協助乳癌病人面對初次化療過程之護理經驗

Nursing Experience in a Recurrent Breast Cancer Patient With the First Time Chemotherapy

隨著醫療科技進步，癌症病人治療後存活率逐漸上升，然而，癌症復發對病患與家庭而言仍是有形及無形的壓力，本文個案在得知乳癌復發後，難過失望之餘對疾病預後、化學治療成效與副作用產生質疑，加上經濟壓力與資訊不足而猶豫是否接受化學治療。住院期間筆者以紐曼模式評估，運用會談、傾聽、觀察等技巧收集資料，確立個案壓力源及主要健康問題有：潛在危險性傷害、家庭因應能力失調、焦慮。筆者除提供個別性護理措施以緩解其生理不適，並扮演協助者、指導者、諮詢者與支持者等角色，提供相關護理指導與正確資訊，澄清對疾病預後與化學治療的疑慮，並協助解決家庭經濟壓力，同時介紹化學治療成效佳的個案，使其能克服心理障礙，坦然接受治療，並對日後的治療抱持正向積極的態度。

This article discusses a nursing care process for a breast cancer patient who considered acceptingchemotherapywhenfacingthe recurrence andmetastasis, financial stress and side effectsof therapy. I appliedtheNeuman SystemsModel to assess and collect information through interviewand observation.Realizingher sources of stress and physical problemswere a potential risk for injury, ineffective coping of family, andanxiety, I provided individual care to relieve her fromphysical discomfort by playing a role of consultant andsupporter. Furthermore, I clarified her questions about chemotherapy, providing guidance and resolving herfinancial stress aswell as using several successful cases of chemotherapy to encourage her.