實證知識轉譯－－化學治療引起周邊神經病變之中西醫結合照護經驗

Evidence-Based Knowledge Transition: An Integrative Nursing Experience With Chemotherapy-Induced Peripheral Neuropathy

周邊神經病變是大腸直腸癌病人接受oxaliplatin（奧沙利鉑）化療藥物常見的副作用，嚴重者可造成癌症病人身心上的重大衝擊。當西醫的照護無法完全滿足病人需求時，中西醫合併照護可做為病人的另一項選擇。本文分享一位歷經直腸癌術後接受化學治療，引起周邊神經病變，接受中西醫結合之照護經驗，照護期間自2022年4月11日至2022年5月27日。運用中醫整體性評估（望、聞、問、切），並藉由傾聽與會談等方式收集資料，確立個案健康問題有慢性疼痛症候群、睡眠型態紊亂及死亡焦慮。護理過程中透過實證步驟進行系統性文獻查證，結合醫療團隊共同擬定照護計畫，提出介入運動、針灸、精油芳香按摩、音樂療法、及耳穴按壓等措施，協助個案改善健康問題，緩解個案對死亡焦慮之情緒問題。期望藉由此實證知識轉譯及中西醫結合護理經驗，提供臨床多元化照護之參考。

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of oxaliplatin in colorectal cancer patients that may impact both physical and mental well-being significantly. When Western medical care alone is unable to satisfy patient needs, integrative care combining traditional Chinese and Western medicine approaches is an alternative option. This article shares the integrative care experience of a post-operative rectal cancer patient who suffered from chemotherapy-induced peripheral neuropathy. An intervention that followed a holistic assessment approach in traditional Chinese medicine (TCM; i.e., observation, auscultation, inquiry, and pulse feeling) combined with listening and communication was conducted between April 11th and May 27th, 2022. The patient’s health problems were identified as chronic pain syndrome, sleep disturbances, and death anxiety. During the caring process, evidence-based practices were applied, the scientific literature was systematically reviewed using an evidence-based approach, and an integrative care plan was developed in collaboration with the medical team. Exercise, acupuncture, aromatherapy massage, music, and auricular acupressure therapies were administered to reduce the severity of the patient’s health problems. It is hoped that this experience combining evidence-based knowledge with integrative care offers a reference for providing alternative patient care in a broad range of clinical settings.