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題名:接受標靶治療的肺癌病患身體心像改變之臨床照護
書刊名:護理雜誌
作者:詹瑞君廖幼婕 引用關係李芸湘賴裕和
作者(外文):Chan, Jui-chunLiao, Yu-chienLee, Yun-hsiangLai, Yeur-hur
出版日期:2014
卷期:61:4
頁次:頁90-96
主題關鍵詞:肺癌標靶治療身體心像護理照護Lung cancerTargeted therapyBody imageNursing care
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(3) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:3
  • 共同引用共同引用:0
  • 點閱點閱:53
肺癌病患在存活期較短與疾病惡化快速的極大衝擊下,標靶治療擁有方便簡單、存活期延長、較化學治療副作用少的多項優點,儼然成為晚期病患最期待的治療方式。然而,目前適用於肺癌病患口服標靶治療的艾瑞沙Gefitinib(Iressa®)與得舒緩Erlotinib(Tarceva®),其易導致全身皮膚痤瘡樣疹、乾燥等皮膚毒性副作用,為最困擾病患的問題之一,不僅嚴重影響其身體心像,產生負向情緒反應,進而影響社交與生活,若減少或停止用藥以減輕副作用,又會擔憂存活問題,此種矛盾情緒造成病患內心極大痛苦,因而無法擁有良好之生活品質。因此,本文將針對此族群病患介紹肺癌標靶藥物產生皮膚毒性症狀與引發身體心像改變之相關知識,並建議使用相關評估工具,依其身體心像改變之生理、心理與社會問題,提供皮膚毒性症狀照護、情緒支持及因應策略之運用,以協助病患重建正向自我概念,並期望未來在臨床上能突破當前護理照護之時間與空間限制外,亦能給予醫護人員更多相關的專業訓練,以提昇醫護人員對接受肺癌病患標靶治療身體心像改變問題的關注,並運用純熟的照護知識與技巧,進而提升臨床護理品質。
Lung cancer has a relatively short survival prognosis and advanced disease progression. Therefore, targeted therapy has become one of the most frequent treatments of this disease. Targeted therapy has several features that effectively extend the survival period; is easy to apply and use; and has fewer side effects than chemotherapy. Therefore, this therapy approach has become the preferred choice of patients with advanced lung cancer. However, current targeted therapies like Iressa® and Tarceva® produce side effects such as skin dryness and acneiform eruption that may bother patients. These side effects may further cause patient concern over negative changes in their body image, and these concerns may influence their work and social lives. Additionally, some patients treated with targeted therapy worry about their chances of survival if they reduce or stop the medication to avoid the side effects. Consequently, patients may struggle with both physical and psychological impacts, and may have problems sustaining a good quality of life. This article focuses on delivering relevant information to patients receiving targeted therapy who suffer from dermatological toxicity and damage to their body image. We demonstrate an assessment tool and information to help patients cope with physical and psychosocial issues through daily skin care routines, mental/psychological supports, and cognitive behavior therapy. These measures may help patients rebuild a positive self-concept. We plan to develop further associated training to provide professionals/care providers with the appropriate knowledge and skills to care for cancer patients in a resource-limited environment so that they may improve the quality of nursing care for patients with body image changes.
期刊論文
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2.Annunziata, M. A.、Giovannini, L.、Muzzatti, B.(2012)。Assessing the body image: Relevance, application and instruments for oncological settings。Supportive Care in Cancer,20(5),901-907。  new window
3.Barankin, B.、DeKoven, J.(2002)。Psychosocial effect of common skin diseases。Canadian Family Physician,48,712-716。  new window
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5.Fingeret, M. C.、Yuan, Y.、Urbauer, D.、Weston, J.、Nipomnick, S.、Weber, R.(2011)。The nature and extent of body image concerns among surgically treated patients with head and neck cancer。Psycho-Oncology,21(8),836-844。  new window
6.Galimont-Collen, A. F. S.、Vos, L. E.、Lavrijsen, A. P. M.、Ouwerkerk, J.、Gelderblom, H.(2007)。Classification and management of skin, hair, nail and mucosal side-effects of epidermal growth factor receptor (EGFR) inhibitors。European Journal of Cancer,43(5),845-851。  new window
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8.Hellgren, E. M.、Lagergren, P.、Larsson, A. C.、Schandl, A. R.、Sackey, P. V.(2013)。Body image and psychological outcome after severe skin and soft tissue infection requiring intensive care。Acta Anaesthesiologica Scandinavica,57(2),220-228。  new window
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11.King, M. T.、Kenny, P.、Shiell, A.、Hall, J.、Boyages, J.(2000)。Quality of life three months and one year after first treatment for early stage breast cancer: Influence of treatment and patient characteristics。Quality of Life Research,9(7),789-800。  new window
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13.Li, T.、Perez-Soler, R.(2009)。Skin toxicities associated with epidermal growth factor receptor inhibitors。Targeted Oncology,4(2),107-119。  new window
14.Melosky, B.(2012)。Supportive care treatments for toxicities of anti-EGFR and other targeted agents。Current Oncology,19(1),59-63。  new window
15.Mok, T. S.、Wu, Y. L.、Thongprasert, S.、Yang, C. H.、Chu, D. T.、Saijo, N.、Fukuoka, M.(2009)。Gefitinib or carboplatin- paclitaxel in pulmonary adenocarcinoma。New England Journal of Medicine,361(10),947-957。  new window
16.Perez-Soler, R.、Saltz, L.(2005)。Cutaneous adverse effects with HER1/EGFR-targeted agents: Is there a silver lining?。Journal of Clinical Oncology,23(22),5235-5246。  new window
17.Rosell, R.、Carcereny, E.、Gervais, R.、Vergnenegre, A.、Massuti, B.、Felip, E.、Paz-Ares, L.(2012)。Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-smallcell lung cancer (EURTAC): A multicentre, open-label, randomised phase 3 trial。The Lancet Oncology,13(3),239-246。  new window
18.Rumsey, N.、Clarke, A.、White, P.、Wyn-Williams, M.、Garlick, W.(2004)。Altered body image: Appearance-related concerns of people with visible disfigurement。Journal of Advanced Nursing,48(5),443-453。  new window
19.Wagner, L. I.、Lacouture, M. E.(2007)。Dermatologic toxicities associated with EGFR inhibitors: Dermatologic toxicities associated with EGFR inhibitors: The clinical psychologist’s perspective. Impact on health-related quality of life and implications for clinical management of psychological sequelae。Oncology (Williston Park,21(11),34-36。  new window
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研究報告
1.衛生福利部統計處(2013)。民國100 年度衛生統計動向--死因統計。  延伸查詢new window
學位論文
1.林如玉(2009)。接受標靶治療之肺癌病患的副作用及其與皮膚相關生活品質探討(碩士論文)。臺灣大學。  延伸查詢new window
圖書
1.Schilder, Paul(1970)。The image and appearance of the human body。New York, NY:International Universities Press。  new window
其他
1.中央健康保險署(2013)。全民健康保險藥品給付規定第9 節抗癌瘤藥物,http://www.nhi.gov.tw/webdata/webdata.aspx?menu=21&menu_id=713&WD_ID=849&webdata_id=2919。  延伸查詢new window
2.National Comprehensive Cancer Network(2013)。Distress management version 2,http://www.nccn.org/professionals/physician_gls/pdf/distress.pdf。  new window
3.US National Institutes of Health and National Cancer Institute(2009)。Common terminology criteria for adverse events,http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf。  new window
圖書論文
1.Bandura, Albert(1994)。Self-efficacy。Encyclopedia of human behavior。New York:Academic Press。  new window
 
 
 
 
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