本篇個案報告是探討一位口腔癌患者經顏面重建手術後的護理經驗,照護期間自2016年4月18日至4月25日止,使用觀察、會談、病歷查閱與直接評估方式收集資料,並運用Gordon十一項功能性健康型態評估,確定個案問題為口腔黏膜改變、急性疼痛、呼吸道清除功能失效。筆者在照護個案期間,運用同理心並建立彼此信任關係,針對個案的問題,提供口腔護理照護、減輕氣切套管留置和術後頸部傷口疼痛、使用胸腔物理治療,以利呼吸道分泌物排除,提供充份衛教、詳盡的解釋,減少其術後的不安,經護理措施介入後,個案不適情形能獲得改善。期望藉由本文護理經驗過程之分享,以提升口腔癌患者經顏面重建手術後病患之護理照護品質及更適切的護理。
This case report was to explore the care of a patient with oral cancer after facial reconstruction surgery care experience during the period from April 18 to April 25, 2016. The data was collected based on Gordon 11 functional health assessment by observation, interview, medical records checking and direct examination. The health problems determined for the case were oral mucosa changes, acute pain, and ineffective respiratory clearance function. During the period of care, the author was empathetic and established a mutual relationship of trust. Based on the caring problems, providing oral care, decreasing the pain of replacement of the tracheal tube, reducing the postoperative pain of the neck, and using chest physical therapy all helped the patient to remove mucus from the airway. Also, providing complete education reduced postoperative insecurity. After the nursing interventions were applied to the case, the discomfort of the patient was ameliorated. Hopefully, through sharing this nursing experience will help to advance the quality of nursing care for oral cancer patients after facial reconstruction surgery.