照護一位腦瘤復發患者之護理經驗

The Nursing Experience of Caring a Brain Tumor Recurrence Patient

本文為照護一位罹患腦瘤復發患者之照護經驗。護理期間自2020年4月7至4月29日，筆者運用Gordon十一項健康評估並藉由觀察、會談、身體評估等方法收集資料，歸納分析出個案護理問題有身體活動功能障礙、無望感與照顧者角色緊張。筆者藉由整體性評估及文獻查閱，與家屬和個案設計個人化的活動時間表，以漸進性的運動，搭配網路影片增加活動多元性。會談時，以詩歌音樂營造讓個案放鬆的會談環境，聖經引導個案表達疾病感受和面對死亡的恐懼，鼓勵個案和家屬主動表達彼此感受。藉由家庭會議召開，個案與家屬討論善終規劃，過程中由護理人員提供相關安寧緩和醫療照護和預立醫療遺囑諮詢資訊查詢，協助完成決策共識。冀望由此護理經驗提供護理人員做為臨床之參考。

This article describes the nursing experience of caring a patient with brain tumor recurrence. Patient information was gathered through interviews, observations, and physical evaluations during the nursing period from April 07 to April 29, 2020. Gordon's eleven Functional Health Patterns were employed as an evaluation framework. Through analysis, nursing problems were identified, including: 1. Impaired physical mobility; 2. Hopelessness; and 3. Caregiver role strain. To address these challenges, progressive activities incorporating online videos were implemented to diversify engagement. Music was utilized to create a serene environment during interactions with the patient, while the Bible served as a guiding tool for expressing feelings about the disease and confronting the fear of death. Encouraging active expression of feelings from both the patient and family members was emphasized. Hospice planning discussions were initiated through family meetings, during which nursing staff provided information on hospice care and advanced care planning, aiding in decision-making processes. The study can serve as a valuable reference for nursing teams faced with similar patients.