照顧一位初診斷骨肉瘤病患接受化學治療之護理經驗

Nursing Experience of Caring for a Patient Suffering from Newly Diagnosed Osteosarcoma and Acceptance of Chemotherapy

本文敘述一位20歲初診斷骨肉瘤女性病患接受化學治療的護理經驗。筆者於2012年4月18日至5月16日照護期間，運用羅氏適應模式為評估指引，與個案及家屬訪談、溝通、傾聽收集資料及確立問題。照護期間發現個案面對癌症及治療所經歷的身心痛苦，加上案母深怕又失去一位至親的壓力，發現個案健康問題有疼痛、焦慮、身體心像紊亂、照顧者角色緊張。照護期間主動關懷並鼓勵個案及家屬，因而建立信任感及良好護病關係，協助及滿足生、心理及社會方面需求，適時提供衛教，減輕個案及家屬焦慮感，成功地協助因應首次化學治療所面臨的症狀困擾，以正面態度面對疾病及後續治療，希望藉此經驗提供護理同仁臨床實務參考。

This paper aimed at presenting the nursing experience of a patient, who was newly diagnosed with osteosarcoma in her early 20s, and her acceptance of first chemotherapy. The nursing period was twenty-nine days, from April 18th to May 16th, 2012, and the nursing assessment was developed within the framework of the Roy adaptation model, to identify the problems based on the functional evaluations and to collect the related data from the patient, including interview, communication, and listening etc. In the very beginning, the patient faced and experienced the cancer therapy and suffered both physical pain and mental exhaustion. Added to that, the patient’s mother worried about losing her daughter to cancer, which also naturally created pressure and stress on the whole family as well as the patient. Within the nursing period, not only did the patient suffer both physical and mental health difficulties including anxiety, disturbed body image, caregiver role strain, but the patient and her family encountered certain unexpected syndromes and torments of post-chemotherapy as well. Therefore, we not only conveyed both the feeling of empathy toward the patient and her family, but also provided them with good nursing care. As a result, the trust relationship was well built between the patient and the nurses, enabling the overcoming of both the illness and continuing problems of post-treatment. The nursing experience discussed in this study could serve as a good example for similar nursing care. Most importantly, it is expected that this nursing experience of caring for an osteosarcoma patient can shed light on understanding the nursing process of a patient and enhance the quality of nursing.