護理經驗

Experience in Caring for a Primary Sufferer of Malignant Pleural Mesothelioma

惡性肋膜間皮瘤是一種主要與石綿接觸有關，極為惡性且少見的肺癌，無法以手術完全切除，對於放射線治療及化學治療效果反應差，只能施以緩和療法。本篇描述照護一位初次罹患惡性肋膜間皮瘤病人因疾病導致身體不適及心理問題的護理過程。運用觀察、會談並利用Gordon十一項功能性健康型態評估工具收集資料，確立病人的健康問題有：營養狀況改變：少於身體需要、活動無耐力、睡眠型態紊亂、體液容積過量、體溫過高及無力感，經由與病人建立良好的護病關係與信任感，運用護理專業知識，與其共同討論並提供直接護理，相關護理指導與心理支持，協助改善身體症狀之不適並完成出院計劃順利轉院。

Malignant pleural mesothelioma is a rare type of lung cancer. The main cause of this cancer isrelated to the exposure to an asbestos environment. Surgical treatment can not remove the tumorcompletely. Radiation therapy and chemotherapy are ineffective in treating malignant pleuralmesothelioma. Palliative therapy seems to be the only preferred treatment choice. This articledescribes the nursing process of taking care of a primary sufferer of malignant pleural mesotheliomaof physical and mental pain. Data was collected from patient observation, patient interview,and the analysis using 'Gordon's 11 items of functional healthy condition'. The results showedpatient health problems included: altered nutrition— less than body requirements, activity intolerance,sleep pattern disturbance, fluid volume excess, hyperthermia and powerlessness. By attaining apositive interaction with the patient, utilizing professional nursing skill, providing direct nursing andrelated nursing care support, the patient's health condition was improved. As a consequence, thepatient was able to transfer out of the hospital. It is hoped that the knowledge learned from thisnursing experience can provide substantial benefits to clinical staff in their practice with such patients.