照護一位長期血液透析罹患卵巢癌後接受化學治療護理經驗

Nursing Experience of Receive Chemotherapy For A Hemodialysis Patient with Ovarian Cancer

本文敘述一位長期血液透析個案因罹患卵巢癌接受化學治療後而影響個案的身、心健康之護理經驗。護理照護期間為2017年10月21日至2018年3月29日，運用羅氏適應模式以觀察、傾聽與病歷查閱進行資料收集，確立主要健康問題為：癌因性疲憊、無望感以及潛在性感染。藉由陪伴與傾聽，與個案建立護病關係，整合相關文獻並依據文獻內容來提供營養與傷口之護理指導以避免傷口感染；鼓勵個案說出其想法，降低個案的焦慮與無助，給予園藝治療、精油按摩、適度運動、透過家人支持和腎友經驗分享等正向能量補充，以緩解其疲憊及使個案能適應疾病所帶來的生活改變，建議臨床血液透析護理人員應該充實癌因性疲憊的知識能力，以協助病人察覺及處理癌因性疲憊問題，盼此經驗可供臨床照護之參考。

This case report explores the patient with chronic hemodialysis suffered from ovarian cancer and received chemotherapy to affect her physiology and psychology. We applied Roy's nursing model to assess and collect data through observation, listening and medical records from October 21, 2017 to March 29, 2018 , and summarized her major health problems: cancer-related fatigue (CRF), hopelessness and potential infection. To improve her problems, we guided her to express her feelings, established nurse-patient dynamic, and provided knowledge related to nutrition and wound care to avoid wound infection. We supplied positive energy activities include horticultural treatment, oil massage, exercise, sharing kidney friend experience and family support, so that the patient relieved fatigue, overcome hopelessness, and cope with the alteration to lifestyle caused by her illness. We suggested that nurses in the hemodialysis room should enhance their ability of CRF to help patients aware and deal with fatigue and shared the experience as a reference for those who care for similar patients.