協助一位乳房膿瘍初產婦再度泌乳之護理經驗

Nursing Experience of Assisting a Primipara with Breast Abscess Re-breastfeeding

林欣燕(Shin-Yan Lin) ； 王紋玉(Wen-Yu Wang) ； 顧雅利(Ya-Lie Ku) ； 傅家芸(Chia-Yun Fu)

《高雄護理雜誌》 36卷2期 (2019/08) Pp. 49-60

https://doi.org/10.6692/KJN.201908_36(2).0005

摘要

乳房膿瘍是泌乳期急性炎症反應，傳統治療方式需以手術切開引流清除膿瘍，常因此而中斷哺乳。本文是照護一位乳房膿瘍初產婦哺乳中斷後再度泌乳的護理經驗。護理期間為2016年3月21日至5月31日，藉由觀察、身體評估、會談等方式進行主客觀資料收集，運用羅氏適應模式進行評估，確立個案有急性疼痛、焦慮、個人因應能力失調等健康問題。筆者經由門診諮詢瞭解個案面臨乳房膿瘍清除後，不知是否能持續哺乳而感到不安，並掙扎是否接受治療，故引發筆者想照護此個案的動機。藉由傾聽及引導個案表達情緒並關懷其需求，提供乳房膿瘍處置相關知識，使其正向面對因治療所造成的哺乳中斷，適時地解決個案乳房膿瘍的問題，協助其重新建立泌乳計劃，進而達到持續哺乳之目標。建議醫療院所可針對哺乳困難的婦女，建立更完善的母乳哺餵支持系統，將有助於乳房出現問題的婦女成功且持續地哺餵母乳。

關鍵字

乳房 ； 膿瘍 ； 初產婦 ； 護理

並列摘要

Breast abscess is an acute inflammatory reaction during lactation. Traditional treatment requires surgical incision and drainage to clear the abscess, which often interrupts breastfeeding. This article is the nursing experience to care for a primipara with breast abscess from interruption to re-breastfeeding. The author collected the subjective and objective data by means of observation, physical assessment, and interviews during the nursing period from March 21to May 31, 2016. Acute pain, anxiety, and ineffective personal coping health problems were assessed and identified by applying the Roy adaptation model. The author understood that the patient felt uneasy for not knowing whether it was more comfortable to continue the breastfeeding and struggle to receive treatment after removing the breast abscess, which triggered the author's motivation to care for the case through outpatient consultation. The intervention assisted the patient to positively face the interruption of breastfeeding due to treatment, by timely solving the problem of breast abscess and assisting her to re-establish the lactation program to enhance the confidence of childbearing by listening to the inner feelings of the case, guiding her to express emotions and caring for her needs, by further providing knowledge for treatment of breast abscesses to achieve the goal of continuous breastfeeding. It is recommended that medical institutions establish better breastfeeding support systems for women who are suffering from breastfeeding side effects and assist women with such breast problems to breastfeed successfully and continuously.

並列關鍵字

Breast ； Abscess ； Primipara ； Nursing

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