協助一位口腔癌病患面對癌病復發之護理經驗

本文探討一位口腔癌面對癌病復發需要再次手術之患者，除手術後顏面外觀的改變，個案對於治療過程漫長，但疾病仍再次復發，因而產生無望感，故引發筆者探討的動機。本文針對口腔癌病患面對癌病復發之護理經驗提出探討，照護期間為2017年2月17日至2017年3月15日，運用Gordon十ㄧ項功能性健康型態進行評估，透過直接照護、觀察、身體評估、會談及查閱病歷等方式收集主、客觀資料，確立個案健康問題有：疼痛、無望感、身體心像改變。在護理過程中，針對護理問題運用專業知識與技能，提供適當個別性護理措施，如：針對個案口腔癌復發無望感而產生的負面情緒，藉由積極陪伴與個案建立信任的護病關係，協助個案正視疾病接受治療並引導其正向面對口腔癌復發的事實，表達內心感受肯定自我價值重獲信心，希望藉此照護經驗分享，提供護理同仁在面對癌病復發個案照護上參考，提升護理品質。

關鍵字

口腔癌復發；疼痛；無望感

並列摘要

This article describes a recurrence oral cancer patient who felt hopeless for his cancer return that needed to undergo a surgery again after completing a long treatment process and facial reconstruction. This paper describes the nursing experience of caring for recurrence of an oral cancer patient from 17th Feb. to 15th Mar., 2017. The author collected subjective and objective data from using Gordon 11 function health patterns to assess the patient through direct caring, observations, listening, and medical record during the period of care. The author found that the patient had some nursing problems, such as pain, hopelessness, changes of body image. In addition to strengthening personalized nursing care through professional knowledge and skills, such as when facing patient's negative emotions from the recurrence of hopelessness, the author stayed close and built trusting relationship with the patient, and guided the patient to express the feelings to face the cancer relapse positively. This nursing experience was presented to serve as a reference for medical professionals who might encounter similar circumstances.