照顧一位乳癌根除術後再次復發患者接受化學治療之護理經驗

Experience of Providing Nursing Care for a Patient With Recurrent Breast Cancer Receiving Chemotherapy

本文是描述一位乳癌根除術後復發病人，接受化學治療之護理經驗，護理期間2010 年12 月21 日至2011 年1 月28 日，以Gordon 十一項健康功能型態為評估工具。藉由觀察、會談、傾聽及身體評估等方式，收集相關資料。發現個案有：組織完整性受損、身體心像紊亂、無力感等健康問題。於照護過程，經臨床解說及操作，讓個案及家屬學會傷口照護；藉由主動關懷、傾聽、支持等方式，協助個案克服疾病和化學治療所帶來的衝擊，使其能面對身體外觀的改變並接受治療。經此次護理經驗，深感癌症復發對病人及其家庭造成很大的壓力，亦會因外觀改變的窘境而自我封閉；護理人員若能適時提供護理指導、澄清疑慮，將能增進其克服疾病壓力與衝擊的勇氣。

This article describes the experience of providing nursing care for a patient with recurrent breast cancer receiving chemotherapy. The nursing process began on December 21st, 2010 and ended on January 28th, 2011. The nursing assessment was based on Gordon's functional health patterns. The medical records were collected through observation, interviews, and physical examinations. The patient's health problems included impaired tissue integrity, disturbance of body image, and helplessness. We offered education for the patient regarding wound care. We also offered care, conversation, and companionship to help the patient overcome pain resulting from cancer and chemotherapy. The patient was able to adapt to the change in body appearance and receive treatment with a positive attitude. Cancer recurrence causes mental stress for patients and their families, and lead to patients’ self-repression. If we can provide more information and direction, patients will be more confi dent in overcoming the impact of the disease.