運用Mishel不確定感理論於一位初次罹患乳癌婦女之護理經驗

This article described the application of Mishel's theory of uncertainty in illness to a middle-aged woman with newly diagnosed breast cancer, particularly from a nursing care prospective in the circumstance of the patient on the verge of facing a series of cancer treatments. The nursing care was from May 23 to May 27, 2016. After diagnosis of breast cancer confirmed, the patient developed high levels of uncertainty towards not only the physical impacts of chemotherapy, but also possible disease progression and further prognosis. As a result, the uncertainty indirectly influenced her motivation to learn for self-care. Nursing assessment was made based on Mishel's theory of uncertainty in illness. The author found that the patient had strong uncertainty towards disease and treatment, and the causes of uncertainty were identified including anxiety, knowledge deficit, and body image changes. We provided several principles of evidence-based nursing care: Enhancing the patient's understanding of disease or treatment and emphasizing health-care awareness; Establishing good communication between the patient and multidisciplinary teams; Facilitating sharing and positive feedback of disease treatment experience among different patients, and building up family and social support system. These interventions improved patient's self-care ability and self-confidence in disease treatment, reduced patient's perceived uncertainty towards disease treatment, and encouraged patient's positive thinking and actively facing the disease prognosis.