[[alternative]]The Experience of Receiving Cryoablation in Elderly Patients with Prostate Cancer

[[abstract]]本研究目的在探討老年攝護腺癌患者接受冷凍治療的經驗與感受。採立意取樣，自2012年3月至9月於台灣北部某醫學中心為收案場所，以半結構式訪談指引，紀錄十二位初診斷罹患攝護腺癌，接受冷凍治療六個月內，年齡介於67-80歲長者的訪談，以內容分析法進行資料分析。結果顯示老年攝護腺癌患者接受冷凍治療的經驗可歸納出五個主題:非預期罹癌但選擇面對、治療方式的抉擇、歷經隱私部位的改變與不適、抗癌過程的隱憂與重生、人際關係的重整。說明老年攝護腺癌患者，初次面對診斷到接受治療的動態過程經驗。受訪者在沒有心理準備下得知罹患攝護腺癌之後，雖然經歷內心衝擊與不安，最後還是選擇面對治療。之後患者主動搜尋治療訊息，在考量治療效果、副作用、對家人的影響，與經濟無虞等狀況下選擇冷凍治療。患者原本帶著樂觀期待的心情，但接受治療後卻出現了腫脹的陰囊、尿管帶回家、尿管拔除後解尿不順，及陰莖完全無法勃起等身體功能的改變，使得未預期失去身體控制的他們陷入不知所措的狀態，開始擔心這些改變會不會持續到未來的生活。當身體逐漸恢復後，患者開始擔心癌症復發，變得非常在意PSA指數的變化。在這一個治療過程中，患者經歷種種改變，在心境與生活上做了重整，開始重視親友間的關係與支持，以及改變生活的模式。 本研究結果有助於臨床護理人員了解老年攝護腺癌患者接受冷凍治療的經驗，提供適切護理與發展攝護腺癌冷凍治療照護指引之參考。關鍵字: 攝護腺癌老年病患、攝護腺癌冷凍治療、經驗[[abstract]]The purpose of this study was to explore the experience of the elderly prostate cancer patients receiving cryoablation. Purposively sampled at a medical center in northern Taiwan from March to September in 2012.Twelve patients newly diagnosed with prostate cancer, aged 67-80 year old and receiving cryoablation within six months, were guided under a semi-structured interview.The data was analyzed by the content analysis method. The results showed that the experience of elderly patients with prostate cancer receiving cryoablation can be summarized into five themes: unexpected cancer but chose to face the facts, the choice of treatment, undergoing the change of private parts and discomfort, fight against cancer accompanied with worries and life reforming , readjustment of the interpersonal relationship. The study showed the experience of the dynamic process, from initial diagnosis to treatment, of elderly patients with prostate cancer who were not psychologically prepare to face prostate cancer. Although experiencing mental shock and anxiety, they finally chose to face the cancer diagnosis and the treatment. Thereafter, these patients actively searched information of treatment. Taking into account of the therapeutic effect, side effects, the impact on the family and financial condition, they chose cryoablation. After treatment, these patients originally with optimistic expectations soon become being at their wit’s end due to loss of body control such as swelling scrotum, the catheter to take home, voiding difficulty after removal of the catheter, failing to erect penis and other body functions etc. They began to worry that these changes will continue into the future life. But when the body gradually restored, they began to worry about cancer recurrence, become very concerned about the fluctuation of PSA index. During the process of treatment, these patients experienced all these changes and then made adjustment on mind and life. They started to pay attention to the relationship and the support of friends and relatives.The results of this study can help nurses to understand the experience of elderly patients with prostate cancer receiving the cryoablation. It also can be made as reference to provide appropriate care and develop the prostate cancer cryoablation care guidelines.Keywords: elderly patients、cryoablation with prostate cancer、experienc