一位年輕產婦於哺乳期間行子宮根除併卵巢移位術之護理經驗

The Nursing Care Experience of a Breast-feeding Young Woman Receiving Radical Hysterectomy and Ovarian Transposition

楊淑文(Shu-Wen Yang)

《長庚護理》 29卷3期 (2018/09) Pp. 478-490

https://doi.org/10.6386/CGN.201809_29(3).0013

摘要

本文描述一位年輕婦女在產後哺乳期間被診斷出子宮頸癌，並接受子宮根除併卵巢移位術之護理經驗。照護期間為2016年1月27日至2月5日，筆者藉由術前訪視、觀察傾聽、查閱病歷、術後訪視8次、電話訪談等方式來收集資料，運用Gordon11項功能性健康型態為評估架構，確立個案主要的健康問題有焦慮、急性疼痛、身體心像紊亂等。照護過程中透過建立完善雙向互動治療性關係，擬定個別及連續性護理措施，於術前陪同個案進行麻醉諮詢，釐清哺乳相關疑問，運用手術情境模擬與適切性衛教，降低個案術前焦慮；術後提供減緩疼痛方法以增加舒適感，並提供哺乳用藥相關文獻提昇認知，使其能安心哺乳、重拾母性自信及維持良好親子依附發展；鼓勵先生及家人支持並參與護理計畫，轉介正向病友分享自我調適經驗，引導正面感受其身體心像改變，得以重新接納自我，使個案住院期間身心問題皆能獲得改善。

關鍵字

子宮頸癌 ； 母乳哺餵 ； 子宮根除 ； 卵巢移位

並列摘要

This article described the nursing care experience of a young breast-feeding woman diagnosed with cervical cancer after childbirth and received radical hysterectomy and ovarian transposition procedure. The nursing care period was from January 27th to February 5th, 2016. The data were collected from eight pre- and postoperative interviews, observation and listening, chart review, and telephone interview after discharge. Utilizing the Gordon 11 Function Health Patterns assessment tool, the main problems of the patient were recognized as anxiety, acute pain, and body image disturbance. Through establishing mutual therapeutic alliance, devise personal and continuous nursing plan, accompany during anesthesia consultation, clarifying the doubt about breast feeding with appropriate education, and simulation of operation scenario, the preoperative anxiety level was effectively reduced. Postoperative analgesia and relevant references about drugs in lactation were provided to decrease discomfort, reassuring safety in breast-feeding and maintaining the attachment between mother and child. Through encouraging the husband and family to participate in the nursing plan and introducing other patients with similar disease to share the experience, the patient were able to adapt the change of body image positively and accept herself and improve physically and mentally during hospitalization.

並列關鍵字

cervical cancer ； breastfeeding ； radical hysterectomy ； ovarian transposition

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