PLANNING THE HOMECARE OF A LARYNGEAL CANCER PATIENT RECEIVING EXTERNAL RADIOTHERAPY ACCORDING TO KOLCABA'S COMFORT THEORY: A CASE-REPORT

Abstract

Background: Comfort is one of the fundamental needs of head and neck cancer patients. Aim: To plan the homecare of a patient with laryngeal cancer, receiving external radiotherapy, according to Kolcaba's Comfort Theory. Method: In this case-report, a 64-year-old male patient newly diagnosed with stage 1-2 laryngeal cancer and receiving external radiotherapy was assessed. The data were collected via face-to-face interviews and observation methods through home visits. The first home visit was performed on the 23rd day of radiotherapy. Four more home visits were applied subsequently following the initial visit. The comfort requirement was examined within the framework of the four dimensions of the model. Nursing diagnoses in the planned homecare were determined via using the NANDA-I classification system. Verbal and written consents were obtained from the patient. Results: Acute pain, impaired swallowing, imbalanced nutrition, impaired skin integrity, disturbed sleep pattern, fatigue, and risk for impaired oral mucous membrane integrity to increase the physical comfort; hopelessness, impaired religiosity, and readiness for enhanced family processes for psycho-spiritual comfort; impaired verbal communication for sociocultural comfort, and readiness for enhanced comfort and risk for infection for the environmental comfort of the patient were addressed in the homecare. Conclusion: Comfort Theory-based nursing care given in the home setting was found as effective to be enhanced the comfort level of the patient. Interventions based on Comfort Theory within the framework of home care nursing roles and functions will positively affect the well-being and functionality of patients with early-stage head and neck cancer.

Keywords

• nursing care
• nursing theory
• outpatient
• case report
• radiotherapy

EKSTERNAL RADYOTERAPİ ALAN LARİNKS KANSERLİ HASTANIN KOLCABA’NIN KONFOR KURAMI’NA GÖRE EVDE BAKIMININ PLANLANMASI: OLGU SUNUMU

Öz

Giriş: Konfor, baş-boyun kanserli hastaların öncelikli ihtiyaçlarından biridir. Amaç: Bu olguda, eksternal radyoterapi alan larinks kanserli hastanın Kolcaba’nın Konfor Kuramı’na göre evde bakımının planlanması amaçlanmıştır. Yöntem: Çalışmada evre 1-2 larinks kanseri tanısı nedeniyle eksternal radyoterapi alan 64 yaşındaki erkek hasta ele alınmıştır. Veriler ev ziyaretleri aracılığıyla yüz yüze görüşme ve gözlem yöntemleri ile toplanmıştır. Hastaya ilk ev ziyareti radyoterapinin 23. gününde yapılmıştır. Ev ziyaretleri, ilk ziyaretten sonra dört hafta daha sürdürülmüştür. Hastanın konfor gereksinimi, modelin dört boyutu çerçevesinde incelenmiştir. Planlanan evde bakımda yer alan hemşirelik tanıları NANDA-I sınıflandırma sistemi kullanılarak belirlenmiştir. Hastadan sözlü ve yazılı onamları alınmıştır. Bulgular: Hastanın ev ortamında fiziksel konforunun arttırılmasına yönelik akut ağrı, yutmada bozulma, beslenmede dengesizlik, deri bütünlüğünde bozulma, uyku örüntüsünde bozulma, yorgunluk ve oral mukoz membranda bozulma riski; psiko-spritüal konforunun arttırılmasına yönelik ümitsizlik, dinsel kurallara uymada bozulma ve aile içi süreçlerde güçlendirilmeye hazır oluş; sosyokültürel konfor düzeyinin arttırılmasına yönelik sözel iletişimde bozulma ve çevresel konforunun sağlanmasına yönelik konforda güçlendirilmeye hazır oluş ve enfeksiyon riski tanıları ele alınmıştır. Sonuç: Konfor Kuramı çerçevesinde ev ortamında verilen hemşirelik bakımının, hastanın konfor düzeyinin arttırılmasında etkili olduğu belirlenmiştir. Evde bakım hemşireliği rol ve fonksiyonları çerçevesinde Konfor Kuramı’na temellendirilerek yapılacak girişimlerin, erken evre baş-boyun kanserli hastaların iyilik halini ve fonksiyonelliğini olumlu etkileyeceği düşünülmektedir.

Anahtar Kelimeler

• hemşirelik bakımı
• hemşirelik teorisi
• ayaktan hasta
• olgu sunumu
• radyoterapi

Kaynakça

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