運用羅氏適應理論於肝癌中年期患者之照護

The application of Roy's adaptation theory in nurising for a middle aged patient developing hepatocellular carcinoma

根據行政院衛生署2004年國人十大死因資料顯示，癌症已連續22年位居榜首，而中年期癌症患者佔三分之一以上，罹癌對中年期患者之影響甚鉅，不僅於患者個人也涵括其家庭。本文即探討一位中年肝癌患者，於接受治療期間，所經歷之困境，包括擔心治療被中止、不可預知的親子分離時刻及疾病產生的身體不適等問題。筆者於93.5.17～6.17護理期間，運用羅氏適應理論，整體性評估患者生理、心理及社會的適應方式，收集主、客觀資料，確認個案潛在危險性感染、舒適型態改變及焦慮等護理問題，並針對個案擬定個別性護理計畫，提供適合的護理措施，給予個案心理支持，增加身體舒適感及減輕面對治療的焦慮。由於罹癌帶給中年患者多面向的衝擊，因此，護理人員在臨床工作中，應提供病患全面性的照護，使病患面對癌症衝擊時，能達到身、心、靈的舒適。

According to compatriot's ten major causes of the death of 2004 National Health Administration of Executive Yuan, the cancer has already ranked first for 22 years in succession, and patients of middle age developing cancer accounts for more than one third. It influences them a lot, not only also includes their family. We investigate the problems of a middle aged patient developing hepatocellular carcinoma during the period of medical treatment, including worry treatment and is discontinued , the unpredictable parent-off spring separates constantly and the disease is produced . I used Roy's adaptation theory to assess patient's physiology, the adaptation ways of psychology and society in globality during one month of study period from May to June in 2004. Data collection comprised the main fact, objective data, and the confirmation of potential dangerous infection, comfortable attitude changes and anxiety, etc. Specific nursing care included the psychological support, the increase of body comfort and decrease in the face of therapeutical anxiety. Due to the multi-faceted impact on a middle aged patient, clinical nursing staff should offer patients comprehensive care to face the strike of cancer, reach the comfort of body, heart, and soul.