運用羅氏理論照顧一位食道癌患者的護理經驗

Nursing Care Experience of a Patient with Esophageal Cancer by the Roy's Theory

在這談癌色變的時代，癌症的威脅仍高居國人十大死因之首。一個有癌症病患的家庭，的確背負著沉重的擔子，得艱辛踱步的面對生活。本個案報告是探討一位食道癌患者因病情惡化再度入院的護理經驗，住院期間自91年4月9日至91年4月13日，以生理功能、自我概念、角色功能、相互依賴等四種羅氏之概念架構，評估確定個案之主要護理問題為：1.睡眠型態紊亂2.排便習慣改變/便秘3.營養狀況少於身體需要4.無力感5.家屬預期性哀傷等五項。依據各項護理問題提出個別性之護理措施，積極處理病患生理上的不適，並鼓勵個案參與自我照顧。提供病患及家屬有關疾病的治療及相關知識，且在照顧的過程中持續關注病人及家屬的情緒反應，鼓勵說出其心中感受。以期病患能在疾病的限制下仍能維持其最高的生活品質。將此護理經驗提出分享，期能提供護理人員對相關個案有更深的認識與了解，進一步能提升照護品質。

In the cancer-overwhelming era nowadays, cancer is still the leading cause of death in Taiwan. Families with cancer patients surely bear heavy burdens and the patients have to struggle for their life. This case report discusses the nursing care for a patient with esophageal cancer who was readmitted due to exacerbation of his illness. He was hospitalized between April 9, 2002 and April 13 , 2002. By the four concepts of Roy's theory , including the physical function, the self-perception, the self-role function, and the interdependence, the major nursing problems of the patient were evaluated to: l.disordered sleeping style 2.change of bowel habit/constipation 3.less than physically needed nutrition 4.asthenia 5. expected mourning of the family. We proposed individual nursing plans according to the respective nursing problems and dealt with the physical discomfort of the patient aggressively and also encourage the self-care of the patient. We provided the related knowledge of disease treatment and noticed the emotional reaction of the patient and his family during nursing care to console for their grief and encourage them to speak out their mind. Hopefully the patient can maintain the highest quality of life under the limitations of the disease. We herein address this nursing care experience to provide deeper understanding of the similar cases for all nursing colleagues, thereby enhancing the quality of care in the future.