中年男性口腔癌接受合併化學及放射線治療之護理經驗

Nursing Experience of a Middle-Aged male with oral Cancer Undergoing Concurrent Chemotherapy

本文旨在照護一位中年期男性罹患口腔癌個案於接受化學合併放射線治療（CCRT）期間之護理經驗。個案在治療過程中出現疼痛、營養攝取不足及無望感等主要健康問題。照護期間自2024年5月22日至2024年6月17日，運用Gordon十一項功能性健康進行全面評估，透過身體評估、觀察、面談及查閱病歷，確認有疼痛／與接受放射線治療引發口腔黏膜炎有關、營養狀況改變：少於身體需要／與口腔黏膜炎導致進食疼痛及攝取不足有關及無望感／與初次罹患口腔癌接受治療副作用有關等健康問題。疼痛方面，除常規藥物止痛外，並輔以冰敷口腔、注意力轉移與音樂療法等非藥物措施。營養方面：透過紀錄體重與飲食攝取量，協同營養師依個案偏好設計高熱量、高蛋白飲食，並輔以營養品補充，以維持足夠能量與預防體重下降。心理社會層面，護理師以關懷、傾聽及陪伴促進情緒表達，並結合心理師輔導、宗教信仰支持及病友團體分享，幫助個案紓解無望感，增強自我控制感與希望感。
此案例經驗顯示，口腔癌病人在接受CCRT過程中常面臨多重生理與心理挑戰，護理人員應及早整合藥物治療、營養支持及心理社會介入，並善用跨專業團隊及支持系統，以提升照護成效與生活品質。此經驗可供臨床護理人員照顧類似個案之參考。

This article presents the nursing experience of a middle-aged male with oral cancer undergoing concurrent chemoradiotherapy (CCRT) who developed treatment-related pain, inadequate nutrition, and profound feelings of hopelessness. During the intensive care period from May 22 to June 17, 2024, a comprehensive assessment based on Gordon’s Functional Health Patterns—conducted through physical examinations, direct observations, interviews, and medical record reviews—guided the implementation of targeted physical and psychosocial interventions. Pain management utilized routine analgesics complemented by non-pharmacological strategies like oral ice application, distraction techniques, and music therapy, while nutritional deficits were managed in collaboration with a dietitian to develop individualized, high-calorie, and high-protein meal plans alongside supplements tailored to the patient's preferences to maintain weight and energy. To address his psychological distress, nursing staff provided empathetic communication, active listening, and continuous companionship to encourage emotional expression, which was further supported by professional counseling, religious resources, and peer group participation to effectively alleviate hopelessness and restore his sense of self-control. Ultimately, this case underscores that oral cancer patients undergoing CCRT face multifaceted challenges, demonstrating that the early integration of interprofessional collaboration, structured nutritional care, and robust psychosocial support can significantly enhance care outcomes and patient quality of life.