一位壯年期女性個案初診斷膀胱癌之門診護理經驗

A Case Study on Outpatient Bladder Cancer Care from A Nurse's Experience with A Middle-Aged Female Patient

本文為一位壯年期女性初診斷膀胱惡性腫瘤，就診過程中對於罹癌的衝擊，無法接受手術後病理報告的結果，以及對疾病後續治療感到徬徨無助，出現情緒低落哭泣情形，引發深入探討的動機。護理期間2023年2月3日至5月17日，運用Gordon十一項健康功能評估工具，藉由會談、觀察、傾聽、住院探視及電訪等方式收集資料，確立健康問題有無望感、急性疼痛、排尿型態障礙等問題。運用個別性護理措施，鼓勵表達內心想法及需求，運用音樂、冥想、適時改變姿位方式及熱敷方法，減緩術後急性疼痛。運用會談技巧引導表達內心想法及需求，同理罹癌內心情緒，傾聽陪伴抒發壓力，減輕疾病治療所帶來的不適感，順利完成初次罹癌治療。

This is a case study describing the refusal to confirmatory diagnosis of malignant bladder cancer in an adult female, and her helplessness and depression about treatment sequalae and cancer prognosis. The patient received nursing care from February 3rd to May 17th, 2023. An evaluation tool called Gordon 11 function health patterns in combination with healthcare skills such as interview, observation, listening, on-site visit and phone calls were applied for data collection and condition analysis. Determined health issues included hopelessness, acute pain and dysfunctional voiding. Individualized interview techniques, empathy, listening and companionship were used to encourage the patient’s expression of thoughts and physical needs. Meanwhile, music therapy, meditation, proper positioning and hot packs were also adopted to relieve postoperative acute pain and treatment-induced discomfort and stress. By applying aforementioned nursing skills, the patient completed her first cancer treatment regimen smoothly and successfully.