照護一位輸卵管癌患者接受化學治療之護理經驗

Nursing Experience of a Patient with Fallopian Tube Cancer Receiving Chemotherapy

本文敘述照護一位輸卵管癌患者接受化學治療導致嚴重噁心嘔吐及掉髮之護理經驗，照護期間為2020年10月29日至11月5日，筆者透過身體評估、觀察及會談，並運用Gordon十一項功能性健康型態為評估工具收集資料與分析，確立個案主要護理問題為：「營養狀況改變:少於身體需要」、「焦慮」、「身體心像紊亂」。此次住院為第二次化療的照護過程，發現個案對化療一直很恐懼，擔心身體無法承受化療造成的影響，及因化療後導致嚴重掉髮，外觀的改變讓個案無法接受，而感到自卑、情緒低落，引發筆者想深入探討，藉由主動關懷、傾聽及陪伴與個案建立良好的護病關係，引導個案說出內心感受，給予支持與鼓勵，使其能夠減輕焦慮並積極正向面對疾病治療。建議日後若照顧此類個案時，於疾病確診後即可運用跨專業團隊合作，與個案及家屬共同討論疾病、治療過程，並共同訂定照護計畫，以減輕其焦慮，提升照護品質，期望藉此照護經驗分享能提供護理人員作為日後照顧類似個案之參考。

This article describes the experience of caring for a patient with fallopian tube cancer who was undergoing chemotherapy at Changhua Christian Hospital. The nursing period was from October 29 to November 5, 2020; this was her second hospitalization for the chemotherapy. The author assessed the nursing needs via physical evaluation, observation, interviews, and Gordon's eleven functional health patterns. Nursing issues established include 1) inadequate nutritional support, 2) anxiety and 3) body image disturbance. The patient exhibited persistent severe anxiety since the initiation of chemotherapy, especially toward the fear of hair loss. The patient had difficulty accepting her altered physical appearance due to the chemotherapy and expressed thoughts of low self-esteem and depression.
Therefore, the author seeks to develop a good rapport with the patient through active caring and listening and provide encouragement and support to help the patient express her feelings and build a positive attitude toward chemotherapy. Furthermore, this article suggests the utilization of multidiscipline professional teamwork in similar cases. Once the patient is diagnosed with cancer, the author recommends a combined meeting with the patient, the family, and the health professional. This meeting aims to provide information and establish a treatment plan through shared-decision making. Additionally, having the patient involved in this process improves the quality of care and may alleviate her anxiety.