照護一位胰臟癌行化學治療個案之護理經驗

Nursing Experience of Caring for a Patient Undergoing Chemotherapy for PancreaticCancer

本文描述照護一位此次住院才知罹患胰臟癌接 受化學治療個案之護理經驗。個案在得知罹癌事 實後，需接受化學治療而對預後產生不確定感，又 擔憂術後返家無法勝任人工血管的自我照護產生的 焦慮感。照護期間自2019年3月18日至2019年3月29 日，藉由觀察、會談、直接照護、身體評估等方式 進行資料收集，並以Gordon 11項健康功能型態進 行整體性評估，確立個案有疼痛、知識增進的準備 度、焦慮之主要健康問題。護理過程中首先與個案 建立良好的護病關係，運用同理、傾聽及呼吸放鬆 的技巧，以緩解疼痛，並適時主動提供化學治療的 相關資訊及教導返家後人工血管的照護技巧，正向 增強個案參與自身的照護技能；並運用貝克焦慮量 表評估焦慮程度，鼓勵個案表達對於焦慮的原因及 感受，以減低其焦慮程度，進而協助個案調適化學 治療過程對預後的不確定感，並增進術後返家人工 血管的自我照護能力，期望此護理照護經驗，提供 日後護理同仁臨床照護之參考。（澄清醫護管理雜 誌 2021；17（3）：58-66）。

This paper describes the nursing experience of caring for a patient who did not know that she had developed pancreatic cancer until the current hospitalization and underwent chemotherapy. After learning about the facts of having cancer and needing to receive chemotherapy, the patient felt uncertainty about the prognosis and anxiety about their inability to independently take care of the artificial blood vessels when returning home after their operation. During the nursing period from March 18, 2019, to March 29, 2019, data were collected by observation, interview, direct care, physical assessment, and other methods. In addition, Gordon's 11 functional health patterns were used for an overall evaluation, and the main health problems of pain, preparedness for knowledge improvement, and anxiety were identified. In the process of nursing, we first established a good nurse–patient relationship, used the skills of empathy, listening, and breathing relaxation to relieve pain, provided information on chemotherapy in a timely and proactive manner, and taught the patient nursing skills for working with artificial blood vessels after returning home, which positively enhanced the patient's self-care skills. At the same time, the Beck Anxiety Inventory was used to assess the patient's anxiety level, and the patient was encouraged to express their causes of anxiety and her feelings, so as to reduce their anxiety level, thereby helping the patient adjust to the uncertainty about their prognosis during chemotherapy and improve their self-care ability with regard to caring for artificial blood vessels at home after surgery. It is expected that this nursing experience can provide a reference for nurses in their clinical care in the future. (Cheng Ching Medical Journal 2021; 17(3): 58-66)