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照護一位初診斷生殖細胞瘤男同志之護理經驗

Caring for Gay Men Newly Diagnosed as Having Germ Cell Tumor

摘要


本文旨在照護一位28歲罹患生殖細胞瘤男同志病人之護理經驗。照護期間自2019年10月7日至10月25日,筆者透過觀察、會談、身體評估及病歷查閱等方式收集資料,使用Gordon十一項健康功能型態評估,確立有疼痛、無望感、家庭因應失能等健康問題。照護期間使用疼痛管理日記達到快速調整止痛藥物,改善疼痛問題;啟動全人團隊會議,使病人了解治療計畫,增進對疾病控制進而改善無望感;運用同志友善醫療手冊促進家庭接納,緩解衝突,提升家庭間的正向關係。同志相關研究顯示家庭的接納是改善心理健康關鍵,筆者於臨床觀察多數同志擔心家人無法接受自己性傾向而造成心理壓抑,建議未來照護相關病人,能早期轉介同志諮商心理師,並與台灣同志諮詢熱線協會共同合作,提供多元性別照護服務,落實對同性族群友善的醫療。

關鍵字

生殖細胞瘤 初診斷 男同志

並列摘要


In this article, we share the experience of nursing a 28-year-old gay patient with germ cell tumor. The patient visited our hospital for neck pain and was unexpectedly diagnosed as having cancer. In addition to physical problems caused by the tumor, the patient experienced hopelessness due to pressure from his family who were unaccepting of his sexual orientation. The care period was from October 7 to October 25, 2019. Gordon's functional health assessment was performed to assess the patient's conditions, and this entailed observation, interviews, physical assessment, and medical record review. Three major health problems were identified: pain, hopelessness, and ineffective family coping. During the care period, the author based rapid adjustments to the usage of analgesics for pain alleviation on a pain management diary. Moreover, the author, along with the medical team, explained the treatment process to the patient and engaged the patient in discussion, which helped reduce his hopelessness. The author used the friendly health-care manual for lesbians, gays, bisexual and transgender individuals, and other sexual minorities to provide therapeutic support to the patient and his family, increase the family's acceptance of nonheterosexual adults, and resolve communication conflicts to ensure a positive family relationship and help the patient overcome the hardship of the treatment process. A study on lesbian, gay, and bisexual (LGB) adults reported that family acceptance among LGB individuals is the key factor for improving their self-rated physical and mental health. According to the author's clinical observation, most of LGB individuals worry that their family members will not accept their sexual orientation and experience psychological depression. Thus, early referral to an LGBTQ+ psychologist is recommended, and medical institutions should cooperate with the Taiwan Tongzhi (LGBTQ+) Hotline Association to provide multigender care services and implement LGBTQ+-friendly medical care. Our successful results encouraged us to share this nursing experience with caregivers encountering similar client situations and needs.

並列關鍵字

germ cell tumor newly diagnosis gay men

參考文獻


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