乳房切除後接受乳房重建手術患者的經驗歷程

本研究以現象學研究法探討乳房切除後接受乳房重建手術患者的經驗歷程，採質性研究中的現象學研究法，自民國102年3月至103年3月，以立意取樣方式在高雄某醫學中心收集15位乳房切除後接受乳房重建手術的病人，以一對一的方式進行深度訪談及錄音，研究者將所有訪談錄音的內容逐字轉寫成行為過程紀錄，並將記錄，以 Colaizzi（1978）做為資料方析的方法，直到沒有新的主題發現才停止收案，經歸納整理出乳房切除後接受乳房重建手術病人的經驗歷程。研究結果顯示乳房切除後接受乳房重建手術病人的經驗歷程共有：「回顧罹癌當下的情景」、「手術過程的歷程感受」、「無法預期術後身體的轉變」、「乳房重建後之因應」等四個主題。透過本研究探討乳房切除後接受乳房重建手術病人的親身經歷，能有深刻的體會與了解，期望能提供相同病人適切護理照顧的參考，以降低病人在生病過程中的焦慮、不安、害怕，而給予病人實質的幫助；也期能協助醫護人員在面對此疾病病人時，能了解病人的內心真正感受，促進彼此互動關係，進而同理病人，提供適切的關懷護理照護，以提升照護品質。關鍵詞：乳癌、乳房切除術、乳房重建術、經驗歷程、現象學

關鍵字

乳癌；乳房切除術；乳房重建術；經驗歷程；現象學

並列摘要

Abstract This study is aimed to investigate the experience of patients who accept immediate breast reconstruction surgery after mastectomy, By phenomenological qualitative research method. The research commenced at march, 2013 and ended at march, 2014. This studies the purposive sampling of the 15 received immediate breast reconstruction surgeries after mastectomy in Chung-Ho Memorial Hospital, Kaohsiung Medical University. The in-depth interview was used for collecting data by process recording. The interviews were first transcribed into processed records, and then employed the Colaizzi (1978) method to analyze the data. The result of the lived experiences of immediate breast reconstruction surgery after mastectomy patients that were collected was then inducted and systematically sorted, which was manifested in four themes：「Recall the time when she was diagnosed with cancer 」, 「feeling about the course of the surgical procedure」, 「Unexpected changes on the body after surgery」, 「The reaction about breast reconstruction surgery 」. Through this result, the researchers are able to observe the experiences and the process of the immediate breast reconstruction surgery after mastectomy. Therefore, they can have a profound experience and understanding as a reference, which they expect to be able to provide better treatment for patients in the same situations and hope to reduce the patients’ anxiety and fear. This study is also able to assist the health care workers when they are facing patients with these kinds of situations. It helps them understand the true feelings of the patients and it also helps them to see from the patients’ perspective. Hence, they are then able to provide a more appropriate and better quality nursing care. Key word：breast cancer, mastectomy, breast reconstruction, experience history, phenomenology