照顧ㄧ位白血病患者初次接受異體造血幹細胞移植之護理經驗

he Nursing Experience of Caring for a Patient　Newly Diagnosed With Leukemia Who Received　Allogeneic Hematopoietic Stem Cell Transplantation

本文描述ㄧ位白血病患者初次接受異體造血幹胞移植之護理經驗。護理期間為2011年5月6日至5月31日，筆者藉由觀察、會談、身體檢查、連續性照顧、病歷查閱及與醫療團隊討論方式收集資料，運用Gordon十一項健康功能型態評估發現有體溫過高、知識不足及焦慮等健康問題。護理期間除監測生理變化外，並主動關懷，其中更扮演諮詢者及教育者角色，提供心理支持、以語言或非語言方式鼓勵表達內心想法及需求，藉由文獻探討進而擬定合宜護理計畫及措施，以增進舒適度。建議增加不同領域之跨團隊合作個案討論，建立造血幹細胞移植病友聯絡網，讓接受造血幹細胞移植患者獲得更完整性的照護品質，期望藉此照護經驗分享，能作為日後護理人員之參考。

This article describes an experience in caring for a patient with leukemia who received　treatment of allogeneic hematopoietic stem cell transplantation for the fi rst time. Nursing care was　provided during 6 to 31 May, 2011. Data were collected through observation, interview, chart review　and discussion with the medical team. Physical examination, continuity of care, and the Gordon's　11-items functional health assessment guide were used to identify health problem and nursing　problems. Three nursing problems were diagnosed and they were hyperthermia, knowledge defi cit　and anxiety. In care of these problems, the author not only played the role of a nursing consultant and an educator, but also provided nursing care including vital signs monitoring, mental support, empathetic conversation and care which promote comfort and decrease pain. This experience suggests that an inter-disciplinary communication is important in establishing the network of contacts for hematopoietic stem cell transplant patients. It also helps health care professionals to further understand patients with leukemia and hopefully to improve the quality of care.